
Physician assisted suicide is a controversial topic due to how serious of a decision it is. Peoples morals and ethics make them stuck on a certain side of this argument without acknowledging the facts. When an individual has a terminal illness, they typically are suffering both emotionally and physically. Patients must simply accept that they have to wait for death to come and their families can do nothing but watch their loved one suffer through their illness. However, the difference is that there is no hope for the patient to beat their illness. Based on research and human experiences, physician assisted suicide should be legal and available for terminally ill patients.

According to the Merriam-Webster dictionary, physician assisted suicide is defined as suicide by a patient facilitated by means or information, as a drug prescription or indication of the lethal dosage, provided by a physician aware of the patient's intent. Unlike euthanasia, the physician is not the one administering the act, instead they are providing the means necessary for the patients to end their own life. Physician assisted suicide is completely voluntary and only the patient can self-administer the lethal dose. The idea behind this is to hasten death, it is not simply suicide and should not be thought of as such. The goal of these patients is to maintain their dignity in their death, instead of suffering, becoming weaker, and eventually succumbing to their illness. The state of Oregon, the American Medical Women’s Association, and the American Public Health Association have stopped using the term physician assisted suicide, deeming it inappropriate and inaccurate due to the suicide aspect (deathwithdignity.org). 

Physician assisted suicide is currently legal in five states of America: Oregon, California, Washington, Montana, and Vermont. In Montana, physician assisted suicide is mandated by court ruling, the decision of the court determines whether or not it is okay to provide the specific patient with the means to end his or her life. Physician assisted suicide is only an option when individuals have a terminal illness and an estimated amount of less than six months left to live. The procedures differ for each state, but participation of the physician is voluntary in all five states. The physician who provides the prescription cannot be persecuted for doing so. Currently, there are nine other states that have pending physician assisted suicide legislations: Kansas, Massachusetts, Michigan, Minnesota, New York, New Jersey, North Carolina, Oklahoma, and Pennsylvania. In Washington, D.C., Mayor Muriel Bowser signed the Death with Dignity Act last December. This legalized assisted suicide in the D.C. area and gave physicians the power to prescribe lethal medication to terminally ill patients with the mental capacity to understand what the consequences of their actions are and who will die within six months. This law, however, was overturned by Congress. 

Physician assisted death should be legalized for terminally ill patients because it is the patient’s life and they should have control over it. The idea of autonomy is the main reason people are in favor of physician assisted suicide. The patients believe they should have the right to choose what is the best choice for them. The patients are aware of the limited amount of time they have left to live and know that death is inevitable for them. There is no hope of a miracle or a cure at this stage for them. Most patients suffer from their illnesses and are constantly in pain. Instead of torturing terminally ill patients and their families, they should have the right to ask their physician for the means to peacefully end their life. By doing this, it saves the patient from suffering through a dragged out death and from expensive medical bills for treatments that do not provide any improvement for their condition. Terminally ill patients are forced to come to terms with their death. The patients know when it is their time to go, otherwise they would not be asking for the means to end their life. Physician assisted suicide allows the patient and their family time to say goodbye. This eliminates the fear that the family would not make it in time if the patient died suddenly as their disease progressed. Physicians have an obligation to relieve the pain and suffering of their patients. If physicians cannot fulfill the requests of terminally ill patients who ask for the means to end their lives, how can they be doing their job to the best of their ability? There is little difference between refusing treatment or medication from doctors, do not resuscitate orders, and physician assisted suicide. While refusing treatment and resuscitation are not technically the same, they are all extremely similar in the aspect that the patients feel that it would be better for them to pass on when it is their time to. The decision to end one’s life is not a small one, it is purely based on how the specific individual is feeling. While it affects their family, it has to do primarily with the patient’s feelings and does not cause harm to others. Therefore, no one should have the right to deny patients of a dignified death if it is what they choose.

Medical bills are one of the many driving forces that make physician assisted suicide the right choice for some patients. Not many people, unless they are faced with these type of bills, think about just how expensive dying is. Today, there is a high cost to dying. People no longer have the luxury of dying without leaving behind expensive medical bills for their loved ones. This is very difficult since not all people have the means to handle their loved one’s affairs, especially while dealing with their grief. In 2008, Medicare paid $50 billion for doctor and hospital bills during the last two months of patients’ lives (The Cost of Dying: End-of-Life Care). In 1971, Timmer and Kovar conducted a study of expenses for hospitals and institutional care during the last year of life of adult patients who died between 1964 and 1965. They discovered from their research that the proportion of deceased adults who received treatment in hospitals or institutional care within the last year of their lives was exceptionally higher than the living population during a 12-month period (Scitovsky). The deceased patients were also more than twice as likely to have bills of $500 or more for care in medical facilities than adults who had the same care but did not die. The median bill for such care was almost three times higher for patients who died. (Scitovsky). In 1973, Cancer Care researched the costs of cancer from 1971 to 1972. The research showed that the average expense of cancer patients who died ranged from $5,000 to $50,000; the average cost was $21,718.  The Blue Cross and Blue Shield Association conducted a study of cancer costs in the last six months of patient’s lives. The research shows that medical bills of patients under 65 years old averaged just about $16,000 per decedent in this terminal phase of life (Scitovsky). Since these studies have taken place, medicine and treatment have become increasingly more expensive, meaning the numbers from these studies are likely to be much higher today. It is very difficult for families to settle the patient’s affairs after they have passed, especially when arranging the expenses of a funeral as well. The terminally ill patients are not going to improve, their condition will continue to get worse, which makes it difficult for some to justify paying such a large bill. 

There are many organizations that advocate for the right to physician assisted suicide. The purpose of these organizations is to fight for the legalization of the right to die with dignity for every individual. These organizations focus primarily on legalization for terminally ill, but some also advocate for disabled individuals. Among the well-known organizations are Death with Dignity National Center, Hemlock Society, Final Exit Network, and Compassion and Choices. Death with Dignity National Center states that their mission is to “promote Death with Dignity laws based on our model legislation, the Oregon Death with Dignity Act, both to provide an option for dying individuals and to stimulate nationwide improvements in end-of-life care” (deathwithdignity.org). This nonprofit organization seeks to educate patients, their families, legislators, and healthcare professionals in regards to Death with Dignity and physician assisted suicide. They focus on promoting Death with Dignity laws in all fifty states after making it possible in Oregon. The organization is currently working with other nonprofit organizations in seven states, including: Maine, Texas, Hawaii, New York, Illinois, Ohio, and Virginia, to strive towards the legalization of physician assisted suicide. The organization Compassion and Choices is the nation’s oldest and largest nonprofit organization that is committed to improving care and expanding choice at the end of life (compassionandchoices.org). Similar to Death with Dignity National Center, Compassion and Choices seeks to inform people and make them feel comfortable by educating them and even offering a free consultation program. They strive to help people receive healthcare that suits their “values and priorities as they approach the end of their life” (compassionandchoices.org). Their focus is to inform people of all their options, whether it be about hospice, palliative care, stopping medical treatment, or for terminally ill patients, choosing the time of their death to save from unnecessary suffering. Other organizations in the United States have similar goals and policies as Death with Dignity National Center and Compassion and Choices. These organizations purpose is vital, without the education, information, and clarification they give to all people, no one would be able to fully understand what physician assisted suicide is and why some consider it the best option for themselves. 

Just as there are organizations in support of physician assisted suicide, there are organizations who oppose it. Among the well-known organizations in opposition to this matter are the American Disabled for Attendant Programs Today, Not Dead Yet, Care Not Killing, the Euthanasia Prevention Coalition, and the World Medical Association. The World Medical Association official position on the matter is: “Physicians-assisted suicide, like euthanasia, is unethical and must be condemned by the medical profession. Where the assistance of the physician is intentionally and deliberately directed at enabling an individual to end his or her own life, the physician acts unethically. However, the right to decline medical treatment is a basic right of the patient and the physician does not act unethically even if respecting such a wish results in the death of the patient." (wma.net). The organization Not Dead Yet is a national disability rights group in the United States. The organization does not see physician assisted suicide as a desirable option meant to give mercy and relief to patients. Instead, they see it as discrimination against the elderly, disabled, and terminally ill.  The focus of Not Dead Yet is to “organize and articulate opposition to these practices based on secular social justice arguments.” (notdeadyet.org). The organization seeks to maintain the equal protection of law for the groups physician assisted suicide would be offered to. The Euthanasia Prevention Coalition works to preserve and enforce legal prohibitions against physician assisted suicide. In addition to providing effective means to control pain and lessen suffering for patients, the organizations main goal is to improve and build better quality hospice and palliative care. The Euthanasia Prevention Coalition, similar to the organizations with opposite beliefs and goals, seeks to educate and inform people on the risks and harms apparently associated with physician assisted suicide. All of these organizations have the same goal in mind, which is to maintain laws that prevent physician assisted suicide in the United States. 

Organizations, such as Not Dead Yet, argue that people should be given the right to live well before given the right to physician assisted suicide. Their argument is that many patients want to end their lives because they are not receiving the support or aid they require to get them through their illness. Organizations like this believe the primary focus should be on helping patients live their lives as comfortably and happily as possible, instead of helping them end their lives. There have also been advances in medication. There are many different palliative care medications that help with pain, discomfort, and common symptoms of terminal diseases. Many believe if these treatments were available to more patients that none of them would ask for help ending their lives. If every patient had more access to palliative care than they would not feel so inclined towards physician assisted suicide. Despite these arguments, while many patients choose this course of action to end the pain they constantly feel, there are many patients who seek this option as a way to maintain control. With the loss of so much control in their lives, they want to maintain control over their death. The patient’s terminal illness already determined what they can and cannot do and how much time they have left alive, so they want to be able to have control over when and how they will die.  There is also the belief that no human has the right to end their own life or to aid someone in ending their own life. This argument has to do with religious beliefs. However, in the United States, there is a separation from church and state. Specific religious beliefs should not be basis for making actions of compassion and mercy illegal. If the patient believes it is not their right to determine when it is their time to pass on, then they would not ask for assistance in taking their lives, instead they would continue to live despite their suffering. 

In 1997 there were two supreme court cases that ruled against physician assisted suicide. In the court case Washington v. Glucksberg, the Supreme Court ruled that a law prohibiting any individual, including physicians, from helping or causing another person to commit suicide, is constitutional. When convicted with this crime, individuals could face up to five years in jail and a $10,000 fine. Glucksberg believed the ban against physician assisted suicide was unconstitutional and violated the fourteenth amendment’s Due Process Clause because it denied mentally capable, terminally ill adults the right to choose death over limited amount of life. However, the Supreme Court ruled in favor of Washington and stated that the law does not violate the fourteenth amendment. In Vacco v. Quill, Dr. Timothy Quill fought against New York State’s ban on physician assisted suicide, declaring it unconstitutional. The law allowed New York patients to refuse treatment that would save their lives, but made it illegal for physicians to assist their patients in suicide, despite terminal illness. Similar to the other court case, they believed it violated the fourteenth amendment. However, they fought for the Equal Protection Clause because this law allowed competent adults to stop treatment, but denied the right for patients who could not withdraw from their treatment. Again, this was ruled in favor of the state. It is clear that Americans value life, however, in Roe v. Wade, the Supreme Court ruled in favor of Roe and now protects the right to abortion under the United States Constitution. Beyond just abortion, late-term termination, meaning the act of an abortion when the woman is in her third trimester, is sanctioned by the Supreme Court. Late-term abortions are a very big part of this argument because when women are in their third trimester, the child has a chance of surviving outside of the womb. The baby is fully developed by six months and though they would be tiny and the child would require treatment after being born, they could still live on their own. This, somehow, is still legal and even considered ethical in the eyes of the Supreme Court. However, when a terminally ill patient is mentally competent and can maintain a healthy state of mind, they still cannot decide when their lives should end. This is what the United States considers moral and ethical. Yet, when a baby who is unable to make decisions or speak for itself, is at risk of being killed, it is considered moral and ethical to terminate that child’s life. The Supreme Court determined that a child who has not yet lived their life or been able to experience the world is disposable. Even the babies who, if given the chance, could survive outside the womb before nine months. However, for someone who has lived their life, is able to make decisions and speak for themselves, and who is now riddled with an illness that is inevitably going to kill them, physician assisted suicide is unethical, immoral, and unthinkable. Patients who are terminally ill choose physician assisted suicide to end their suffering and maintain control. Women have abortions to kill the child inside of them. No matter what the circumstances are, that is still the end goal of this procedure. It is very difficult to comprehend how between these two cases the only one considered murder is physician assisted suicide, not abortion. 

Many people often forget that behind all of the debates and court cases, there are real patients and their families. It is vital to take into consideration the emotions, fears, and realities that these people face every day of their lives. Andrew Solomon describes his feelings about his mother’s death by saying though it was the hardest day of his life, he knows it was the right decision for her and the rest of his family. He remembers his mother as someone who “valued control and she valued coherence, and she died as she had lived, with elegance.” (The Shadow Side of Assisted Suicide). Her best friend died screaming in a hospital bed from cancer, and after her diagnosis of ovarian cancer, she made it clear she did not want the same fate. Another woman, Judith Dunning, was diagnosed with brain cancer that continued to progress despite going through many rounds of treatment. She was forced to spend most of her day asleep, needed help with basic tasks, and was beginning to lose her ability to speak. Before the End of Life Option Act became law, she recorded a video making it clear what her wishes were, she had no desire to live when she lost her ability to communicate (Physician Aid in Dying Gains Acceptance in the U.S.). Judith was Dr. Rabow’s patient and he was opposed to physician assisted suicide, but since she was very determined about what she wanted, he gave the prescription. He described her house being “full of people who didn’t want her to end her life, but were there to support her and respect her well-considered decision” on the set day of her death (Physician Aid in Dying Gains Acceptance in the U.S.). Some, however, were prevented from receiving the assistance they needed to peacefully end their life. Tracy Snelling was diagnosed with stomach cancer and while at first the doctors and her family were optimistic, the cancer became aggressive and spread. Treatment did not work and the cancer became terminal. Despite the push towards palliative care, there are limitations to it. There was nothing strong enough to alleviate Tracy’s pain. She was unable to keep foods or liquids down and suffered terrible nausea which caused her to throw up every few hours. By the time she had applied for Dignitas, it was too late and she was not well enough to make the two trips to Switzerland. Due to the law forbidding physician assisted suicide in the U.K., she had a very painful death that she did not deserve. 

Physician assisted suicide is something that people immediately reject because of its connotation to suicide and the fact that it inevitably results in the death of an individual that others know about and can prevent. However, because of the severe nature of terminally ill patient’s diseases, death is inevitability around the corner for them. Having the means to decide when and how one will end their life is an important aspect of control for patients because their illness has left them vulnerable and powerless. This is their last chance to maintain a sliver of power in their lives, it would not be right to deny them the right to die peacefully, with dignity, and surrounded by the ones they love.
