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Homework answers / question archive / Alexander 1 Alyssa Alexander LVN Pamela Rollins M

Alexander 1 Alyssa Alexander LVN Pamela Rollins M

Sociology

Alexander 1 Alyssa Alexander LVN Pamela Rollins M.A. ENGLISH 1302 04 APRIL 2021 Draft- Why Should Physician-Assisted Suicide be Legal Unfortunately, death is a natural part of the life process. But while death is inevitable, an agonizing death with the loss of dignity should not be. Imagine being in the shoes of a person who is terminally ill. Years of your life has been consumed with doctor's appointments, medical treatments and studies, medications that make you nauseous, you have lost your hair, so you wear a wig or head wrap, you are constantly lethargic, and today your doctor tells you your probability of life is six months to a year because your cancer has metastasized to your brain. What thoughts would be going through your head? Do you want to die in your home with hospice care? How much of a burden is this about to become? What will my family say? Do I even want to suffer any further? The questions are never-ending. However, with that being said, if someone is terminally ill and would rather receive physician-assisted suicide than suffer an agonizing, painful death, should that not be their choice? "Many persons approaching death are clinically depressed or have other psychiatric comorbid conditions, and some contemplate suicide." (Snyder and Sulmasy) Yes, contemplate suicide. As a nurse who has personally watched terminally ill individuals wither away right in front of my eyes, I have a particular interest in physician-assisted suicide and for those who may be desperate for Physician- assisted suicide currently or in the future. Physician-assisted suicide is a controversial topic many people find uncomfortable conversing about. Alexander 2 Yale Journal of Biology and Medicine’s article, In Pros and Cons of Physician Aid in Dying, write about a pathologist named Jacob Kevorkian who advertised himself as a death counselor in the 1980s in the Detroit area. He was assisting patients with the self-administration of lethal medications. His first patient ended her own life in 1990. He assisted another one hundred and thirty deaths by suicide over the next eight years. In 1999, he publicly distributed a video of himself euthanizing a patient and was convicted of second-degree murder and sent to prison. After the matter, Kevorkian's physician contemporaries "filed suit against New York's Attorney general, arguing that the State of New York's prohibition against physician-assisted suicide violated the Equal Protection Clause of the Fourteenth Amendment. They argued, in effect, that the right to refuse treatment was effectively the same as the right to end one's life. The Supreme Court ruled in Vacco v. Quill (1997) that there is no constitutionally protected right to die. It left such decisions to the states. The Court also ruled in Washington v. Glucksberg (1997) that a right to aid in dying was not protected by the Due Process Clause." (Dugdale et al.) Oregon passed the first "death with dignity" law the same year, followed by Washington in 2008, Vermont in 2010, and Montana decriminalized it in 2009. It is now decided by the states and is legal in eleven states, including California, Colorado, District of Columbia, Hawaii, Maine, Montana, New Mexico, New Jersey, Oregon, Vermont, and Washington. It appears these states followed suit because they too believe in the quality of life versus the quantity of life. Numerous people believe Physician-assisted suicide is that PSA is unethical and "intentionally ending a person's life is beyond the scope of medicine." (Rosenberg et al.) Physicians take an oath to protect and become an advocate for their patients when they become a doctor. Their oath clearly states, "I will neither give a deadly drug to anybody if asked for it nor will I make a suggestion to this effect." (Procon.org) In Ethics and the Legalization of Physician- Alexander 3 Assisted Suicide: An American College of Physicians Position Paper by Annals of Internal Medicine, it states that “physicians should not participate in intentionally ending a person's life, and that physician-assisted suicide requires physicians to breach specific prohibitions as well as the general duties of beneficence and nonmaleficence. Such breaches are viewed as inconsistent with the physician's role as healer and comforter.” It is believed to be hypocritical of a doctor to take the life of a patient when their role is to heal. American Geriatric Society Members' Views conducted a study on Physician-Assisted Suicide that surveyed one-thousand four hundred and eighty-eight randomly selected American Geriatric Society members via email. There was a total of three hundred and sixty-nine members, about 24.8% response rate, that completed the survey. The results were 47% percent supporting Physician assisted suicide and 52% opposing Physician assisted suicide. (Rosenberg et al.) There are many people that believe Physician- Assisted Suicide is unnecessary and if better palliative care were provided, PSA would not be needed. "Society's focus at the end of life should be on efforts to address suffering and the needs of patients and families, including improving access to effective hospice and palliative care. The American College of Physicians remains committed to improving care for patients throughout and at the end of life." (Sulmays et al.) Yale Journal of Biology and Medicine also shared a survey from Oregon's Death with Dignity Act stating refractory physical pain is no longer the most compelling reason for ending one's life through lethal ingestion. There were a total number of one thousand four hundred and fifty-nine total members. The Oregon data suggest that the vast majority of patients elect Physician assisted suicide because they are concerned about "losing autonomy" (90.6%) or are "less able to engage in activities making life enjoyable" (89.1%). Some fear a "loss of dignity" (74.4%), being a "burden on family, friends/caregivers" (44.8%); or "losing control of bodily Alexander 4 functions" (44.3%). Concern about inadequate pain control was why pursuing lethal ingestion in only 25.7% of cases. (Lydia S. Dugdale et al.) In the 2014, the IOM report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life found that challenges remain in delivering quality end-of-life care to a growing and diverse elderly population, especially regarding access to care, communication barriers, time pressures, and care coordination. Inadequate reimbursement and other disincentives also create barriers to palliative and hospice care. It is believed that if better palliative care were provided to patients in a timely manner, the chances of a patient wanting or considering Physician-Assisted suicide would be decreased. As difficult as this topic may be, one should try to keep an open mind for people with terminal-illness’. "Like abortion, this is an emotional topic. As a geriatric[ian], I have seen situations that could justify suicide. I would rather see this as an acceptable decision/action, as opposed to a lonely ride into the next level beyond life." (Rosenberg, et al.) Ethics and the Legalization of Physician-Assisted Suicide: An American College of Physicians Position Paper By Annals of Internal Medicine also bring up ethical arguments in support of Physician-Assisted Suicide and highlight the principle of respect for patient autonomy and a broad interpretation of a physician's duty to relieve suffering. Proponent’s view Physician-Assisted Suicide as an act of compassion that respects patient choice and fulfills an obligation of non-abandonment. Physician-assisted suicide is a chance for people with terminal illnesses to die on their terms and with what dignity they have. They should not be forced to endure agonizing suffering until the time of their natural death because others believe it is immoral. Life should be about quality, not quantity. "With advances in medicine and technology, individuals with chronic and terminal diseases are living longer but often face prolonged periods of disability and potential uncertainty Alexander 5 related to their conditions. This trend has led to increased attention to PAS as a potential option for patients at the end of life." (Rosenberg, et al.) HIPPA, Health Insurance Portability and Accountability Act of 1996 is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge. The right to die with dignity should be a matter between an individual and their physician. It is rational and understandable to have the belief that Physician-Assisted Suicide is not a "natural death." However, if a person uses empathy and attempts to see how a terminally ill person may feel, it could change their stance on the matter. Put yourself or a family member in a terminally ill individual’s shoes and attempt to see it from their point of view. Their suffering is unimaginable and their choice in physician-assisted suicide should be just that, their choice. If numerous terminally ill individuals have considered or even had thoughts of suicide, what does that make one think? It makes me think they would rather die than suffer any longer. Die rather than be unable to walk or talk, die with remembering who their loved ones are, die with what dignity they have. Obviously, the choice for Physician-Assisted Suicide cannot possibly be easy for the terminally ill or their family, but when life becomes nothing more than misery, pain, and lack of dignity, death might be more desirable. Alexander 6 Work Cited Bibliography Snyder, Lois and Daniel P. Sulmasy. "Physician-Assisted Suicide." Annals of Internal Medicine 135.3 (2002): 209-216. 25 4 2021. . Dugdale, Lydia S, et al. “Pros and Cons of Physician Aid in Dying.” The Yale Journal of Biology and Medicine, YJBM, 20 Dec. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6913818/. Sulmasy, Lois Snyder, et al. “Ethics and the Legalization of Physician-Assisted Suicide: An American College of Physicians Position Paper.” Annals of Internal Medicine, American College of Physicians, 12 Jan. 2018, www.acpjournals.org/doi/full/10.7326/M17-0938. Rosenberg, Lisa J., et al. “Results from a Survey of American Geriatrics Society Members' Views on Physician?Assisted Suicide.” American Geriatrics Society, John Wiley & Sons, Ltd, 2 Dec. 2019, agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.16245. Alexander 7 Erdtmann, Fredrick. “Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.” OUP Academic, Oxford University Press, 1 Apr. 2015, academic.oup.com/milmed/article/180/4/365/4160443. CDC. “Health Insurance Portability and Accountability Act of 1996 (HIPAA).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 14 Sept. 2018, www.cdc.gov/phlp/publications/topic/hipaa.html.

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