Palliative Care and Physician-Assisted Suicide

Introduction

Palliative care is a multidisciplinary approach to improving the quality of life and reducing pain and suffering in persons with critical illnesses. Physician-assisted suicide entails a doctor helping a patient terminate their life by giving them the tools and information they or needs to do so (for instance, the physician offers counseling, sleeping pills or other lethal drugs, and information regarding their use, while knowing that the patient might commit suicide). In the United States and around the world, the issue of assisted suicide is a major one. There is a lot of argument regarding whether a terminally ill patient has the freedom to be assisted in dying. Because of religious and ethical objections, some people oppose assisted death in favor of palliative care, while others support it out of respect for the dying (Vandenberghe, 2018). A humane person should conclude that terminally ill patients should be allowed the right to die with dignity to relieve their suffering, decrease the financial burden on their families, and maintain people’s right to decide their fate.

Medical Ethics

The first national articulation of healthcare ethics was a primary goal of the American Medical Association (AMA). The AMA’s primary mission is to advance medical knowledge and public health via education and outreach. A physician’s ethical obligations include loyalty to their patients and consideration for their decision-making processes. Conversely, physicians are not defined entirely by their work. Like their patients, they are moral agents who draw from a wide range of cultural, spiritual, and philosophical traditions (Vandenberghe, 2018). Patients’ demands and preferences may conflict with physicians’ need to maintain moral standing and continuity in their personal as well as professional lives.

It is critical to preserve the medical profession and individual physicians’ integrity by allowing doctors to act (or stop performing) in line with their consciences in professional activity. It is, therefore, essential that the medical profession provide physicians ample leeway to practice following their well-considered, sincerely held convictions (Preston, 2019). Conscious physicians should examine the impact on their integrity, well-being, and the welfare of their patients in each action (or inaction) they take, as well as the implications for other patients, before making any decisions. Additionally, doctors are required by law to follow the principle of voluntary participation and provide patients with information on all treatment alternatives, even those to which they have ethically objected.

Arguments Supporting Physician-Assisted Suicide

Modern medical science in palliative care has made significant advances in extending human life. Respirators can help a patient with a failing lung, and drugs can help keep the patient’s bodily functions running at a steady pace. Individuals who have a reasonable chance to survive an accident or illness are the greatest beneficiaries of medical technology. However, it is only a way to extend the pain of the terminally ill. The goal of medicine is to ease a patient’s pain. In contrast, medical technology in palliative care does little to alleviate the suffering of a patient who is dying. Sometimes pain medication is not enough to ease the symptoms (Gerson et al., 2020). Ending the suffering caused by a disease that no medicine can treat should be allowed for terminally sick individuals. Assisted suicide should be a choice for the terminally ill patient since it is in their best interest.

In addition, the physical pain of a dying person might be terrible to the person’s immediate family members. Friends and family members are left in anguish when they lose a loved one because palliative care failed to save them. Regardless of whether or not a treatment is successful, medicine carries a heavy price tag. Families of terminally sick patients are often unable to afford the treatment. Every day that a competent dying person is kept afloat, the hospital’s costs rise dramatically. The monthly expense of caring for a dying person is estimated to be anything between $2,000 and $10,000 (Vandenberghe, 2018). Just a few wealthy dying patients can afford to purchase more time at the hospital.

Patients from less fortunate backgrounds must bear the financial burden of their deaths. The cost of caring for a loved one who is nearing the end of their life is sometimes overlooked by the loved one’s family. However, when a loved one passes away, the family is left to deal with a hefty hospital cost and is frequently bankrupted as a result. Most people nearing the end of their lives desire a death that is free of suffering and filled with as much comfort as possible (Gerson et al., 2020). It is by no means a consolation to abandon the family’s finances. It is impossible for terminally sick patients who have embraced their inevitable death to save their families from going into debt since they are unable to stop the mounting medical expenditures. Patients nearing the end of their lives should be given the option of medical assistance in dying so that their family’s financial burdens and their pain might be lessened.

Patients and loved ones of those facing a life-ending illness know that the result will be the same no matter how much money they have. It does not matter if palliative care and the ensuing medical bills take up 24 months or 15 years of the person’s life; they will still die with more mental anguish than they required. As a result, there is no need to subject terminally ill persons to more severe pain than they can handle (Gerson et al., 2020). Delaying death by increasing a patient’s level of pain and suffering is no better than allowing them to receive the physician-assisted suicide they desire.

Arguments against Physician-Assisted Suicide

Suicide by a physician is a medical practice that should be avoided at all costs. It should not be an alternative since witnessing the induced death of another human being produces ethical disquiet. Physicians, and other medical professionals, must adhere to a set of ethical and legal standards. Physician aid in dying is a result of subpar medical care. Critically ill patients or in difficult situations in life may find it easier to die with the assistance of a doctor (Gerson et al., 2019). Even if a patient meets all of the prerequisites to acquire this lethal medication, this does not guarantee that they will use this opportunity wisely. A moral wrong does not equal an ethical right. Before providing a patient the tools to end their life, doctors should devote more time and investigation in palliative care to finding a solution to their problems.

Physicians, who are not psychologists, cannot tell if a patient’s desire to end their life is a result of acute depression, which is one of the most common grounds for making physician-assisted suicide illegal. If the practice becomes legalized, people’s faith in doctor-patient interactions could be undermined. Additionally, the elderly and infirm would regard assisted suicide as their responsibility, and patients who may not speak for themselves would still be executed. Because palliative care is an alternative to assisted dying, healthcare providers should advocate for it to save lives (Gerson et al., 2019). Some nurses asked to perform assisted suicide state that they educate the patients on another option, palliative care, which best serves them, where many trust them and do not desire assisted suicide.

Conclusion

Assisted suicide is a problem that has been discussed since the beginning of time; still, no consensus has been achieved. It remains a contentious topic in today’s culture, where many believe that there will be a treatment for all diseases and their underlying medical issues in the future. The government should improve and enhance palliative care programs as well as raise awareness of specialist treatment choices for terminally ill patients in the workplace and society. However, palliative care often prolongs the dying process, resulting in incapacitations, unbearable pain, and indignity. To commit suicide with the aid of a physician, one is provided with the information, the means, or both, necessary to complete the act, such as counseling about fatal doses of medications, prescriptions for such lethal doses, or the provision of drugs. Physician-assisted suicide is a common request from terminally ill patients nearing death. That these individuals are in such pain and that the only way they can end it is by dying under palliative care is heartbreaking. Suicide with the assistance of a physician should be permitted so that those nearing the end of their lives do not have to endure an agonizing death at the hands of their loved ones.

References

Gerson, S. M., Bingley, A., Preston, N., & Grinyer, A. (2019). When is hastened death considered suicide? A systematically conducted literature review about palliative care professionals’ experiences where assisted dying is legal. BMC palliative care, 18(75), 1-13.

Gerson, S. M., Koksvik, G. H., Richards, N., Materstvedt, L. J., & Clark, D. (2020). The relationship of palliative care with assisted dying where assisted dying is lawful: A systematic scoping review of the literature. Journal of Pain and Symptom Management, 59(6), 1287-1303.

Preston, N. (2019). How should palliative care respond to increasing legislation for assisted dying? Palliative Medicine, 33(6), 559-561.

Vandenberghe, J. (2018). Physician-assisted suicide and psychiatric illness. The New England Journal of Medicine, 378(10), 885-887.

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