

Ever since Dr. Kevorkian or "Doctor Death" drove his car around the united states assisting over 40 patients to take the own lives physician aid in dying has been a topic which has sparked controversy (DiManno). Although his actions did receive large amounts of negative feed back it did lead much of the population to the question of whether or not it should be legal for an individual to have medical assistance to take their life in certain situations such as terminal illness or chronic physical pain. Through the years this idea has adopted the name physician aid in dying. Personally I believe that we should, because when it comes to our body we should have 100% control over what we choose to do with it. Even if that is choosing to take our own life in times of great physical pain and suffering. Although physician aid in dying is already legal in five states, I believe that it should be legal in the remainder of the states in the United States. While I know that the thought of a doctor prescribing a lethal dosage of a medication to help a patient to take their life can be disturbing to some people it should not be illegal. If that were the case eventually it could be illegal to get tattoos or have hair cuts that may be disturbing to some people. The way I see it is that if PAD is really what someone wants it should be an option to them no matter what state they live in. The thought of someone suffering from a terminal illness, but their only way to stop it, is illegal. That is what what I find truly disturbing. Through the use of first hand accounts as well as factual information, I will provide a clear understanding of physician aid in dying, exposing the ethical reasoning that support its use and statistical data collected in states where it is already legal, that will persuade you to see that physician aid in dying should be legal in every state in the united states, to ensure that our lives are truly in our hands. It is time for US citizens to realize that physician aid in dying is something that can affect us all and above all something that can affect the ones we love, so in the end there is nothing more important than fighting for its nation wide legalization.

Physician aid in dying has become a beckon of hope for the terminal ill patients in states where it is already legal, this hope comes from the realization that they no longer have to fear a slow and painful death caused by their illness. We can not let the fear of the unknown hinder the spread of this hope to every terminally ill patient in the United States no matter what state they live in. So far PAD has become legal in only five states, those of which are Montana, Oregon, Vermont, Washington and most recently in 2015, California (Dahl). I feel the reason so few states have voted to legalize PAD can be contributed to a blurred understanding of what physician aid in dying truly is. While although the name itself seems kind of self explanatory, the majority of the nations population has little to no understanding of what actually takes place in the PAD process. This lack of understanding can lead voters to voting against its legalization purely due to a fear of the unknown. So to help clear things up the actual definition of PAD is "A doctor knowing and intentionally providing a person with the knowledge or means or both required to take take their own life, including counselling about lethal dosage of medication, prescribing such lethal doses or supplying the drugs" (CNN). Further more the doctor themselves do not administer the drugs, they simply make them available to the patients, meaning the doctor may write the prescription, but the patient must then pick it up from the pharmacy and the time and place in which they take it is completely up to them. 

The idea of a doctor actually administering the drugs themselves is what is known as Euthanasia (Van Delden). This small but important difference is possibly one of the leading contributing factors halting the nation wide legalization of PAD, because when people think of euthanasia they tend to imagine only negative aspects such as lethal injections in prisons (Van Delden) (Annas). These negative aspects can cause voters to over look all the positive aspects that could come from nation wide legalization of PAD (Van Delden). These positive aspects include the right for the patient themselves to determine when enough is enough and when exactly they want to end the excruciating pain that their illness is causing them. This is why the numerous organizations such as Death with Dignity(DD) that support physician aid in dying try so hard to ensure that people are given the proper information to confirm that this distinction between the two is easily seen. Since the legalization of physician aid in dying nation wide would enable people all over the united states to be given the option of ending the pain they face due to their unfortunate illness.

 Another fear of nation wide legalization of physician aid in dying, comes from the belief that doctors could abuse this power of being able to help patients end their life and get away with it (Irvine). What this means is that doctors could potentially kill patients without the patients consent and while although one might think this could be a real problem, the fact is, it would be nearly impossible due to the strict guidelines and documents that must be kept during the PAD process to prevent those exact issues from happening (Physician-Assisted Suicide Fast Facts."). These guidelines are almost identical between the five states where PAD is legal, which is important because it ensures that all patients receive equal treatment and also that there are no differences legally between a physician aid in dying case that is performed in Oregon and one that is performed in California. Some of these guidelines include the following. First the doctor themselves must be willing to precipitate in process, then the patient must make two oral request for PAD separated by at least 15 days. The patients must also provide a written request with at least two witnesses and there must also be two doctors who confirm the diagnosis. Finally, the patient must also be deemed mentally capable to make these request and if they are not they will be subject to a further psych evaluation (Physician-Assisted Suicide Fast Facts."). So as you can see these strict guidelines not only ensure that the doctor does not abuse the patients right, but also that the doctor's rights are protected as well. This is especially important, because even though I feel strongly that physician aid in dying should be made legal in every state, I do not think that doctors should be forced legally to participate if they do not agree with it. So with this better understanding of PAD and all the steps within its process you can see that its nationwide legalization would do nothing but provide patients with terminal illness the access to another option if desired, other then just suffering through the remainder of the life they have left. Which is the very point I am trying to make with my argument, that if physician aid in dying was legalized nationwide it would simply allow patients to have the choice to end their pain. 

Along with the fear of doctors abusing PAD, polls have shown another issue holding back the nationwide legalization of physician aid in dying is that voters also fear that physician aid in dying would be overused and used in instances where it is not necessary or in other words, that people who have terminal illness that are treatable would contemplate PAD, due to the high cost of the treatment. Although this could be a possibility, data collected from Oregon a state where PAD is allowed has disproven this fear and shown that just because PAD is made legal nationwide does not mean that everyone with a terminal illness is going to seek it out, which is the opposite of what many people believe. There is proof of this in a graph created by the Oregon department of human services showing not only patients who requested PAD, but also those who actually ended up taking the lethal dose from the years 1998-2006 (Number of DWDA). This graph showed us that out of the eight year span the greatest amount of people to request PAD in one year was seventy and out of those seventy, only forty actually took the lethal dose of medication (Number of DWDA).  The graph also showed that out of everyone who requested PAD only 3% reported having financial trouble caused by the high cost of treatment (Number of DWDA). A poll done by the Oregon department of human services also showed that patients did also say that just being able to have PAD as an option helped to alleviate the fear of the continued pain that they were going to have to face in the time leading up to their death. Personally, just knowing that physician aid in dying is able to help patients period, even just to help alleviate the fear caused by their illness is enough to fight for PAD's nationwide legalization, because ethically I feel that there is no better cause then fighting to ensure that a person facing untold amounts of pain and suffering be given every option to help improve the little bit of life they have left.     

 The term ethics is defined as the principles of right conduct, so when one looks at the definition of physician aid in dying, which is to help alleviate a persons pain when they have no other treatment options, is there ever a better demonstration of ethics then that (Cramer)? The answer is no, there is no better demonstration of ethics then in the case of PAD. A physician's ethical obligation is to ensure that they do everything in their power to help alleviate a patient's pain, while adhering to the patients wishes. So in the event that a patient request to take their own life and there is nothing medically left the doctor can do to improve their current physical state, PAD is the only ethically sound option. 

An article written by Mars Crammer demonstrates this perfectly. It was 2012 when his wife Mathilde was diagnosed with a very rare cancer that caused chronic pain and also decimated her immune system. The only treatment was daily blood transfusions which took place every one to two days. This treatment at best only gave her a few months to live (Cramer). It was at that time his wife made the decision to request their family physician to aid her in the dying process which was only possible, because they live in the Netherlands where PAD is legal (Cramer). Feeling that he was ethically obligated to help relieve her pain, the physician prescribed the lethal dosage, which allowed her to die peacefully in her home surrounded by her loving family (Cramer). After reading this I truly understood how ethical PADs really is, because it allowed Mathilde to take control of her life back from the disease that was crippling it. The only down side to this is that, if this scenario had taken place in any of the states in the US that didn't allow PAD, the out come would have been a lot different. Mathilde would have been forced to either move to one of the few states where PADs is legal or suffer in pain for the few months of life she had left. 

While some people think that it is unethical for the patients themselves to consider taking their life through PAD, many changed their mind when the story of Brittney Maynards became nation wide news in October of 2014.  Brittney Maynard was like any other 28-year-old whose biggest problem was planning her wedding or trying to figure out how many kids she wanted to have with her soon to be husband, when she was diagnosed with the deadliest form of inoperable brain cancer known as glioblastoma. After failed treatments of radiation and chemotherapy doctors gave her at most six months to live. Doctors also warned that during those six months she would not only experience crippling physical changes that would cause her to need round the clock care, but she would most likely forget the names and faces of those she loved. After understanding the severity of her diagnosis, Brittney along with her husband decided to move from their current home in California to Oregon, since at that time Oregon was one of the few states where PAD was legal in the United States. After doing this, she received large amounts of negative scrutiny about how unethical her decision was to take her own life, most people didn't know that she had already tried all other treatment options and nothing had worked. But Brittney's response to these negative comments quickly made them think otherwise. She stated "I am not killing myself, cancer is, I'm just choosing to die on my on terms while I still remember my family's faces" (CBS). Which puts into perspective what PAD really does for a person in both her and Mathildes situation. It allows them to regain control of the brief moment of their life, that their terminal illness has forsaken them to. In the end I still do not not see how some viewed her decision as unethical, the only part that I found to be unethical is that a portion of the short time she had left had to be spent moving states, which could have been prevented if physician aid in dying was made legal nationwide. Although it is two late for Brittney who, with the help of PAD passed away in November of 2014, we can still fight to make PAD available in every state to ensure that nobody in the future has to uproot their lives and move to a different state wasting what little bit of time they have left. 

Lastly I want to prove why legally, PAD should be legal nation wide. In every aspect of medical care, the patient is given complete control over not only the kind of treatment that they receive but also whether or not they even want to be treated in the first place. Throughout a patient's medical records, you see things like DNR (do not resuscitate) which means that if a patient's heart quits beating, for instance during a surgery, they do not want to be resuscitated and by law medical personal such as doctors or nurse can not try to save them.  A patient can also state whether or not they want to have blood transfusions in life threatening situations. In all of these cases the patient has the legal right to refuse these such treatments even if it means ending their life (Brink). So why can the same not be said for physician aid in dying?

 How is it fair that in every state a patient can legally refuse medical help to save their life, but a patient in most states cannot seek medical help to end their pain by taking their life. Some may argue that in the cases I mentioned first a doctor was not doing anything to purposely harm the patient, but in the case of PAD they are. I do not agree with this, personally I think that in all three cases including PAD the doctor is simply following the patients wishes in which they are legally entitled to. One way I believe this legal issue with PAD could be fixed would be to make physician aid in dying a federal law instead of a law that must be passed in every individual state. This would enable it to become mandatory in all 50 states, therefore allowing physician aid in dying to become an option to terminally ill patients, no matter which state they lived in, which is the goal of my entire argument.

So as you can see there is a lot more to the controversial topic that is physician aid in dying. Just like with every controversial topic there will always be those that will always fear its legalization. I truly believe that we can come to see that its nation wide legalization is not only the best possible outcome, but it is also an inevitable one, because PAD is something that can affect everyone of us at any point in our life. I only hope that after giving you not only a detailed look and understanding into what physician aid in dying really is, but also showing you the statistical data and ethical reasoning that proves many of the fears surrounding its legalization are simply unfounded. You can come to see that PADs nation wide legalization would do nothing but ensure that every patient in the future who is diagnosed with a terminal illness no matter which state they call home. Is given the option of physician aid in death so that they can decide for themselves whether they want to try and endure the pain caused by their illness for the remainder of their life or decide to take their life before the pain becomes to unbearable.  

