This paper aims at successfully presenting the range of ethical norms – specifically, using the reasoned principles propounded by Deontology – which are applicable to the practice of Physician-Assisted Suicide. Corollary to such a goal, this paper likewise aims to lay a moral judgment pertinent to ethical standing of the same, in the hope of informing consequent choices which are to be made relative it.
Physician-Assisted Suicide, it shall be elaborated later, can be plainly described as a deliberate truncation of life decided solely by patients, for reasons which can include, but may not be limited to, being in a state of highly compromised existence due to a permanent debility or significant loss of autonomy, or being in a state of extreme suffering secondary to an prolonged agony and/or excruciating pain, as well as having to face the prospect of the inevitability of an imminent death.
I find this issue worthwhile to discuss since Physician-Assisted Suicide is fast-becoming an accepted alternative to palliative care, in seeking to effectively address the plight of suffering patients. That being said, there are reasons to believe that, no matter how sugar-coated or deflective modern-day connotations of Physician-Assisted Suicide may become, it nevertheless falls under the category of “suicide” – i. e. , the conscious, deliberate and willful taking of one’s life.
And since suicide as such is incurably difficult to justify in respect to its inherent moral basis, I believe that expounding on the topic is a case that needs to be carefully unraveled, especially for healthcare providers who are actively involved in the process of completing the procedures pertinent to Physician-Assisted Suicide.
The central argument and position which this paper adopts lies in arguing that, on account of the inherent harm which suicide impinges in on human life, it is imperative to give healthcare providers the latitude and liberty of terminating any existing relationships with patients opting for Assisted Suicide, following the dictates of their ethical reasoning or the demands of their religious moral stipulations. Analysis of Physician-Assisted Suicide from a Professional Perspective
There are good reasons to believe that Physician-Assisted Suicide presents an ethical dilemma for healthcare providers, not only because their ethical beliefs can be violated by the mere concept of assisting in a suicide procedure, but also because the completion of the act necessitates their professional participation. Herein it is necessary to distinguish the patent difference between Physician-Assisted Suicide and legitimate Euthanasia.
On the one hand, Euthanasia operates on the principle of “letting die” – i. e., that there is no moral obligation to resuscitate or prolong the life of a patient when imminent and inevitable death is palpable, inasmuch as when the prospect of letting him or her live results to an existence bereft of autonomy or consciousness to say the least. Many ethicists distinguish further the difference between the implications of active – i. e. , that which is induced to patients – and passive euthanasia – i. e. , that which omits unmeritorious tools to prolong life; and they appear to be unanimous in affirming that passive euthanasia is a morally justifiable stance.
Baird and Rosenbaum state: Letting die involves omitting the steps necessary to prolong life, such as failing to resuscitate a patient in heart failure, withholding penicillin from an elderly person with pneumonia, or ceasing chemotherapy for a cancer victim. If a physician enters a hospital room and turns off the machines that sustain life, that physician is doing something active, but turning off machines that sustain life is normally thought to be a form of passive euthanasia. (1989, p. 10).
On the other hand, Physician-Assisted Suicide implies “the physician helping to bring on the patient’s death by providing the means to do it, but the patient performs the lethal action” (Bunch, 2005, p. 3). If with passive Euthanasia, the involvement of healthcare providers lies in providing palliative care or making patients’ suffering more bearable, Physician-Assisted Suicide necessitates their direct involvement in the completion of the suicide, however indirect such participation may be liberally construed.
For while the sole responsibility of ending life rests into the shoulders of the patients themselves, the nature of Assisted Suicide essentially involves giving the patients the material provisions – e. g. , machines and/or tools – necessary for them to execute the truncation of their lives. It is therefore not for nothing that the procedure is succinctly called “Physician-Assisted”; for by right of analysis, it is not entirely incorrect to surmise that healthcare providers are being made accessory to a “crime”, owing from the fact the procedure is akin to helping a person commit suicide.
Analysis of the Issue from the Ethical Perspective of Deontology; Against Utilitarianism It is axiomatic for any ethical dilemma to have two conflicting sides. As for Physician-Assisted Suicide, “the underlying debate is…(whether) the individual’s role in his or her death should be…active, self-assertive (in that it) may include ending one’s life…or acceptant, obedient and passive…where ‘allowing to die’ is the most active step that should be taken” (Battin, 2005, p. 5).
On the one hand, one may be led to consider that Physician-Assisted Suicide is justified on a more utilitarian ground: i. e. , the beneficial end for which an act is pursued, say, to provide patients a way deliver themselves from their suffering, renders the act morally justifiable (Henry, 1991, p. 46; Mill, n. p. ). Put simply, the principle of utility maintains that the end of a certain human action is necessarily the standard unto where morality should be based.
To this end, it helps to cite that the most prominent advocate of such stance is the infamous Dr. Jack Kevorkian – a physician who claims to have assisted hundreds of death, and who, in the course of his advocacy, has developed a suicide machine called “Thanatron” – a deathbed equipped with a trigger attached to lethal substances which, if pulled by patients, can induce them into the process of dying (Bunch, 2005, p. 6; The Kevorkian Verdict, 2008).
On the other hand, the issue needs to be appreciated under the lenses of Deontology; for only in emphasizing the duty to uphold what is right, at all times and in all circumstances, can healthcare providers realize the weight of the moral implications involved in assisting in a suicide procedure.
Commonly applied to the field of professional work, the principle of Deontology contends that each person has the moral obligation to do what is morally upright, not on account of its beneficial outcome which may ensue from pursuing it, but precisely on account of upholding the inherent goodness that marks the choice of acceding to the dictates of moral law (Marta, et. al. , 2008, p. 592).
As for healthcare providers, their sacred duty lies in promoting the welfare of their patients. This further implies that they are mandated to avoid any kind of action or intervention which disrespects their duty to protect life at all cost. And since Assisted-Suicide, as indeed all types of suicides, constitutes a gross violation against the sacredness of human life, healthcare providers are therefore demanded by moral law not to take part in such procedure.
For even if Physician-Assisted Suicide is argued to serve the best interest of the pain-gripped patients, it nevertheless renders all other palliative possibilities void to even warrant an evaluation, and thereby dismisses the importance of other alternatives to help them exist humanely with the help of families, loved ones, or friends. Life is, at the very least, good; and this is exactly the basic premise which is presupposed by the reasoned principles of beneficence and nonmaleficence.
Accordingly, healthcare providers are tasked to exhaust and pursue every and all means necessary to care for the welfare of the patients, and thereby are mandated by law to avoid doing them any harm, precisely on account of the fact that human persons are believed to inherently possess a type of dignity and worth unlike any other creatures of this planet. Which is why, many ethicists and church-moralist demand that healthcare providers must not be permitted to ‘consent to’ Physician-Assisted Suicide, or any acts of similar kind and nature, whether implicitly or explicitly (Declaration on Euthanasia, no. 2).
For if, in the ultimate analysis, any decision to end suffering by truncating life altogether remains to be a gross violation against the intrinsic positivity which characterizes human life, then it is only imperative that concerned individuals – specifically, healthcare providers – must not be in any way forced to attend to any procedure that permits a patient from taking his or her life. Framing Courses of Action Using an Ethical Decision-Making Model In view of the foregoing, it may be wise to lay herein the possible courses of action as a response to the ethical dilemma generated by Physician-Assisted Suicide.
For such purpose, it may be insightful to follow the sequential decision-making model propounded by a number of ethicists (Van Hoose and Paradise, Kitchener, Stadler and Rubenstein to name a few) whose framework basically includes (1) the identification of the problem and moral issues involved, (2) the laying of potential courses of actions, and delimitation of the most viable option/s thereof, and (3) the implementation proper (Forester-Miller & Davis, 1996).
The first step has largely been met in the discussions above. The second step meanwhile requires the identification of prospective courses of action which can be leveled. In view of such need, three courses of actions can be briefly cited. First, after learning the implications relative to Physician-Assisted Suicide, healthcare providers can nevertheless opt to proceed with assisting such a procedure, against the dictates of his or her conscience.
Human freedom, after all, is the final arbiter that chooses which path from among the given possibilities is to be concretely taken. Second, when conflict of interest arise – i. e. , when healthcare professionals’ ethical moorings run against the desire of their patients to truncate their lives – then they can always respectfully call the attention of the authorities directly supervising them, so as to seek for clarification and/or exploration of a possibility of reassignment.
In case such option is denied, then healthcare providers can always invoke the right to dissent and terminate existing relationships with patients who desire to end his or her life, knowing that the risk of silence can prove costly if culture of death is tolerated from within the workplace. Finally, after carefully weighing the consequences of these prospective courses of actions, both for the healthcare providers’ sake and for the sake of practicing an ethically-informed profession within the workplace, as well as for the sake of the patients, then and only then can they implement their decision, and learn from its consequences later on.
Summary and Conclusion This paper now ends with a thought which affirm its initially stated position: that it is imperative to give healthcare providers the liberty of dissenting against any act that may violate their reasoned moral principles, specifically in instances where Physician-Assisted Suicide is involved. If only to sum, the paper argued that the ethical dilemma lays basically on the fact that suicide is a direct violation of the intrinsic goodness of human life.
And since Physician-Assisted Suicide requires the participation of healthcare providers, then those who may have assisted such procedure can be argued to be partly morally culpable in the patient’s commission of suicide. This, by inference, also constitutes serious violations in respect to the principles of beneficence and nonmaleficence, since the two principles summarily express an avowal to use professional knowledge solely in the service of promoting human life.
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