Physician assisted suicide is quickly growing theories regarding the legalization domestically and in other countries. Physician assisted suicide (PAS) can be defined as a physician intentionally giving someone the tools to end their life or directly end their life for them. This mostly occurs in terminally -ill patients. An example would be of a stage IV cancer patient consulting with a physician about lethal doses of medication and being prescribed the same medication. PAS is to not be confused with euthanasia. Euthanasia means “the act of killing for reasons of mercy (PAS 8).” There are two types. There is active and passive euthanasia. Active euthanasia consists of directly causing the death of a terminally ill patient, as passive euthanasia means to end all life saving measures and let them pass of natural causes. The key difference between active euthanasia and PAS is who administers it. The essay will include discussions on the history behind physician assisted suicide, patient rights and family influences, the potential for malpractice of physicians, eligibility of a person, and reasons why others feel that PAS is justifiable. As of now, there is no clear wrong or right developed for PAS. The purpose of the paper is to bring awareness, inform the reader and provide possible outcomes. This essay stands to argue against the legalization of physician assisted suicide in the United States.

It is said that all euthanasia is illegal in all 50 states. However, in 1976, the Supreme Court’s decision in the case of Karen Ann Quinlan fell in favor of Quinlan’s parents. The story is that Karen fell into an irreversible coma after a drug overdose in 1975 and was placed on life support. Her parents were faced with to Supreme Court to remove her from life-support. “On June 26, 1997, the U.S. Supreme Court ruled that individuals do not have a fundamental, constitutional right to physician-assisted suicide.” (PAS 8) The ruling overturned the previous decisions regarding the Washington State Vs. Glucksberg and New York Vs. Quill. In the Washington case, the court ruled that Washington state had a law that prohibited people from aiding in suicides. That’s the same thing they did for the New York case. The reason goes back to the 14th amendment, it was said that it violated the equal protection clause. The equal protection clause says, 

“No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.”

The constitution pushes most responsibility off to individual state laws. Explaining how we have states such as Oregon who have legalized PAS. It is also legal in California, Washington D.C., Washington, Colorado, Vermont, Montana and it is legal in the countries of Switzerland, Germany, Japan and Canada. 

Every patient is entitled to certain rights when it comes to healthcare. This list is known as a patient bill of rights. There are multiple versions of patient bills of rights. Some differ from hospital facility to clinics and private insurance companies. Recurring things that are normally seen in a bill of rights is the right to confidentiality, copy of medical records and written instructions of procedures to name a few. Ultimately, all decisions go back to the patient. It is a person’s choice to end their life.  Patients have rights to refuse treatment or resist medications. However, if their judgement should ever be compromised mentally or physically, the family or next of kin is to make judgement for them. Family influences can vary from good to bad. The family may or may not agree with the patient’s choice. Family can also subtly influence a patient to participate in physician assisted suicide. If they have negative intentions or energy around the patient, then that can push a patient to consider PAS because the person can become depressed, feel that they have nothing to fight for, or do not want to burden the family to care for them. Even physicians can move a patient subtly in the direction of PAS. The medical field is a cost -conscious community and insurance companies as well as hospitals value and save all the money that they can. These reasons are important in the argument of why PAS should not be legal as if so, this can lead to unlawful activity and potentially deny a person a choice to live just to save money.

 A doctor named Jack Kevorkian was an avid supporter of physician assisted suicide. He gained national spotlight because of his support, especially giving that PAS was not named legal yet in the state of Michigan. An editor of biography.com writes that “Kevorkian became fascinated with death and the art of dying” during his residency. He became known as ‘Dr. Death’ around his colleagues. He developed his own suicide machine made of 45 dollars’ worth of materials and he named it ‘Thanatron’ which is Greek for ‘Instrument of death.’

“The Thanatron consisted of three bottles that delivered successive doses of fluids: first a saline solution, followed by a pain killer and finally and fatal dose of the poison, potassium chloride.” (Biography)

Kevorkian first gained the spotlight of the media when he assisted in the death of 54-year-old Janet Adkins. Adkins was an Alzheimer’s patient. He was charged with Adkins’s murder, but charges were later dropped due to Michigan’s undecided stance on physician assisted suicide. Even after being charged and acquitted of all charges, this did not stop Kevorkian to continue to attempt to prove that euthanasia and PAS should be legalized. He is said to have assisted over one hundred thirty people.(Haberman) He created a new machine in which he called the “Mercitron.” This machine “released carbon monoxide through a gas mask.” (Biography) He was not convicted until March of 1999. Biography.com states that He was convicted of second degree murder of Thomas Youk and the illegal delivery of a controlled substance. Thomas Youk suffered from Lou Gehrig’s disease and his recording of his suicide was released by Kevorkian to the news program of CBS, 60 minutes. 

Dr. Jack Kevorkian is a prime example of how legalization could lead to abuse and unconsented acts of mercy from physicians. As Huntoon notes that, “Those who violate these guidelines by administering death, of course do not report their violations, except in anonymous surveys (99.)”  He goes on to quote an article published by the Heritage Foundation that was found to discover that 

“In the Netherlands, several official government sponsored surveys have discovered that in thousands of cases, doctors have intentionally administered lethal injections to patients without a request and that in thousands if cases, they have failed to report cases to the authorities (99.)” 

It is a dangerous matter, as it is impossible to know the real intentions of people. Even if they are not lethal injections, many doctors feel that it is okay to ease the caregivers burden. Although the survey was conducted in another country, there is evidence that this can happen in the U.S, as Kevorkian is an example of exactly why physician assisted suicide should not be legalized. It can destroy morals of individuals and many doctors can end in prison or lawsuits.

To be considered eligible for PAS the person must be able to take the medication on their own. Death with dignity also states that to be eligible, a person must be 

“a resident of California, Colorado, District of Columbia, Oregon, Vermont, or Washington,18 years of age or older, mentally competent, and diagnosed with a terminal illness that will, within reasonable medical judgment, lead to death within six months.”

Each state has their own specifications for residency, such as a certain amount of years the patient must be living there. However, most states must be presented with two documents that prove the patient’s residency to the state. The process is simple. The patient must be state their first oral request for assistance in dying, then they must wait a minimum of fifteen days to place a second oral request. The physicians check to ensure that all eligibility requirements are met in the first oral request period. A written request is then required and can be written any time after the first oral request. Two physicians must agree that patient is competent before they are approved. (DWD)

Terminally -ill diseases can be more than just cancer or a rare aggressive disease. PTSD can be considered ‘terminally-ill’. This brings up the case of a young woman of her twenties in the Netherlands who decided to partake in physician assisted suicide. She remains unnamed, it was reported she was granted assisted suicide due to ‘incurable’ Post- traumatic stress disorder caused by sexual abuse she experienced between the ages of five and fifteen. Matt Payton, writer of Independent, quotes Mail Online who reports, “As a result of her abuse, she suffered from post-traumatic-stress disorder (PTSD), severe anorexia, chronic depression and hallucinations.” It was also stated that physicians found that she was competent, and nothing influenced her judgement. This story does not make sense because if she were to have depression then she should not have been allowed to go through with physician assisted suicide. The story has caused quite a controversial debate over the young woman’s death. Because of the claims made, it is proven that PAS should not be legalized because we will never grasp the full extent of this story in complete context and this also could potentially lead to patient abuse and malpractice among doctors.

Those who believe in physician assisted suicide argue that it is a right. Therefore, we have “right to die” protests and speeches across the country. Andrew Lewis makes note that.

 “the right to physician assisted suicide is an inalienable, individual right, which should be recognized throughout the country, not merely because it is consistent with the principles stated in the Constitution, but because it is an inescapable expression of liberty.” (PAS 39)

Even physicians who support PAS believe that this can be a way to end a patient suffering. All suffering may not be physical but also the psychological suffering that happens due to the physical suffering. (Snyder) Persons in support, argue that “the decision to end one's life is intensely personal and private, harms no one else, and ought not be prohibited by the government or the medical profession.” (Snyder 212) Most debates in agreeance for PAS are based on individual rights as an individual and how they should be honored throughout the country.

Physician assisted suicide is essentially a ‘merciful death’, but it is different from active euthanasia. PAS is not honored in the constitution and is up to individual states. There is evidence of real issues that physician assisted suicide can bring on such as the malpractice of doctors and unconsented PAS. Jack Kevorkian is an example of this abuse. It is proven that family and healthcare professionals can influence patient’s decisions in subtle ways and this can potentially be harmful and remove a patient’s right to live. As the case in the Netherlands, it can be possible for patients with mental illnesses be granted assisted suicide even though their judgement is impaired. Evidence for PAS includes the reasoning of how it is an undeniable right of an individual. In conclusion, Physician assisted suicide should not be legalized in the United States as it can potentially do more harm than good in the long run.
