In this article, a man was found trying to assist his terminally ill wife in her own death. Principally, is this ethical or unethical? Consider the rights that family members have in other medical circumstances. Compare this case to the Terri Schiavo case. What similarities are there? Why is this case ethically different?
(Submitted by Jane Tingley)
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I am inclined to believe that assisted suicide, in cases where the desires of the patient to die are well-established and of sound logic (e.g., the patient is terminally ill or has no true quality of life remaining), is often ethical. However, I would restrict this ethicality to instances of physician-assisted suicide, rather than allow the killing of a spouse (as in the article) or acquaintance without medical guidance, regardless of the person's desire. For assisted suicide to remain ethical, the reasonableness of one's desire to die should be first established, which requires professional assessment of one's condition and prognosis rather than lay judgment. I do believe everyone has a right to self-determination in controlling their own lives, including when and where they die, assuming that result is no longer avoidable and that their decisions do not come at the cost of others' rights or well-being, which in the case of assisted suicide, they do not. By the same token, in upholding the principle of autonomy for patients, patients must be allowed to direct their lives where they please making decisions along the way, including directing the course of their own death. Any norms of society, be they shaped religiously or otherwise, that condemn suicide of any sort ought not supercede a patient's autonomous decisons, even when they conflict.
ReplyDeleteThere are arguments made against the ethicality of assisted suicide that may appeal to a moral imperative not to purposefully destroy a human life or else devalue human lives in general. However, I would argue that physician assisted suicide attempts to preserve human dignity during death by avoiding unwanted treatment or continued pain being foisted on patients. By respecting the patient's desires, human life is not at all devalued. In fact, it is more highly appreciated. Also, though the Hippocratic Oath is often used as an argument against assisted suicide, I also think this is misguided. Though physicians are bound by a duty to do no harm, to treat that statement as unbending is unreasonable. What is harmful is relative, and in the case of assisted suicide, one can argue that respecting one's wishes to die does more good for the patient than actual harm. Where killing a healthy patient may be wrong, allowing a terminally ill patient to die as per his wishes may promote good. The same act has different ethical implications in different contexts. So, overall, to judge the blameworthiness of a physician or patient by the Hippocratic Oath or social norms is fruitless as they are too often relative and open to interpretation. Respect for the patient's rights to refuse treament, to self-determination, and to autonomy are more valid criteria for judging whether doctors and patients act ethically.
So, as long as professional physicians are involved in the process, and the soundness of mind of the patient and the clarity of their wishes are established, in situations of grim prognoses, physician assisted suicide remains ethical.
-Patrick Duggan
This case demonstrates the need for reform of the laws regarding end of life decisions. Medicare, an expense that costs the United States over $300 billion annually, covers 45% of healthcare expenses for people over age 65. About 25% of these expenses are spent during the last year of patients’ lives. These expenses could be avoided by advocating the importance of advanced directives by the elderly. In the case involving Robert Yagi and his wife, it appears his wife does not have an advanced directive stating what actions should be taken while she is terminally ill. It is unfortunate that her husband attempted to take the situation into his own hands by trying to end his wife’s life, both dangerously and painfully, with a gun.
ReplyDeleteThis situation is similar to the Schiavo case because Terry Schiavo also did not have an advanced directive stating her end of life wishes. If insurance companies required their clients over age 21 to choose a surrogate decision maker or write a living will that addressed their end of life concerns, then this country may have avoided both of these situations. Without an advanced directive, families are left to decide how doctors will care for their incapacitated loved ones. Also, doctors and families do not always see eye to eye on the best plan for the patient. These disagreements can lead to messy legal battles simply because the patient did not leave behind a legal document stating his or her wishes.
The fact that Mr. Yagi resorted to the use of a gun also brings up the debate over physician-assisted suicide. Many would agree that it is more ethical to end one’s life with medication rather than a weapon; however, it is difficult for people to accept the notion of physician-assisted suicide because they equate it with murder. I think other states should follow Oregon and Washington’s lead and allow physicians to prescribe lethal doses of medication to competent, terminally ill patients. It is more ethical to allow patients to end their lives than it is to violate their autonomy by keeping them alive via painful and costly means.
I agree, I think that physician-assisted suicide is absolutely ethical in certain situations. The article mentions "death with dignity," which I think is the primary reason that physician-assisted suicide is indeed ethical. If a patient is terminally ill and cannot enjoy a decent or normal quality of life in their remaining time alive, it isn't right to force them to remain alive, especially if in pain or if they are slowly deteriorating (become increasingly dependent on caregivers, i.e. incontinence, assistance with feeding, etc) and are mortified with the changes they are undergoing. The situation in the article is extremely sad in that the man felt that he had no other option than to shoot his wife. It doesn't clarify if the wife even wanted to be killed, though, which is a huge piece of information missing and I think the key point in the whole discussion.
ReplyDeleteIf some sort of legislation or law were to be passed allowing physician-assisted suicide, I think that it should be detailed in the description of the process leading up to the actual humane euthanization. Family members and doctors would have to individually meet with the (terminally ill) patient to determine the motive and reasoning behind their decision. The system could easily be abused by suicidal individuals if there were not proper psychological assessments in place. However, if a patient's life will definitely end due to some sort of terminal illness, why should they not be able to dictate the terms of their own death? If a patient is determined to be mentally sound, family members understand and respect the wishes of the patient, and the prognosis of the patient is death, I believe that physician-assisted suicide is ethical.
I find the topic of physician assisted suicide very interesting. However in this particular scenario it is important to specify that I believe there is a huge difference between the ethics of "assisted-suicide" and "physician-assisted suicide". First off, assisted suicide is still illegal throughout all 50 states. However, physician assisted suicide is permitted both in oregon and washington under the enactment of their Death With Dignity Act. Personally, in scenarios where a patient is diagnosed as terminally ill and their quality of life is being compromised either by pain or life sustaining measure and they make a voluntary decision to request assisted suicide through the help of a family member or friend as their mean to the end, then their autonomy should be respected. However, I do not agree with physician-assisted suicide because I think it opens the door to a very slippery slope. The Hippocratic Oath is spoken by every doctor upon recieving a medical degree and it clearly states they will never give a poison to an individual to whom they are treating and they will do no harm. To me it is unethical to request the help of your doctor in committing suicide when he is the one responsible for keeping you alive and well. I think it would destroy the physician-patient relationships which American doctors strive to perfect. Additionally, the major argument in favor of legalizing physician assisted suicide is the principle of autonomy and respecting a patients will to die. This argument however is flawed because requesting to stop using life supporting medication or treatments is one thing, demanding medication for the choice to overdose is another. The doctor would be respect the principle of autonomy and sieze all life saving procedure however it is not his responsibility to supply you with the means to kill yourself.
ReplyDeleteA person has certain rights in the United States. There are some occasions that we take individuals rights to life away. However, if we grant an individual the right to life, they should also have the ability to take their life away, under certain circumstances, in a humane way. If an individual is suffering from an illness that makes their lives miserable, almost torturous to live, that individual should have the right to end their life. These individuals have to undergo enough hardships themselves, if they are able to comprehensively understand what they want and what that means they should be able to take their own lives, or have someone help them out. Family members have the right to say what happens to an individual under certain circumstances (when an individual is unconscious or otherwise incoherent). However, if a person is coherent and conscious they should be able to take their own life or opt to take their life. This is different than the rights of family members in the case of an emergency. Only the individuals themselves have the right to negate their own life. Therefore the only way an individual can take their own life is if they are coherent or if it is in their will that under certain circumstances they would like their life to end, otherwise another family member does not have the right to decide when the individual’s life should be taken. Terri Schiavo was in a vegetative state for years. She had a do not resuscitate order on originally yet her husband had her on life support and on a feeding tube. Officials would not let him pull the life support or the feeding tube even though it went against her wishes and she was unable to live a life. However, this case the women had a terminal illness but was otherwise happy. She had not, as know to authorities, asked to be terminated by her husband and authorities are unsure if her husband was of sound mind as neighbors said the couple appeared happy. The ethical difference exists in that Terri Schiavo’s will had been taken away when they ignored her do not resuscitate orders and then did not allow her husband to take her off life support. She was in a vegetative state unable to live a happy life and therefore should be allowed to take her life. However in this case the women, as authorities know, did not want her life to be taken and were happy with her life. The difference is that she was happy even though she was dying and not in enough pain or suffering to remove herself from this world; whereas, Terri was in a vegetative state and unable to live an enjoyable life.
ReplyDelete-KEENAN
Aiding in another’s suicide may at the moment seem like a helpful gesture, but in the end is simply murder. If one chooses to take their life (although I don’t condone it) it is their own personal decision and they should never coerce another into participation. In the given situation the husband did not merely aid in a suicide, but attempted to kill his wife. She may have been suffering from a terminal condition, but it is unclear whether she expressed the will to die; even if so, the husband has no right to be the one to take her life. The most important components to a “good death” are the aspects of control, dignity and predictability, all of which do not reflect the happenings in this situation; thus, the proposition that the husband was asked to perform such acts is unlikely. What further leaves me to suppose this to be a murder are the unknowns; for example, what was the husband’s mental state? Did the wife designate her husband as a healthcare proxy? And was there ever any evidence that she wanted to end her life?
ReplyDeleteIn the situation of a health care proxy, an individual is appointed to make decisions on behalf of another if they should ever become unable to do so. In instances such as those, when an individual is unconscious or doesn’t have the ability to make sound choices on their own, it is acceptable to allow another to make decisions for them. This is the only right that family members have regarding another’s life, otherwise no one have the power to take or give life to one that does not want it.
If the situation was as stated above, the assistance in another’s suicide, then the parameters of the situation have several different implications. For example, the expressed want to end one’s life would be present. Therefore, although there is another entity assisting in the suicide, the wife would have still been granted autonomy and respect for her personal wants and desires. However, the main ethical difference in that situation and that of Terry Schiavo is that Terry’s autonomy was completely disregarded. Due to Terry’s unconsciousness all intrinsic value she possessed was completely disregarded, and unwillingly Terry’s life was ended. As stated before, most simply want a sense of control in regards to their own death, this doesn’t mean that I am an advocate for suicide, but rather the spreading of knowledge regarding hospice service and others of the sort places where one can end their life in a pain free and dignifying manner.
I think that this man trying to help his wife in her death is ethical if it is clear that this is what she wanted. Although some may say that assisted suicide is unethical because you are “killing” somebody, the person’s autonomy should be respected. Yes, the man also has a duty to perverse life and to act beneficently, but the woman also has her right to autonomy. I think the way one feels personally regarding the issue, from an ethical stand point, says a lot about what values and rights the person holds to a higher regard. If somebody is against this man trying to help his wife in her death, aside from religious reasons, they probably feel that their duty to preserve life and not to harm anybody is far more important than respecting one’s wishes. But the opposite is also true. As I feel, a person’s right to autonomy far outweighs our duty as a whole to preserve life, because if we take away our right to autonomy we are taking away our rights to make every basic decision about our lives. Much in the same way terminally ill patients sign DNRs, this woman simply made a choice regarding her death and how she wanted to die. Her choice, and her right to make that choice should be respected.
ReplyDeleteTorri
This is an extremely sensitive issue and one that I am conflicted on. I am not sure that assisting suicide is ethically sound on the basis that all life is sacred. In this country we view suicide as a crime, and one that should be avoided. Police officers have the right to assess certain sucidal citizens and place them on suicide watch to avoid deaths resulting from suicide. Allowing assisted suicide is like opening a can of worms. What if I am a 20 year old, found to be mentally competent and I want do die? Would anyone be able to go to a physician and request death? I feel the that allowing physician patient suicide could set a dangerous standard and precedent.
ReplyDeleteHowever, on the other side, if specific regulations were brought into place, such as only those terminally ill would have the options, prehaps this can be deemed more ethically sound. If regulations are to who, is allowed to seek assisted suicide and counseling is provided for the individual and family invovled.
Lastly I think its important to note the doctor's point of view. Is it ethical to ask a doctor to even end a life? Under what circumstances? If a doctor takes an oath to do no harm, is this casuing harm? or are the benefits greater than the consequences for ending an individuals life? And what if doctor's don't believe this is ethically sound and do not want to participate? Would they be allowed a choice? or would it be mandated that they perform this service?
In conclusion, in order for this to be somewhat ethicially sound, I think many regulations need to go into affect and many questions need to be thought out and carefully addressed.
-A. Rabens
If a patient has a terminal illness and they have expressed in their views before(advanced directed, etc) that they wish to have no life sustaining procedures or treatment, and they do not want to live to suffer through an inevitable death, than I believe physician-assisted suicide is ethical. The only situation this can be ethical in is one in which the patient has expressed this view and made it clear. It is not ethical to make someone suffer and live their last time in pain. If someone wants to go peacefully, then they should be able. The similarities that this case presents with the Terry Schiavo case are that it needs to be clear the intents of the husband. In Terry Schiavo's case it as not clear that the husband was looking out for the best interest of his wife. The plea to end of life decision must be consistent with the values and morals of the persons life. In the Schiavo case, it was unknown what she truly wanted, just as it is in this case.
ReplyDeleteIn response to the case involving the 71-year old man who shot his wife- I think that the ethics behind this issue rely a lot on what his wife wanted and exactly how the act was carried out. If the wife, who is dubbed as being terminally ill, wanted to end her life that way, then her husband was only complying with her wishes. However, was shooting her really the answer and how does it compare to physician-related suicide? Isn’t it really the same thing- Both the husband and physician providing the means to an end?
ReplyDeleteIt’s every person’s deontological right to reserve their choice for a ‘death with dignity’. Relating this to doctor assisted suicide, if the patients is suffering from a terminal illness they have the right to end their suffering. It is important to discuss what exactly happens in physician-related suicide. The physician does not actually inject the patient with a deadly dose of drugs, but instead provides a prescription or ‘the means’ for the patient to make the final decision.
This being said there is a difference between a physician-related suicide and what the husband tried to do for his wife. But holding the gun and shooting her the husband violates his wife’s deontological right to choose when she dies. Regardless of whether she wanted to die, he pulled the trigger, she did not. For this reason I would not be surprised if a court ruled in favor of attempted murder.
I agree with Patrick in that assisted suicide should be ethically defensible in which the desires of the patient to die are well-established and of sound reasoning. The patient must have a medical reason for ending their life, as in terminal cancer, excruciating pain for prolonged periods and an absence of consciousness. As Patrick has mentioned, it should only be defensible with physician-assisted suicide and not “spouse-assisted suicide” as there are possibly more complications than with a using a physician. Physicians have the ability to evaluate the patient and gauge how much pain they are in. Physicians also have the ability to survey the status of the patient and perhaps asses their chances of survival in the near future. Only after these conditions have been met, can physician-assisted suicide take place because otherwise there would be too many unknowns and physician-assisted suicide could possibly run rampant. The worst case scenario would be a physician murdering patients. Additionally, multiple physicians should evaluate the patient to minimize complications and prevent conflict of interests. Patients have rights to their own body and they should decide how they want to end their life. A logically sound patient with a terminal illness or unbearable chronic pain will not suggest suicide unless they really mean it. Only after these conditions have been met is physician-assisted suicide ethical.
ReplyDelete-Lawrence Yu
As a person who is in favor of assisted suicide, this seems like an easy issue for me to side with. This 71 year-old-man shot his terminally ill wife in an attempt to ease her pain. However, the problem has less to do with whether assisted suicide is ethical or not, and more to do with the fact that no one has proof for or against his claim that she wanted to die.
ReplyDeleteIf physician assisted suicide is not going to be legal, there need to be regulations put into place that legally cover people who have assisted their loved ones in suicide. Whether this man is guilty of murder or of love, he will be put on trial for attempted murder. If this man is found guilty, he could go to jail for 25-life, possibly because he cannot prove his wife actually wanted to die. Hopefully in the future, people will take into account the fact that the people who assist loved ones in suicide, are heros in the eyes of the dead, and should not be portrayed as murderers in the eyes of the living.
-Jessie Kavanagh
Though the thought of assisted suicide could seem immoral, or even repulsive to some, I am of the opinion that it is certainly an option that should be made available for those who need it. Disregarding the potential for possible abuse by doctors into "egging" people on to choose assisted suicide, allowing someone to choose the way they go is perhaps the most power of autonomy that individual may have.
ReplyDeleteMany people die everyday in accidents or situations that are beyond their control. At the same time, though not uncommon, people die peacefully as well. However, there are the unfortunate few who have to live out the last moments of their life in excruciating pain and/or discomfort. Who are we to say that it was more benefitial to these people to leave the world with only pain as the last memory etched into their mind?
As Jessie said, (I will quote this, since I feel it is such an aptly put, and powerful statement) "Hopefully in the future, people will take into account the fact that the people who assist loved ones in suicide, are heros in the eyes of the dead, and should not be portrayed as murderers in the eyes of the living."