
Picture your life in your late 80's. Imagine that your heart is failing and you are in the midst of extreme suffering due to terminal cancer. Your doctor tells you that you have at most six months to live but you cannot endure the pain any longer as you, quite literally, wait to die. Now imagine that there was a way out, a way to end the pain and suffering. In a few countries and states there is this option. This option is called physician assisted suicide. Physician assisted suicide (PAS) means to, at the request of a patient who is suffering and expected to die, have a physician provide a lethal drug able to mercifully end the life of that patient. To some this option may sound completely absurd or even facetious. However, it is actually a viable alternative to ending your days in pain and misery. America is based on freedom, where each human being has the inalienable rights of life, liberty and the pursuit of happiness. If citizens have the right to life why shouldn't they be given the right to end it, especially if it is in their best interest, their pursuit of happiness? It has also been widely used throughout history, even dating back to ancient times, where it was seen as a "good death" (Lachman). By looking at the reputable history of assisted suicide, acknowledging one's inalienable rights given by the constitution amidst an evolving American culture, and the fact that it could relieve a great deal of suffering for patients and their families, it is clear that physician assisted suicide should be legal throughout the entire United States. PAS reinforces patients' freedom, giving them a chance to die painlessly while preserving their dignity, and escape their pain.

Due to constitutional rights, the United States federal government is currently not allowed to pass a law legalizing assisted suicide. This was determined by the two Supreme Court cases, Washington v. Glucksberg, and Vacco v. Quill where it was decided that "the government's interest in preserving life and preventing intentional killing outweighed the patient's interest in the liberty to choose to die" (FindLaws). Although the federal government cannot legalize PAS, it is not restricted from state law. As of now, five out of fifty states in the U.S. have passed laws legalizing PAS. These states include Oregon, California, Montana, Washington, and Vermont. Under these laws a patient who wishes to request PAS must be at least 18 years old, have six or less months to live, and have given two oral requests (at least 15 days apart), and one written request (State-by-State Guide to Physician-Assisted Suicide, 2015). Patients who decide upon PAS must administer the drug themselves to avoid the possibility of someone convicting a doctor of murder. Two major sides to this issue have developed: a secular side and religious side. A scholar said, "Americans divide fairly sharply on this issue. It depends on their value system. If their values are primarily based on what they believe and the personal choices that they want to make, personal control over things, a secular value system versus people who make their decisions based on religious choices, that God alone decides the day of your death" (Grossman). The secular side is generally more for PAS while the religious side is more against it. Acquiring a historical perspective on PAS provides an explanation of why PAS is not already legal nationwide across the United States, while also hinting at the reasons why it should be legalized.

 Assisted suicide dates back to ancient times. It was particularly common and widely accepted in Ancient Greece and Ancient Rome. For example, "In ancient Greece it was accepted, even common, for old or sick people to voluntarily end their own lives ... In ancient Rome, voluntary suicide was also sanctioned by society. It was practiced routinely by the elderly and by people with terminal or painful diseases" (Fontana 147). Assisting people with their own deaths used to be the norm. It was seen as the practical choice a person should make. So why did this practice seem to become widely unaccepted in the succeeding years? The answer to this question is Christianity, for "With the rise of Christianity, these practices were prohibited. Saint Augustine and later Saint Thomas Aquinas held strong beliefs that suicide for any reason was wrong, and although it continued to be common in the Middle Ages, to Christians it remained a terrible sin" (Fontana 147). Christians hold a strong belief that any form of murder or suicide is a "terrible sin". Christianity became the accepted religion in Europe, halting, for the most part, the acceptance of assisted suicide. America was later founded by Europeans which is why Christianity is the nation's major religion, explaining why assisted suicide has been outlawed in the country up until recent years. It can be concluded that a major reason assisted suicide has yet to be accepted throughout the United States is because Christianity has been such an important aspect of American culture and history. However, just because the dominant religion in our country is against PAS does not mean citizens should not have the option to make their own decision when it comes to whether they pass away or suffer. 

The United States was founded on the principle of freedom where each citizen is guaranteed certain inalienable rights. These rights include the right to life, liberty and the pursuit of happiness. Based on these rights it would make sense to allow a person to choose their fate. If a person wants to die there should be circumstances in which it is permitted. If they have the right to life they should also have the right to death. If what makes them happy is to die and be relieved of pain, then they should be allowed to choose that option. Although the constitution does not provide the right to physician assisted suicide, "the Supreme Court established that the due process clause protects a patient's liberty to refuse medical treatment, even if that refusal would ultimately lead to the patient's death" (FindLaw). If a patient refuses treatment causing them to die, aren't they seemingly instituting a method of prolonged suicide? It would make more sense to have a physician assist the patient in dying mercifully rather than making him or her draw out their death. If the patient's death is inevitable it is sensible for a physician to help ease the process. Another reason the federal government is unwilling to pass such a law is because of the nation's history and tradition. In the court case Washington v. Glucksberg, the court conducted a historical analysis where it found that "the right had no place in the country's tradition or history, given the fact that assisted suicide had been consistently rejected in the past and was banned in a large number of states" (Waimberg). The reason physician assisted suicide is not part of our history or tradition is largely due to the Christian beliefs our country was founded upon. History and tradition is not a valid argument over the time American society has evolved, and simply because we have or haven't done something in the past does not mean it is in the peoples' best interest. The evolution of American society is evident with the advances in medical technology that allow people today to live much longer than they used to (Andre and Velasquez). When America was founded over 200 years ago, if a person became ill with a terrible disease, they would likely die due to a lack of advanced medical treatment. Now there is technology designed to keep people alive who are suffering from diseases once deemed deadly. There is now question of whether or not one should be kept alive just because there is technology with the ability to sustain a life. After analyzing the United States constitution and the changes in American society it is clear that PAS adheres to the rights of the people stated in the constitution, and that the longstanding policies surrounding this practice should be reevaluated to keep up with our ever evolving nation.

The final, and most important, reason assisted suicide should be legalized is because it will give patients a chance to be relieved of their pain, while also relieving the family's pain. It is hard for people who have never been a suffering patient or a patient's family or friend to understand PAS. But logically, it does not make sense to make a patient suffer until their inevitable death. It seems as though humans more humane to dogs then they are to fellow human beings. Dogs have feelings and are a significant part of many peoples' families, yet people often don't let them suffer as they let humans do. Watching a loved one suffer brings a family pain, so seeing the loved one relieved of their suffering will alleviate the family's pain. If a patient does choose to request and go through with PAS, an additional benefit is that it will decrease medical expenses. This is a minor argument in the grand scheme of things, as money shouldn't come before somebody's life. But, nonetheless, less medical expenses is still a definite plus to PAS. Families are already under enough stress and pain as it without the cost of medical expenses added to that stress.  PAS can be a win-win for a patient and the family.

Despite all of these reasons that support the legalization of physician assisted suicide, there is still an opposition. One of the major reasons people oppose the idea of assisted suicide is because they are afraid that it has the potential for abuse. For example, "Some worry that elderly and disabled patients may be pressured into choosing physician-assisted suicide, or that these patients may not be presented with the full range of available palliative (pain-relieving) care" (Annas). If assisted suicide becomes the norm, patients may feel pressure by family or society to request PAS. These worries can be quickly disputed by statistical evidence. In the states that have legalized PAS, there have been very few patients who have chosen to request it. "In 2013, 77 people in Oregon died by PAS, accounting for 0.21 percent of all deaths in the state. Similarly, in Washington in 2014 there were 170 deaths due to PAS, accounting for 0.33 percent of all deaths" (Carter). This statistic indicates that PAS is only used for extreme cases and is not at all abused. Another statistic makes that point that if all 50 states legalized PAS and PAS only accounted for 0.25 percent of all deaths in 2014 then there would have only been 6,942 physician assisted deaths (Carter). If these states don't abuse PAS then the country as a whole will not abuse it. This disproves the argument that PAS will be abused if it is legalized.

Another argument of the opposition is that the law will eventually become so out of control that it may expand to permit involuntary euthanasia (Annas). Involuntary euthanasia is the killing of a patient without the patient's explicit consent (Nordqvist). This will not happen for a couple of reasons. The first reason is that there will be strict laws in place that prevent doctors from gaining too much power and certain guidelines that the doctors must follow. Like any other law in the United States if these laws were broken there would be major consequences. Nobody wants PAS to get out of control and proper laws would ensure this. The second reason is that there is a code of Ethics for Nurses that requires nurses to discuss all options with a patient and to do as much in their power to treat and provide care for the patient (Trossman). Nurses know that they need to abide by this code to remain employed. Another major reason many oppose assisted suicide is seen from a more religious standpoint. Those of Catholic faith view suicide as "as a grave offense against love of self, one that also breaks the bonds of love and solidarity with family, friends, and God" (Haerens). They believe that life is sacred and that a community should do all that it can to protect it. In other words, suicide devalues human life. Another argument religious groups make is that patients who are suffering are often depressed, which may influence their decision to want to die prematurely. "The movement to legalize euthanasia does not enhance freedom or self-determination because many of those fighting to kill themselves are depressed and need" (Haerens). These opponents believe that the focus should be less on death, and more on providing the patients with as much palliative care as possible to help relieve them of their depression. All life is precious, but that doesn't mean that helping somebody end their life a little early destroys the value of it. The value of life has already been destroyed when a suffering patient is kept alive past the point at which they should be through use of medical technology. If a patient is truly suffering it does not necessarily mean that they are depressed. There comes a point when pain can become too intolerable, even to a patient with the most positive of mindsets. When a patient is consumed by intolerable pain, he or she should be allowed to make the decision whether or not they wish to keep living.

The legalization of assisted suicide comes with strict guidelines and the laws of states that have already passed PAS ideally model this idea. To reiterate, in the states of Oregon, California, Vermont, and Washington, residents have the option to request PAS if they are of the age 18 or older, have six or less months to live, and have given two oral requests (at least 15 days apart), and one written request (State-by-State Guide to Physician-Assisted Suicide, 2015). In order for the 45 remaining states to pass adequate laws regarding PAS, something must be done. People should speak out and tell their own stories of how they or loved ones have suffered in states where PAS is not already legal. Methods of advocacy include utilizing different forms of media such as books, magazine articles, television, blogs, and social media. By speaking out through use of media like this, the cause will gain supporters which will catalyze protests and the potential to gain notice by lawmakers. People should also write to their local and state congress, arguing for the legalization of PAS in their home states. If enough states decide to legalize it, the federal government may be swayed into legalizing PAS for all states. In states that have legalized PAS, increased effort should go towards training nurses in palliative care in order to decrease the amount of patient PAS requests.

Physician assisted suicide should be by no means the first option for a patient who is suffering. PAS should be an option only in times of desperation when there is no other choice. It has been in practice since ancient times, and was once respected before being condemned by religious followers and other adversaries. After reflecting on historical opinions of assisted suicide, acknowledging one's inalienable rights given by the constitution and the unceasing changes in American culture, and explaining the relief PAS could bring to the patient and his/her family, it is clear that, despite the opposition, physician assisted suicide should be legal throughout the entire United States. Although many people believe that any form of suicide destroys the purity of life, those critics must remember that even if assisted suicide becomes legal, it will not be a mandatory medical practice. If assisted suicide is against a patient's religion or ethical values, they will not be forced to pursue that option. It will instead be a choice they can either choose to make or not make. Having the choice to decide whether to die or keep on living when one is dying and suffering is a right that every free American should have.

