Mentally competent patients should have the right to die.  When a patient deems his or her pain to be too great to bear, and when modern medicine has the means to put them out of their misery, it is morally wrong to make them endure.  Often times, such patients would rather die with their dignity, versus having their family watch them fight a losing battle, and then face the massive financial burden of keeping them alive in a hospital bed.  In some cases in the United States, patients like Brittany Maynard (who had terminal brain cancer) have chosen to move to states where physician-assisted suicide is legal (Zakaria 1).  When laws like Oregon’s “Death with Dignity Act” have already been passed in five states (Richardson 1), it presents a loophole in the system.  If people truly want to choose the route of euthanasia, all they need is a change of residency, and they can make it happen.  When the option is available in five states already, it only makes sense to make physician-assisted suicide federally legal so that terminally-ill patients have the option without having to go through the unnecessary hassle of moving states.  At this point, it only makes sense to allow physician-assisted suicide.

Matthew Donnelly, a patient who had lost a nose, a hand, most of the other hand, his jaw, and was left blind due to cancer and begged his family to end it all.  Every day his family had to live with the fact that Matthew no longer had the will to live; he was simply sitting in a hospital bed hoping that he would die because his pain was so great.  In this situation, the patient was competent enough to regularly express his misery to his doctors and his family, yet he was unable to choose to legally end his life, because he was not necessarily terminally-ill, even though his suffering brought his quality of life to an unbearable level for both him and his family.  His doctors gave him the estimate that he would live for only a year more.  To his brother, this was a year of agony for Matthew.  Because Matthew’s brother went through the guilt of having to watch his brother suffer and beg for death, he took it upon himself.  He took a .30 caliber pistol to the hospital one day and shot his brother to death (Andre 1).  Modern medicine has the means to take such patients out of their suffering.  Although some may argue that the hospital is a healing place, and that modern medicine allows us to keep patients alive for longer, sometimes this only means that modern medicine will draw out suffering.  For Matthew Donnelly, this was the case, so much so that his brother killed him.  Cases like Matthew’s beg the question, “When should a patient be able to choose end their own suffering?”  The answer to that question is simple:  a patient should be able end their suffering when they deem it too great to endure and cannot have a decent quality of life due to their condition.  Families should not have to watch a loved one, a mother, a father, a sister, a brother, suffered endlessly.  Doctors should not be forced to keep a patient alive while they listen to their pleas to end it all.  In some cases, medical workers, like Matthew Donnelly’s brother, were unable to sit complacent with a patient who begged for death.  Barbra Mancini was taking care of her father when a similar situation arose.  She was prosecuted and charged with a felony when she gave her father, John Yourshaw, a lethal dose of morphine after he repeatedly expressed his wish to die (Zakaria 1).  If patients were given the option to control their death’s, families and medical workers would be better off, since they would not have to live with the associated emotional suffering.

Only five states in the U.S. allow physician-assisted suicide (Vasquez 1).  This is striking particularly because some sources have found the general public to be in favor of physician-assisted suicide (Singer, Solomon 1).  Another source found that “two thirds of oncology patients and the public found euthanasia and physician-assisted suicide acceptable for patients with unremitting pain”, and that” “More than half of oncologists had received requests for euthanasia or physician-assisted suicide,” while, “Nearly one in seven oncologists had carried out euthanasia or physician-assisted suicide.” (Emanuel 1).  This leads to one of the biggest problems with physician-assisted suicide:  the issue of when a patient can be considered mentally competent enough to make the decision to request euthanasia.  The same source that found these figures also mentioned the fact that “patients with depression and psychological distress were significantly more likely to have seriously discussed euthanasia” (Emanuel 1).  While this is of particular concern to a lot of people, I would argue that depression and psychological distress are a result of their circumstances.  How could a patient not be distressed and depressed when they are diagnosed with terminal cancer, and when they are in immense suffering?  If a physician is concerned with a depressed patient making a request for euthanasia, perhaps they could refer them to end-of-life therapy, or anti-depressants.  Even then, these two solutions could backfire, resulting in an even worse mental state.  Simply put, depression and psychological distress should not be a factor in determining a patient’s mental competency.  If a patient is in a dark enough place to request physician-assisted suicide, it only speaks volumes to the severity of their case.  More valid arguments are brought up, however, when patients are in a comatose state, as they cannot verbally say, “I am ready to choose euthanasia,” or if a patient suffers from a serious mental condition such as schizophrenia, which can make you delusional.  In such cases, the patient’s true wishes cannot be clearly determined, and euthanasia should not be an option.

Many arguments against physician-assisted suicide are grounded in other aspects of the issue.  I previously mentioned the idea that some argue that the hospital is supposed to be a place of healing, and that doctors are the healers in society (Boudreau 1).  Burke J. Balch, Director of Medical Ethics for National Right to Life Committee makes the argument that physician-assisted suicide should never be permitted and that it is always morally wrong.  He also makes the claim that legislation allowing euthanasia “would be manipulated by the health care industry and by those who regard human life as worthless if the person is not fully productive, engaging, and interacting within society,” (Balch 1).  Balch addresses this issue as if it would be an easy decision for a patient or a doctor to carry out physician-assisted suicide.  As I previously mentioned, my source from “The Lancet”, a peer reviewed medical journal, stated that only one in seven oncologists have actually carried out a physician-assisted suicide.  Euthanasia is not a casual issue, and it is not common place.  Making the option legal in more places would not put any more pressure on patients to end their own lives.  These patients are undergoing very severe pain, and to play it off as if it is not their own decision, or that society sees them as useless, is offensive.  Matthew Donnelly did not choose his illness, but he wanted to choose his way out, and without the means to do so, his brother saw it fit to take care of it himself.  Brittany Maynard took the time to move to Oregon just so she would have the right to die.  Going through the process of changing residencies would surely have allowed her to think about what she was doing, yet she went through with it.  Balch’s arguments, and the arguments of his peers at the National Right to Life Committee simply do not hold up.  There are, however, far more credible sources that argue against the idea of physician-assisted suicide, and much more effectively so.  Craig Paterson, Norman E. Bowie, and Prof. Tom Sorell discuss the issue from a natural law perspective in their book Live Questions in Ethic and Moral Philosophy: Assisted Suicide and Euthanasia: a Natural Law Ethics Approach.  Citing hundreds of medical journals, they credibly and collectively argue that physician-assisted suicide is not “pro bono publico” (not for the public good).  They call all of their readers to try an influence policy away from legalizing physician-assisted suicide and to call for “better hospice care, pain management, and a better response to caring for the ill” (Paterson 1).  This argument is valid, and obviously it would be ideal to have even better hospice care, but frankly, modern medicine has made amazing advancements in just the past one-hundred years, and we have still not been able to eliminate pain and suffering.  Until medicine accomplishes that, if it ever does, physician-assisted suicide should still be on the table.  The idea that hospitals are to be places of healing only furthers the point that physician-assisted suicide should be allowed.  If hospitals are places of healing, and hospice care truly needs to be improved, in the meantime euthanasia is a very valid option.  Euthanasia is a healing option if unbearable pain is something the patient is suffering from.  Leaving someone on to suffer just for the sake of keeping them alive longer, even if they request euthanasia is not a healing practice.  All this accomplishes is emotional suffering for the patient, the family, and the doctor, as well as the financial burden, and the permanent mark left for all who will remember the patient as how they were in the last chapter of their life.  Keeping a suffering patient alive against their request is not conducive to healing; it does the opposite.

Dr. Nikola Biller-Andorno, Director of the Institute of Biomedical Ethics of the University of Zurich, Switzerland, makes the argument that “the role of physicians is not simply to preserve life but also to apply expertise and skills to help improve their patients' health or alleviate their suffering,” (Biller-Andorno 1).  Based on this argument from a reputable and world-famous medical expert, it is indeed wrong for doctors to leave a terminally-ill patient suffering.  A doctor should seek to alleviate suffering if their health will not improve.  On these grounds, Matthew Donnelly should have been granted the opportunity to choose his own death, versus having his brother come to the hospital to murder him.  Dr. Biller-Andorno even furthers my similar point by saying that, “Some patients wish to proactively shape the end of their life; to those patients, taking action to end their life is better than passively waiting for death to occur,” (Biller-Andorno 1).  Why should a patient have to wait in suffering for their death?  Why should a doctor not be able to take the role of healer, and alleviate that suffering?  If anyone is going to make the argument that doctors should be healers and that the hospital is a place of healing, physician-assisted suicide needs to be an option for terminally-ill patients, for whom hope is generally lost.

The Oregon Death with Dignity Act truly makes the act of euthanasia ethically sound.  The qualifications are innumerable, and the procedure has to meet a number or very specific criteria.  One of the most striking, yet important requirements, given in the legislature is that “No less than fifteen (15) days shall elapse between the patient's initial oral request and the writing of a prescription under ORS 127.800 to 127.897. No less than 48 hours shall elapse between the patient's written request and the writing of a prescription under ORS 127.800 to 127.897.,” (127.850 s.3.08.).  Additionally, it requires that the patient be “an adult who is capable, is a resident of Oregon, and has been determined by the attending physician and consulting physician to be suffering from a terminal disease, and who has voluntarily expressed his or her wish to die,” (127.805 s.2.01.).  They must fill out a form indicating that they have spoken to their physician about the possible risks of ingesting their prescription, and what they can expect from it.  In addition to written consent, a patient must give verbal consent as well.  Given these very specifics requirements and instructions regarding the euthanasia procedure, it seems like the Oregon Death with Dignity Act does not take death lightly, contrary to the opinion of many critics, who think that physician assisted suicide undermines the value of life.  It gives a lot of qualifications to be met by patients, ensuring their mental wellbeing, their consent, and their condition, to make them eligible for euthanasia.  The Oregon Death with Dignity Act makes euthanasia a viable an ethical option for terminally-ill patients, while eliminating the possibility of coercion.

Although I believe that in an ideal world, physician-assisted suicide should extend to any patient enduring bad enough suffering to request euthanasia, Oregon’s “Death With Dignity Act” does a good job of regulating those who can and cannot opt for euthanasia.  It limits the option to terminally-ill patients who meet very specific criteria and makes them undergo a process leading up to euthanasia.  I think that this is at least a decent middle ground for the United States, since there is such a controversy around it.  The general public agrees that it should be allowed (Singer 1), but people still have such reservations about the issue, since it is often seen as going too far with medicine, and sometimes even seen as “playing God”, an opinion not even limited to the heavily religious groups.  Death is a huge part of life, and a very heavy topic.  Most people would have reservations when manipulating life and death, which is understandable.  However, it is hard for me to understand just why some argue that it is even remotely okay to allow a suffering (especially terminally-ill) patient on a hospital bed, begging to die. The emotional stress associated with watching a family member die slowly while constantly wishing for death negatively effects all parties involved: the patient, the family, and the doctor.  It simply is the ethical thing to do to allow a patient to decide when to end his or her own life.  Patients should have the right to control their own deaths instead of just being victims to whatever terminal illness may slowly kill them.  Patients generally do not want to be remember in such a negative light, and do not want to leave their families with a huge hospital bill.  If a patient is mentally stable and can competently give their consent, they should be granted the right to die. None of us chose to be born, but we should all be granted the right to a peaceful death with minimal suffering. Euthanasia offers a simple solution to patients who do not want to simply wait for their death to occur. Take a moment to consider the hypothetical situation that you have terminally-ill brain cancer, and your family will have to watch you suffer a long and painful death, and then be left behind with the financial burden of keeping someone on life support for an extended period of time. If you live in the state of South Carolina, the option of euthanasia is not even available to you.  Only if you live in five select states would you be allowed to end your life by your own choice, versus prolonging your and your family’s suffering.  Would you, at that time, wish that you had the option to a death with dignity? I certainly would.
