For as long as humans have walked the planet, we have had injury, sickness, and death. Naturally wanting to live longer, mankind led itself to medicine and treatment, allowing us overtime to live longer, healthier, and more fulfilling lives. As sophistication came to the medicinal field overtime, treatment ethics and the doctoral code came to fruition, stating that doctors would do only and everything in their power to prolong and work towards the health of their patients. Eventually, man brought foreword the question; ‘What if we do not wish to be saved?’ As we know now with advanced 21st century medicine practice, we can prolong lives with life support for years, treat cancer with aggressive and painful chemotherapy, and allow the demented and mentally deteriorated extra years to live with relative ease. But do all patients will for this extension? Do some just want to move on to their next life? Yes, and here in America, most do not have the choice to move on by their own terms. People can refuse treatment of course, and live through their pain until their deaths, which many choose to do. The question remains, why can’t Americans outside of six states and Washington D.C. get life-ending medical treatment if it is warranted by their physical and/or medical conditions? It is an intangible human right to determine the path taken for our physical bodies, and so physician assisted suicide must be a legal medical practice in the United States as it is in much of the developed world.

Across Europe and in the vast majority of democratic Asian countries, physician assisted suicide is commonly practiced, with palliative medicine doctors performing the procedure thousands of times per year. Patients are granted the procedure for a number of aliments, including clinical depression, severe mental illness, dementia, cancer, terminal illness, and several other less common conditions. For obvious reasons, one cannot simply walk in and die, as a loose background check would violate doctoral oaths of helping their patients as opposed to harming them, even under deceit. In Rachel Aviv’s article “The Death Treatment,” she details the most famous instance of physician assisted suicide in the United States thus far, the story of Brittany Maynard, a 29 year old Californian who chose to establish residency in Oregon in 2014 as Oregon was the only state with the United States “Right to Die” law in affect. Maynard had a terminal brain tumor, and was assisted in taking her own life in November of 2014. As a viral news story and topic of mass debate across the medical and law fields, the country micro examined Maynard’s story, and although conservatives and liberals fought fiercely in defense of both sides, just three years later we see the same law in effect across six states and in Washington D.C., one of these states being California where Maynard initially hailed from. What Brittany Maynard experienced was an immense release of pain and sorrow that would have dragged on for over a year had she been denied the treatment that she sought, and her testimony released through CNN outlined her happiness just before she passed away and how thrilled she was for the end, an attitude that proves the reasoning behind PAS.

Emotionally, assisted suicide is a hard situation for the deceased, their families and their peers. Ethically, the gray area is far less, as physician assisted suicide is as essential of a practice as giving a sick man an antibiotic. With all rights given to American’s in our constitution as well as legislation since, it appears to make no sense that PAS is not nationally legalized. For example, abortion is nationally a legal practice, and while this is not in any way intended to bash abortion as a medical practice, there is little difference between ending undesired life at a very early stage and ending life at a point when the patient no longer wishes to live. I anything physician assisted suicide is more ethically sound because the deceased is the one who decides their faith. The United States government allows us to decide what we put into our bodies, how we spend our time and with whom, and so much more, including how to treat ourselves and our children medically and otherwise. Yet, the vast majority of citizens are not at will to choose death, which is unacceptable. John Wilkinson in his palliative medicine journal titled “The Ethics of Euthanasia” provides context to and maintains the notion that he right of man to choose is intangible, and that by not allowing such a right the United States government is guilty of some pretty severe hypocrisy specifically in medicine. Wilkinson also cites Social Darwinism and Confucianism as philosophies in direct support of all types of palliative medicine, and analytically, PAS is rather underwhelming in terms of medical practice that is widely illegal. The difficulty lies is rationalizing and simplifying PAS is a way that would gain stream for legislation, and while easier said than done, our progress as a nation since 2014 gives hope to the cause.

Internationally, physician assisted suicide is about as common and life saving surgery in practice, mostly because of the rationale behind the procedure and the sheer numbers of patients operated on. Analytically, testimony from physicians largely supports PAS, but there are of course outliers. In Banovic Bozidars scholarly journal from the Iranian Journal of Public Health, Bozidar provides peer testimony of fellow palliative physicians and their experiences and opinions on their field of practice. Bozidar formulates a study-based conclusion in support of physician-assisted suicide, but goes on to express his own dissent on the topic, disagreeing with the vast majority of his peers. Statements in his conclusion include a slippery slope argument in terms of medical malpractice and also taking a religious front, calling euthanasia murder and using scriptural support, condemning the practice. Bias under Dr. Bozidar’s religious stance and his argument about medical malpractice is a fallacy as a result of his pre-disposition against palliative medicine. For a scholarly journal, opinions largely dominate the counter argument, perhaps diminishing credibility against a pro-PAS argument. Also worth being noted, Iran is split quite tightly on the subject despite practice being legal, which may contribute to hostility. Ultimately, much opposition against palliative medicine practice is a matter of personal philosophy and belief, which is not a strong argument against anything.

Considerable arguments against palliative medicine procedures come from three main sources, historical philosophies, current law, and religious scripture. These stances do not gain much traction from research or logical appeals, but they are successful because the aforementioned stances are important to many people, specifically religion and philosophy. A large consensus of people in the world live their lives according to a religion or philosophy and make decisions according to such guides. Across nearly all nations of the world a law governs the way we the people act, making legislation a huge talking point against palliative medicine where it is not yet legal. Ronald Dworkin recognizes these niches of arguments in his novel “Life’s Dominion: an Argument about Abortion and Euthanasia.” Citing deities across many religions, Dworkin condemns what medicine is morally unlawful in the eyes of God, strictly referring to palliative procedures as murder instead of their medical titles. Politically and philosophically, Dworkin is opinionated and mostly uses the way he chooses to live and the state of law in the United States at the time of his novel, which in the late 1990’s, was strictly pro-life in this aspect. At it’s core, many of the examined counter-arguments researched for this assignment were matters of personal belief and law, things that are both dynamic amongst humans, as we constantly believe different things to be true and as legislation is altered seemingly day to day. Any agreement against palliative medicine, while notable, likely will not stand in the near future, because as we have seen throughout previous years, man and medicine are cooperatively evolving along side each other in belief and practice, leading the belief that there is no reason to doubt the legality of PAS in the near future both nation and perhaps worldwide.

Excluding material based on practice from around the world and focusing rather on the United States for which this essay is directly addressed to, the consensus of medical professionals in the United States is radically becoming pro-physician assisted suicide as well. Dr. Diane Meyer of the American Medical Association performed a large scale survey over two years beginning in 1996 and concluding in winter of 1998 that collected data based on an in depth survey of palliative medicine strictly amongst members of the American Medical Association. The study came about as a result of the legalization of the Right to Die legislation for Oregon in 1995. Of the 1900 board certified physicians that completed the questionnaire, just over 71% scored within the sect of the study indicating overall support of legalization for palliative medicine at the national level, indicating that Meier was correct in her hypothesis of medical personnel support of the cause. The most shocking part of the survey is that it was taken at a point in history when PAS was all but illegal in the United States with the exception of Oregon. Now almost twenty years later with six more states/provinces having legal physician assisted medical practice, support amongst both medical personnel and civilians has obviously increased exponentially since the survey was taken, indicating a rise in support for the cause of palliative medicine.

Peter Saul is an emergency physician and full time psychiatrist with active participation in over 4,000 patient death processes as well as counseling for thousands more. In his 2013 Ted Talk, Saul, using his medical expertise, personal experience, and research based study on pathological decision making in regard to PAS gave in depth insight to the state of mind of patients participating in this method of medicine that is so controversial. Dispelling theories against the practice is the main purpose of physicians like Peter Saul, as his livelihood is dependent on such medical practice. Saul affirms that people granted physician assisted suicide go through and in depth interview and qualification process and the families of the deceased are given much thought prior to physicians agreeing to perform the operation, as it is at the discretion of the doctor as well as the patient for operating. Since Saul is also a psychiatrist and counselor for people looking to be operated on, his knowledge of the minds of patients and their families allowed him to conclude that the overwhelming majority of patients families are ultimately supportive of their decision. For us to know that not only the patients are willing but also their loved ones can bring us comfort in the fact that in some cases moving on is simply for the best.

Some people become doctors and medical personnel because they are pursing a career. Many want to make a lot of many, many want the prestige of a doctorate. Exceedingly more people that choose medicine as their profession wish to help people that require such discourse. It is baffling that physician assisted suicide is not widespread legal in the United States because one of the most vast aspects of treatment is relieving pain and suffering of patients, and one may argue that there is no larger release of such pain and suffering than death, however grim and remorseful it may be to say so. Humanity must accept death for what it is, the end of one life and the beginning of another despite our own valid personal beliefs and what they lead us to think. Palliative medicine and physician assisted suicide help people that require treatment for their ailments and illnesses and when you comb through all the fluff and controversy surround the topic, it is quite clear that those who are sick have the right to treatment and palliative medicine is exactly that.
