
Due to many different ethical implications, physician-assisted suicide carries much controversy in our society today. The idea of "suicide" in any form is something widely considered taboo in society. Suicide having a negative connotation has lead people to associate the same negative connotation with physician-assisted suicide. An ethical implication to consider is the position that physician-assisted suicide puts doctors in. Aiding a patient in his or her own death would violate the physician's Hippocratic oath. Lastly, people are concerned that if physician-assisted suicide were legalized people would become more desensitized to it. This could result in it progressing to vulnerable communities like the disabled. With correct government regulation, legalizing physician-assisted suicide would create a viable option for terminally ill patients to die with dignity and by their choosing.

Physician-Assisted Suicide is often confused with euthanasia, but there is a difference between the two. Physician-Assisted Suicide is when the physician provides the patient with the means and/or the knowledge to commit suicide. Euthanasia is when a physician administers the means of death, usually a lethal drug. Currently, physician-assisted suicide is legal in the Netherlands, Luxembourg, Colombia, Belgium, and Switzerland ("Assisted Suicide Laws Around the World"). In the United States there are assisted dying laws restricted to terminally ill and mentally competent adults in Oregon, Montana, Washington, Vermont, and California ("Death with Dignity Around the U.S."). Some of these have Death with Dignity laws. Death with Dignity allows mentally competent, terminally ill state residents to voluntarily request and receive a prescription medication to hasten their death ("Death with Dignity Around the U.S."). However, the resident must have a terminal illness and prognosis of six months or less to live. 

Early last year, the case of Brittany Maynard brought physician assisted suicide back into the limelight. Brittany was a 29-year-old woman from California who was diagnosed with terminal brain cancer (NBC News). In January of 2014, she was diagnosed with grade two-brain cancer (Maynard). By April, it had advanced to a grade four and Brittany was given a prognosis of six months to live (Maynard). After her diagnosis, she decided that she wanted to end her life on her own terms, which was illegal in California. Brittany took to social media advocating for the "Right to Die." She was featured on CNN, People, and other major news outlets (Maynard). Brittany moved from California to Oregon, leaving behind her friends, family, and entire life in order to take advantage of Oregon's Death with Dignity Law (NBC News). In November of 2014, Brittany ended her life peacefully by ingesting a lethal pill prescribed by her doctor (NBC News). She was surrounded by her family and loved ones. The day of her death had been chosen and planned out months in advance. Brittany refused to define her choice as suicide; she used mellow, sanitized language to detract from the fact that she was killing herself (Maynard). She did not believe it was suicide because she was not suicidal and did not want to die (Maynard). According to Brittany, because there was no cure and her death was inevitable she chose to die with dignity. Brittany sparked a wave of discussion and debate nationwide about the ethics of physician-assisted suicide as well as euthanasia. Less than a year later, an End of Life Option Act was passed in California; Brittany's death played a major role in the passing of this bill (Egan).

One issue surrounding physician-assisted suicide is the terminology and diction used when discussing it. Advocacy groups believe the word suicide is too harsh and does not accurately reflect the patient's choice. They believe this is different from suicide because death is already inevitable for the patient. The patient is just choosing to speed up the process. These advocacy groups want "physician-assisted suicide" to be replaced with kinder alternatives like "aid-in dying," "dying with dignity," "right to die," and "compassionate dying"(Federman). According to a survey done by Pew Research Center, the public is split with 47% approving of physician-assisted suicide and 49% disapproving (Liu). When asked whether they supported the right to end the patient's life by some painless means, 70% were in favor (Liu). Finally, only 51% were in favor when physician-assisted suicide was described as doctors helping a patient commit suicide (Liu). This survey is a perfect example of why word choice is so important when discussing an issue like this. When the words used are less harsh, more people are in support. When surveyors are bluntly honest about the reality of the situation, fewer people are in favor. This brings up an important question about how one should describe physician-assisted suicide and whether one should even use the term physician-assisted suicide.

There are many different reasons to advocate for the legalization of physician-assisted suicide. Through physician-assisted suicide, a patient's unbearable pain and suffering will end. They will die knowing it was their choice, as opposed to the alternative where their end-date is decided for them. Because they are able to make this choice, they will be able to die with dignity. They will die with their mind still fully intact and able to make rational decisions. Brittany Maynard is a perfect example proving this point; she spoke of her decision saying, "It has given me peace. I do not want to die, but I am dying, and I want to die on my own terms" (Maynard). It was extremely important to Brittany that she died with dignity and on her own terms (NBC News). Physician-assisted suicide would also reduce health care costs. With physician-assisted suicide, doctors and nurses would be able to focus their efforts on patients who have a chance at living. It could also reduce the pain and suffering of the patient's family. Their family will feel better about this decision knowing they died in peace. After the patient has passed away, the vital organs can be saved and used to help save other patients' lives. By making physician-assisted suicide illegal, people may attempt to or commit suicide in messy, horrifying, or traumatic ways. Restricting people from committing physician-assisted suicide is a violation of their personal liberties. As humans, people should have the right to choose the time of their death; they should be allowed to choose to not live with unbearable pain. A study published by The Journal of the American Medical Association showed that requests for physician-assisted suicide are not uncommon (Back et al.). Even though physician-assisted suicide is not legal in Washington State, where the study was conducted, physicians admitted to assisting their patients, most often when they displayed physical symptoms (Back et al.). 38 out of the 156 patients that requested physician-assisted suicide received prescriptions and 21 died resulting from that prescription (Back et al.).  John West, the son of two physicians, assisted both of his parents in their suicide (CNN). West admitted that physician-assisted suicide is a lot more common than the public knows. He said, "a lot of doctors have their own stashes and a lot of doctors help their patients; it happens all the time" (CNN). Even though physician-assisted suicide is illegal, it is happening anyways. By legalizing physician-assisted suicide, the government could put regulations to make sure it was done the proper, safe, and humane way.

With legalization, there would need to be restrictions. Physician-assisted suicide should be limited strictly to terminally ill patients with six to eight months or less to live. Physician-assisted suicide should be restricted to the terminally ill because, while many other people are also in pain, only the terminally ill are about to die. They already have a prognosis of a short time left to live. They should be allowed to decide when. Doctors should not be required to assist patients in this act because some doctors are simply not comfortable with it. They are uncomfortable with the practice for various reasons such as it violating their religion or their Hippocratic oath. Physician-assisted suicide should be legalized nationwide because it is a basic right. If it were left up to each state, people in certain states would be denied one of their basic liberties. If physician-assisted suicide were to be legalized nationwide, the law should be modeled after Oregon's Death with Dignity Law. They place appropriate restrictions on the law. Physicians are allowed to prescribe the lethal medication, but the patient must "pull the trigger." The medication has to be self-administered because this makes sure the patient actually wants to end their life. It is much easier to do something when someone else does it. If the patients have to administer the medication themselves, then it makes it harder. It also takes away the aspect of malpractice or wrongdoing. If the doctor administers the drug, they are opened up to increased scrutiny. Family members could accuse them of murder saying the patient did not want to die. Doctors could easily take advantage of this too; mercy killing could become far too common. It would be like treating humans as animals. Instead of the vet putting down a dog, the doctor would be putting down their patient. With self-administration, this is not a problem. In order to even be eligible, a patient has to be diagnosed by an attending physician, as well as a consulting physician. They have to be diagnosed as terminally ill and given six months or less to live. The patient has to be 18 years or older, a resident of the state, and capable of making rational decisions regarding their health care. The patient must be 18 years or older because children are not mature enough to make a decision this serious. If the decision were given to the parent of the child, no parent would choose to end his or her child's life early. The parents would want to maximize the time they had with their child. The attending physician gets to decide whether the patient is eligible or not. The patients must orally request the medication at least twice; they must also submit one written request. The physician is required to educate the patients on alternatives such as palliative care, hospice, and pain management. Finally, the physician has to request, but not require, the patient let the next of kin know of their decision. With proper restrictions, such as those in Oregon, physician-assisted suicide could be beneficial to the entire country. It would give citizens the personal liberties they deserve. These restrictions would dismiss a person's reservations regarding the ethical implications of physician-assisted suicide. The government should not be able to restrict one's own life and death; that is something that should be decided individually because it is a basic human right. 

Many opponents of physician-assisted suicide believe that legalizing it would endanger the weak, corrupt medicine, compromise the family, and violate human dignity and equality (Anderson). They bring into account the Hippocratic oath that states, "I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect." This statement should more or less apply to the mentally ill, not the physically ill. The Hippocratic oath is one of the oldest binding documents in history; it dates back to the Fifth Century BCE. While some of the ideas in this oath are probably still relevant, many others are outdated. Society has changed so much since then. It is illogical to think that every principle followed back then should still be applied to society. For example, the Bible is another older document that people try to abide by. There are many outdated ideas in the Bible that people no longer follow and nobody seems to have an issue with it. According to the Bible, people should not eat shellfish, have tattoos, or mix linen and woolen garments. These are all normal things that people do in today's society. The same thing would be the case with the legalization of physician-assisted suicide. Secondly, physician-assisted suicide does not endanger the weak and marginalized because proper restrictions have been set forth to avoid this. It is limited strictly to the terminally ill who are going to die regardless of the when and why. Opponents fear that physician-assisted suicide corrupts the medical profession and distorts the doctor-patient relationship because patients can no longer trust their doctor (Anderson). The goal of a doctor is similar to someone in retail; they must keep the customer or patient happy. A doctor cannot do anything to a patient that the patient does not want done. This brings up two different cases: disconnecting and nonconnecting (Thomson 498). Disconnecting cases refer to a patient's decision to discontinue life-saving treatments in progress (Thomson 498). Nonconnecting cases occur when a patient refuses life-saving treatment from the beginning (Thomson 498). Nonconnecting is often viewed as "letting nature take its course" (Thomson 501). There is a gray area with disconnecting. People view disconnecting as "not merely letting nature take its course but rather causing it to" (Thomson 501). In nonconnecting cases, where the patient has a disease and refuses treatment because he or she wants to die, there is nothing a doctor can do. So what is the difference between this and physician-assisted suicide? Either way death is inevitable. Patients will still be able to trust their doctors because physician-assisted suicide is a personal choice. It is not forced on anyone. Doctors will still have the patient's best interest at heart. Another argument of the opposition is that physician-assisted suicide violates human dignity and denies equality before the law (Anderson). Legalizing physician-assisted suicide would lead to some people being valued more by the law; however, this is not the case. Society approves of killing in many other circumstances such as war, self-defense, and capital punishment and yet society still values human life. The right to suicide can be justified by the constitution's vow to uphold personal autonomy; also, physician-assisted suicide does not cause bodily harm to anyone except the patient (Neeley). Under the law, everyone is still equal. No one is classified as worthless or valuable. The terminally ill still have just as much to contribute to society as someone who is perfectly healthy. A terminally ill patient could still write a Pulitzer Prize winning book or cure cancer if they wanted to. If they want to end their life early though, they should be granted that. 

Some opponents argue that physician aid in dying should wait until the United States can guarantee adequate access to health care to all of its citizens (Jones). Waiting around on the United States' health care system is pointless because it could be years and years until there is any real change. It is believed that terminally ill patients without health insurance may end up choosing or be pressured to choose physician-assisted suicide for financial reasons (Jones). Even with health care changes, such as ObamaCare, medical costs continue to rise; patients still must take finances into account. These opponents make a fair and valid point, but the reasoning behind a patient's decision does not and should not matter. They can make their decision based off of any reason they want; what matters is that they have the freedom to make this decision when they are terminally ill.

