The aim of the current essay was to present the case for medical aid in dying (physician-assisted suicide) from a healthcare context. It is worthy to note that there is a marked difference between voluntary active euthanasia and medical aid in dying. In the former, life-ending medication is administered at the request of the patient without any form of mediation by the physician (Steck et al. 938). Physician-assisted dying is achieved through the administration of a toxic concentration of barbiturates.
Attempts to decriminalize suicide can be traced back to 1972 when the government of Canada formally decriminalized suicide. Nonetheless, it took 45 more years for the government of Canada to formally legalize physician-assisted suicide in 2015 (Attaran 2080). The delay in approving physician-assisted suicide was attributed to the fact that the practice is a controversial subject from different perspectives. A case in point, religious principles of modern states such as the US, Canada, Italy, and Saudi Arabia influence national legislation. Leading religions such as Islam and Christianity regard all forms of suicide as murder (Yousuf and Fauzi 67). Therefore, it would be improbable for the state to yield to the demands for physician-assisted dying without any form of resistance.
Nonetheless, given the fact that some of the countries in the Western hemisphere have legalized medically assisted dying; the adoption of the practice creates a legal lacuna, because it is not possible for the state to determine whether the practice will be abused by the patients and physicians. In spite of the fact that both the US and Canada have consented to physician-assisted suicide, the debate regarding the merits and the demerits of the practice continues. It is worthy to note that up to the present moment the ethical dilemma concerning the practice has never been fully addressed. A case in point, some physicians and healthcare institutions funded by religious groups are vehemently opposed to medically assisted suicide (Cooperman et al. 3). Besides, dissenting opinions continue to be heard from other quarters.
The administration of medical aid in dying is justified as long as there is foolproof diagnostic evidence indicating that the patient is terminally ill.
Framework and Integration of the Practice
Given the current trends in the legalization of medical aid in dying, it was deduced that physicians, governments, and healthcare facilities are slowing embracing medical assisted dying. A case in point, the practice has already been legalized in five states in the US. Besides, terminally ill patients in the states of California, Washington, Vermont, and Oregon are permitted by the state laws to receive medical aid in dying. The legalization of the practice was achieved through the enactment of special legislation such as the Oregon Death with Dignity Act (Hall et al. 693). The state of Montana required terminally ill patients to obtain a court order before receiving medical aid in dying. A common trend was observed in different countries whereby, the patient had to be terminally ill and likely to die within six months for him or her to be considered for medical aid in dying. Therefore, the framework for physician-assisted suicide and the approach employed to entrench the practice in mainstream healthcare was within the context of the law. A different framework was observed in European countries such as Netherlands, where euthanasia and medical aid in dying were permitted for non-terminal medical conditions (Steck et al. 938).
Justification for Medical Aid in Dying
The case for physician-assisted suicide was also supported by empirical evidence from previous studies. A study by Hall et al. confirmed that close to 10% of terminally ill patients would prefer to accelerate their deaths through physician-assisted dying or any other legal means (693). It is also worthy to note that paradigm shifts were observed in modern societies, as more persons become affluent and exposed to lifestyle diseases. The latter were some of the leading causes of terminal ailments. They may be caused by lifestyle diseases were, in most instances, painful, and they tended to prolong for a long period (Steck et al. 938). Besides, medical intervention measures in such cases only extended the period that the patient was exposed to unnecessary suffering up to a point when their mental estate was compromised. It was in such circumstances that medical aid in dying was most justified. In addition to alleviating pain and suffering, medical aid in dying would help lower the cost of treatment for terminally ill patients, which was extremely high and ineffective (Scitovsky 826). Therefore, the current surge in lifestyle diseases and terminal ailments not only provide a justification for physician-assisted dying, but also raise fundamental questions regarding legal orthodoxies governing the practice.
Another fundamental justification for the adoption of medical aid in dying was the fact that the practice was in line with ethical principles, which were the hallmarks of medical practice. Non-maleficence and beneficence were some of the fundamental principles in medical practice (Luce and White 225). Besides, other principles that governed medical practice included the recognition of the sick person’s right to self-determination; these principles were first postulated by Beauchamp and Childress in 1978 as a guide for medical ethics. In addition, they were enshrined in the Hippocratic corpus. Therefore, a combination of the right to self-determination, the obligation to assist the patient when a need arises (beneficence), and the duty to avoid harm justified the need for physician-assisted suicide in cases when there was no hope for recovery.
Additionally, it was noted that ethical principles obliged the physician to consider the interests of the terminally ill and to continue holding the interests at heart. The patient’s right to self-determination afforded the patient with a right to prioritize and define their needs in the healthcare context. Therefore, it was only imperative for the doctor to meet such needs. Besides, the unwritten code of moral justice posits that terminally ill persons were but a microcosm of the wider society (Luce and White 224). Therefore, they should be treated justly regardless of their health condition. Nonetheless, it is worthy to note that the adoption of ethical principles in medical practice does not provide sufficient justification for physician-assisted suicide, primarily because they only act as a guide that defines the cases that may qualify for medical aid in dying.
Demand for Medical Aid in Dying
According to a study conducted by Steck et al., it was noted that the demand for medical aid in dying was relatively low, given that only three percent of the deaths were attributed to medical interventions in dying (942). It was stated that the demand for medical aid in dying was more prevalent in Europe compared to the US (Steck et al. 942). Besides, specific demographic factors defined the demand for physician-assisted suicide. A case in point, it was noted that male cancer patients were more likely to request medical aid in dying. Besides, the most affected population was between 60-85 years (Steck et al. 942).
One of the fundamental challenges that impeded the widespread adoption of the practice was the fact that medical aid in dying could only be administered to patients who were mentally capable of consenting to the process. In a case study undertaken by Ladouceur, it was noted that it was not always possible for the patient and the family to decide when it was the most appropriate time to request for physician-assisted dying (8). In some instances, the request for physician-assisted dying may be delayed up to a point when it was practically impossible to administer medical intervention before death due to the diminished capacity of the patient (Ladouceur). Therefore, terminally ill patients and their families would need to place a request before it was too late.
Summary and Conclusion
The primary goal of the current essay was to elucidate the merits for medical aid in dying. Given the literature sources reviewed in the previous sections, it was noted that the practice was justifiable taking into consideration medical ethics (beneficence, non-maleficence, a person’s right to self-determination), the high cost of sustaining terminally ill patients, and the pain and emotional distress experienced by such persons. It was specified that the practice was legalized in selected countries in Europe and North America, and the demand for physician-assisted dying was rather low perhaps due to the misconceptions associated with the practice. Nonetheless, it was postulated that the growth in affluence and lifestyle diseases would increase the incidences for physician-assisted dying.