
In the year 2015, 132 individuals in Oregon chose to end their life with a lethal prescription from doctors; including Brittany Maynard, a young woman who wanted to end her suffering from brain cancer as she became an activist for the Right to Die Movement. This number has tremendously increased from sixteen individuals since the Death with Dignity Act was first implemented in 1998. Physician assisted suicide is defined as suicide by a patient, facilitated by means (as a drug prescription) or by information (as an indication of a lethal dosage) provided by a physician. In this case, the doctor is aware of the patient’s intent. This is also known as death with dignity. The right-to-die movement has been ongoing for decades, arguing whether patients suffering from terminal, incurable, and excruciating medical conditions or diseases should be granted the right to find relief in a dignified death.  Patients that do not have a chance at survival want the option to choose when they die so that they do not have to suffer any longer. Similarly, advocates of this movement feel that patients should have the privilege to ask their doctors to aid them in ending their life so that they do not have to continue living with pain and dependency on medication and other people. People against this movement argue that making it legal for doctors to aid in the death of their patients will persuade more people to choose this option in order to save money for their families on their medical bills. However, courts have already made it legal or patients to refuse medical treatment that could help them live longer, and having a physician hasten their death is not substantially different. There are also doctors at this time that are prescribing large quantities of lethal medication to patients that they know have the desire to end their own life. Reasons that the right to die should be allowed and physician assisted suicide should be legal include medical purposes, financial costs, and because it is morally just.

Currently, physician-assisted suicide is legal in only five states in the United States. These states include California, Oregon, Vermont, Washington and Colorado. The method of how the assisted suicide is performed is different in each of the states, but is most commonly done with the prescription of a lethal dose from a physician. In the state of Montana it is also legal, but only under a court order and ruling. Physician-assisted suicide is legal in some other nations as well, such as Switzerland and the Netherlands. The Netherlands was one of the first and one of the only countries that have legalized passive euthanasia. Oregon passed the Die with Dignity Act in 1997, as it became the first state in the United States to legalize physician-assisted suicide. This law permits patients to be given fatal prescriptions if they meet a certain criteria. The patient must have less than six months to live, be mentally capable to make the decision on his or her own, and voluntarily have the desire to die. Since Oregon passed this law, the debate for assisted suicide became more popular and other state legislatures have taken an interest to and debated similar initiatives. In Michigan in 1998, advocates of the right to die made an attempt at legalizing assisted suicide but voters were not in favor of it (Childress). Although it was not approved in Michigan, many other laws and legal action have been set in place in other states since then. 

The right to die should be seen as a fundamental right to United States citizens’. The Constitution protects the citizens of the United States and entitles them to their basic rights. These rights include the freedom of choice, being in control of their life and fate, and the pursuit of happiness. However, the Constitution does not recognize the right of terminally ill patients to dictate how or when they will end their own life if they so choose. America was founded on the basis of every citizen having their right to choice and not giving them this option is taking that away from them. Though the Court denied a constitutional right to commit suicide, it allowed individual states to decide whether the practice of assisted suicide should be acceptable, leaving the option for states to legalize the practice. 

Although this may be true, the choice of end-of-life care should not be determined by the government but should instead be the decision of the patient. Because physician assisted suicide is not legal throughout the nation, the patient’s right to choose is being taken away. The government does not know what is in the best interest for each individual patient, and therefore this decision should be able to be made between a patient and his or her doctor. It is inhumane to deny the terminally ill to have the dignity of their death and the legal aid of a doctor could be a comfort to the patients that know they are facing death soon. According to Montana Supreme Court Justice James Nelson, "Society does not have the right to strip a mentally competent, incurably ill individual of her inviolable human dignity when she seeks aid in dying from her physician"(“Right to Die”). In other words, once a patient gets to the point where they have lost their quality of life, they should be given the option to find relief in a dignified death. The government and society should not have the right to interfere in the choice of the patient.

Similarly, advocates of the Right to Die Movement believe that patients should be informed and aware that there are many medical options in their end-of-life care. They then should have the availability of choosing what they want for themselves. Due to the fact that courts have already ruled that patients have a right to decline medical aid and treatment, they should also be given a similar right to ask for medical assistance and decide when they are going to die if they are terminally ill. Patients were granted this right and the right to informed consent in 1973 when the Patient’s Bill of Rights was developed. The Patient’s Bill of Rights entitles them to the autonomy of medical decisions and fair treatment, which should include a say in all decisions. Barbara Coombs Lee, president of an advocacy group called Compassion & Choices, says, “We don't promote just one choice (in end-of-life decisions). We think people deserve an entire spectrum of choices, but people who are mentally alert and who are making a rational decision to choose — not life or death, because that decision has already been made — but when and how they will meet death, those people deserve a peaceful and gentle option in the dying process” (Karaim). This quotation is important because it reveals how the ill patient is going to die regardless of if they use lethal medications that they are prescribed by their doctors. In other words, these patients are not choosing death, but rather have come to terms with the fact that they will die and would like a choice in ending their life without pain and suffering.  If they are capable of making a rational decision and are accepting of the fact that they are facing end-of-life decisions, then they should be given the power to determine when they will die. Patients that seek to end their life want to take this path because of the loss of ability to engage in activities that make life enjoyable, loss of dignity, and loss of control of bodily functions. In this condition, they are not living the life that they want and if they would rather die earlier than have to live longer while they are suffering, they should be capable of doing this.

One of the main reasons that patients seek physician-assisted suicide is due to financial implications. Some patients and their families cannot afford to continue paying to treat their illness. Patients and their families are continuing to spend immense amounts of money on medical bills and treatments when they are facing an incurable illness or condition, which is irrational. In some cases, they are going into debt when they do not even want to be alive anymore. There should be other alternatives to how these medical situations are handled when they cannot afford to pay the medical bills. Some doctors encourage physician-assisted suicide so that patients are not increasing their medical bills in their final days if their condition/ illness is terminal. Overall, allowing patients to escape this reality would reduce the financial burden of the health care bills that is placed on their families.

Another reason is because advancements in technology and medicine have altered the way people live. These medical advances are allowing humans to live much longer lives than they otherwise would have. This is not always what is best, especially if you are a patient suffering with no chance of relief. Physician assisted suicide being legalized would allow for not every life to be prolonged. Also, if people were anticipating on choosing this option to end their life early enough, their organs could be harvested and donated to other patients in need or for medical research. This would be beneficial because the organs would still be healthy instead of getting weaker as the patient fought for survival. Planning on physician-assisted suicide would also allow for patients to say final goodbyes to their families and loved ones. The families of the ill, as well as many other people, are uncomfortable with the idea of the patient choosing death even though they know the alternative is pain and suffering. This is primarily due to the fact that nobody knows what will happen after life, and it is hard to imagine losing someone voluntarily. However, being able to make final arrangements will be more likely to put the patient at ease in facing their death and be more accepting of it.

In almost all of the states where physician assisted suicide is legal, there is specific criteria that must be met before a patient can consider this option. If the patient does not qualify to the conditions, then they will not be eligible to receive the medication needed. Some of the criteria include being at least 18 years old, being diagnosed with an incurable disease with an expectance of less than six months left to live, being mentally and physically capable to advocate for themselves, have requests from other physicians agreeing with the diagnosis, and to be living in a state where physician assisted suicide is legal. Having these principles set makes sure that the patient is not being influenced to make the decision and is proficient enough to make it for them. Also, even if they meet the criteria and receive the means to end their own life, it is done on their own terms. This means that if they change their mind and do not wish to proceed with death, they do not have to. This allows for the patient to fully be in control of their death and choose what they want. The physicians of the dying patients are also part of the decision because they approve whether or not the specific patient should be permitted to end their life based on their condition. Each case is looked at differently and the doctor looks at what the patient wants and needs, so physician assisted suicide will not be accepted for everyone that is dying.

A particular example of a highly publicized case is the Terri Schiavo Case. She was a comatose patient that was in a vegetative state for fifteen years after a heart attack. Her husband wanted to remove the feeding tube from her, which would result in her passing away almost immediately. Her parents wanted to fight to keep her alive, and battled her husband in court. The case was heard in several different courts because judges went back and forth debating whether or not to remove the feeding tube. Finally Terri’s husband won the court case at the U.S. Supreme Court level, drawing a lot of attention to the right-to-die movement (Simon). This case led to a great deal of activism with a lot of media representation on both sides of the argument, with many people agreeing with the decision of her husband. Due to the fact that patients that are brain dead with no chance of recovering, their families should have the right to decide when it is acceptable to end life support. In some cases, patients know that they are terminally ill and that there are no medical solutions to their illness or condition. Facing severe amounts of pain with no known cure is detrimental to the patient’s health, both physically and psychologically. Medically, it makes sense to end a patient’s life and suffering if there is no way to improve their health conditions.

Another example is Brittany Maynard, a patient who was suffering from brain cancer and did not want to endure the battle any longer. Maynard moved to Oregon where physician assisted suicide is legal so that she could receive lethal pills to end her life when she chose to. Maynard said, “I refuse to subject myself and my family to purposeless, prolonged pain and suffering at the hands of an incurable disease” ("​Dying Wish: Arguing the Right to Die"). This quotation is just one example of a patient battling an incurable disease who does not want to continue the struggle, and her feelings reflect the opinions of many other patients in her position. In an interview with CBS Maynard talked about how she did not want to die, but she wants to be in control of her life/death rather than letting the cancer take over and control her (Crawford). When she moved to Oregon, she became an advocate for the right-to-die movement and released a nation-wide video, bringing attention to the controversy. Maynard made the decision to end her own life in November of 2014. Her case drew a lot of attention to the movement as well and inspired the state of California to take action into legalizing physician assisted suicide. ("Dying Wish: Arguing the Right to Die") Many people who heard about her story and saw her video were able to understand why she wanted to end her life. Maynard’s personal experience opened up new acceptances and created a better understanding for death with dignity from a dying person’s point of view.

An alternative to physician-assisted suicide is palliative sedation, which drugs the patient into unconsciousness to avoid the pain until they die. The main purpose of palliative sedation is to end the suffering of the patient and find relief to the pain that they are experiencing at the end of their life.  This is a legal option to prescribing lethal doses of pills to a patient seeking to end the pain they are facing. Some physicians believe that this end of life option is humane because eventually it becomes cruel to hearten terminal patients to continue suffering when there is no hope (Chambers). Some of the families, caregivers, and doctors of the patients are concerned with the fact that palliative sedation is an unnecessary option and are too similar to physician-assisted suicide. However, this is not unnecessary because it is essentially finding a relief for the patient, which is the same goal of physician-assisted suicide. 

 On the other hand, there are still many people not in favor of legalizing physician-assisted suicide. There is no constitutional “right to die” and permission of assisted suicide leaves vulnerable and ill patients susceptible to coercion from their families. Patricia King, a Georgetown University law professor said, “Many Americans-particularly the poor, the disabled, the elderly and members of racial and ethnic minorities- worry that if assisted suicide becomes widely available they will be viewed as ‘throwaway people’”(“Right to Die”). Furthermore, the elderly and mental and physically disabled people could feel pressured into choosing physician assisted suicide because they are more vulnerable. If patients are facing an illness that is very expensive to treat and time consuming, they may feel coerced into ending their life to relieve the feeling of burdening their families. Some people against the right to die think that allowing patients to choose physician-assisted suicide will cause family members and insurance companies to try and pursue this decision. However, in most cases the families do not support their loved one dying unless it is what they want and is truly best for them to be out of pain. 

Another reason the opponents of physician-assisted suicide are against it is because they think that physician’s are taking advantage of their medical knowledge. They argue that legalizing it, takes away from the doctors role in society. "Allowing physicians to participate in assisted suicide would cause more harm than good," the American Medical Association's official position on the practice states. "Physician-assisted suicide is fundamentally incompatible with the physician's role as a healer, would be difficult or impossible to control, and would pose serious societal risks" (“Right to Die”). Critics feel that by allowing physician-assisted suicide, doctors will be going against the Hippocratic Oath, which is a pledge for doctors that they will not cause any harm. It also could be said that there is no definite way of knowing if the doctor’s diagnosis is completely accurate. Just because they say there is less than six months to live doesn’t mean they cannot live any longer than that. There is always new technology coming out and a cure could be found to a previously incurable disease. However, some patients do not want to wait to find out if they are suffering so badly and are already facing end-of-life decisions.

Although there are currently only five states with legal death with dignity actions and one with legal actions through court, there are now several states beginning to look into and considering taking action on legalizing death with dignity. For example, Hawaii, Kansas, New Jersey, and Connecticut, as well as a few others, have all started to come up with legislative bills to legalize assisted suicide in their states.  The right to die is becoming more accepted in the United States as people are fighting to legalize it. Throughout American history, many essential laws have been passed regarding basic human rights. Some of these laws include the right to vote for all people regardless of gender, race or religion, gay rights, or the right to privacy. Having the right to die is not all that different. Somebody that has a terminal illness and is suffering should be able to be put out of their pain if they want to because it is the most humane option.
