Physician-Assisted Suicide ~An Examination of Ethics and Dignity at - PowerPoint PPT Presentation

Physician-Assisted Suicide ~An Examination of Ethics and Dignity at the End of Life~ Breanne Parets

The Hippocratic Oath “I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect ” -Hippocrates (ca. 400 BC)

Legality of PAS by State

Outline  Background Information  Arguments For and Against  Biblical Texts, Christian Doctrine, and Worldview

Eligibility Requirements  Mentally competent  Over 18 years old  Resident  Terminal illness, less than 6 months  Capable of self-administration

Procedure  Two oral requests  Written request with two witnesses  Physician attestation of mental capacity  No coercion  Minimum of 17 days to complete

Diagnosis and Prognosis Common Diagnoses in cases of PAS: Washington (2015) Oregon (2016) Cancer ALS Cancer Neurodegenerative Disease Heart Disease Other Unspecified

For Physician-Assisted Suicide Autonomy: A person’s rational capacity for self-governance or self-determination Autonomous persons have the right to die if they so choose

Against Physician-Assisted Suicide Neither “the presence nor the intensity of pain” were in any way associated with a desire for a hastened death From The Primary Care Companion to the Journal of Clinical Psychiatry: Official Journal of the Association of Medicine and Psychiatry

For Physician-Assisted Suicide No one wants to spend their last days in the relative comfort of palliative care Even just the fear of increasing pain, discomfort, and dependence is more than enough to burden patients

Against Physician-Assisted Suicide Most requests for PAS are based on depression and fear Rather than killing people, end of life care needs to focus on caring for the entire well- being of patients and their loved ones

For Physician-Assisted Suicide People do not choose PAS because of the pain, physical or otherwise, but because of the indignity of being helpless and dependent on others If a terminal patient wants to die with dignity, let him die!

Against Physician-Assisted Suicide “Every suicide, and especially an assisted suicide, represents a failure of the human community to affirm the value of a person’s life” -American Life League

For Physician-Assisted Suicide At the end, maintaining the quality and dignity of one’s life is more important than the desire to merely extend one’s life When the time comes, euthanasia may be the only way to free people from their agony, and it is therefore the merciful thing to do

Against Physician-Assisted Suicide Calling it physician-assisted suicide is a euphemism The American Medical Association rejects physician-assisted suicide because they believe it to be “fundamentally incompatible with the physician’s role as healer”

For Physician-Assisted Suicide A physician’s obligation is not only to preserve life, but also to minimize suffering When the only way to eliminate suffering is to end life, it may be the merciful thing to do

Against Physician-Assisted Suicide It’s a slippery slope… Allowing PAS opens the door for abuse and exploitation, and may lead to the legalization of euthanasia at large

What is Human Dignity? Autonomy and the Perceived Quality of Life vs. Humanity and the Endowed Sanctity of Life

Physician-Assisted Suicide is a Tragedy

Psalm 139:13 “For you formed my inward parts; you knitted me together in my mother’s womb. I praise you, for I am fearfully and wonderfully made”

Summa Theologica “To bring death upon oneself in order to escape the afflictions of this life is to adopt a greater evil in order to avoid a lesser” - Thomas Aquinas

Dietrich Bonhoeffer “God has reserved to himself the right to determine the end of life, because he alone knows the goal to which it is his will to lead it”

The Gospel of Life “It is never licit to kill another: even if he should wish it, indeed if he request it because, hanging between life and death, he begs for help in freeing the soul struggling against the bonds of the body and longing to be released; nor is it licit even when a sick person is no longer able to live” - St. Augustine

Philippians 2:4 “Let each of you look not only to his own interests, but also to the interests of others” 1 Timothy 5:8 “But if anyone does not provide for his relatives, and especially for members of his household, he has denied the faith and is worse than an unbeliever”

Psalm 139:16 “Your eyes saw my unformed substance; In your book were written, every one of them, the days that were formed for me”

Even in the midst of suffering, even when a patient has only days left to live, he is still valuable in God’s sight If God values the life of the terminally ill, then so should we

Bibliography  Allecial, J. (2016, April 4). Death with dignity doctors create new medication. In American Pharmacists Association . Retrieved April 30, 2017, from https://www. pharmacist.com/ death-dignity-doctors-create-new-medication  Anderson, R. (2015, March 24). Always care, never kill: How physician-assisted suicide endangers the weak, corrupts medicine, compromises the family, and violates human dignity and equality. In The Heritage Foundation . Retrieved April 30, 2017, from http:// www.heritage.org/health-care-reform/report/always-care- never-kill-how-physician-assisted-suicide-endangers-the-weak  Aronczyk, A. (2015, February 10). When your doctor gives you '12 months to live,' here's what that really means. In WNYC News . Retrieved April 30, 2017, from http://www.wnyc.org/ story/how-long-do-i-have-doc/  Assisted suicide laws in the United States (2017, January 6). In Patients Rights Council . Retrieved April 30, 2017, from http://www.patientsrightscouncil.org/ site/assisted-suicide-state-laws/  Barbiturates (2017). In Drugs.com: Know more. Be sure . Retrieved April 30, 2017 from https:// www.drugs.com/drug-class/barbiturates.html

 Barbiturates drug profile (2015, January 8). In European Monitoring Centre for Drugs and Drug Addiction . Retrieved April 30, 2017, from http://www. emcdda.europa.eu/publications/ drug-profiles/barbiturates  Battin, M. P., van der Heide, A., Ganzini, L., van der Wal, G., & Onwuteaka- Philipsen, B. D. (2007, October). Legal physician-assisted dying in Oregon and the Netherlands: Evidence concerning the impact on patients in "vulnerable" groups. Journal of Medical Ethics, 33(10), 591-795. Retrieved April 29, 2017, from https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC2652799/  Bauer, A. (2014, August 14). Talking with your doctor about prognosis. In Cancer.Net . Retrieved April 30, 2017, from http://www.cancer.net/blog/ 2014-08/talking-your-doctor-about-prognosis  Brock, D. (1992). Voluntary active euthanasia. In Hastings Center Report, 22 (2).  Brody, J. E. (2007, March 6). Tough question to answer, tough answer to hear. In The New York Times . Retrieved April 30, 2017, from http://www.nytimes. com/2007/03/06/health/ 06mbrody.html  Chapple, A., Ziebland, S., McPherson, A., & Herxheimer, A. (2006, December). What people close to death say about euthanasia and assisted suicide: A qualitative study. Journal of Medical Ethics , 32 (12), 706-710. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563356/  Colorado. (n.d.). In Death with Dignity . Retrieved April 28, 2017, from https://www.deathwith dignity.org/states/colorado/

 Culp-Ressler, T. (2014, December 17). Most doctors in the United States now support 'Death with Dignity' laws. In ThinkProgress . Retrieved April 29, 2017, from https://think progress.org/most-doctors-in-the-united-states-now-support-death- with-dignity-laws-8888c575c2ea  Doctors often misdiagnose the terminally ill (2015, December 7). In Vermont Alliance for Ethical Healthcare . Retrieved April 30, 2017, from http://www.vaeh. org/doctors-often-misdiagnose-the-terminally-ill/  Euthanasia and physician-assisted suicide (PAS) around the world: Legal status in 28 countries from Australia to Uruguay (2016, July 20). In ProCon.Org: The Leading Source for Pros & Cons of Controversial Issues . Retrieved April 29, 2017, from http://euthanasia.procon. org/view.resource.php?resourceID=000136  Euthanasia terms and definitions (n.d.). In American Life League: Building a Culture of Life . Retrieved April 29, 2017, from http://www.all.org/learn/euthanasia/ definitions/  FAQs (n.d.). In Death with Dignity . Retrieved April 29, 2017, from https://www. deathwith dignity.org/faqs/  Finn, J. W. (2006, June 1). Determining prognoses for patients with terminal illnesses. American Academy of Family Physician , 73 (11), 2062-2067. Retrieved from http://www.aafp.org/ afp/2006/0601/p2062.html  Gloth, F. M. (n.d.). Physician-assisted suicide: The wrong approach to end of life care. In United States Conference of Catholic Bishops . Retrieved April 30, 2017, from http://www.usccb. org/about/pro-life-activities/respect-life-program/ physicianassisted-suicide-the-wrong-approach-to-end-of-life-care.cfm