The Legalization of Physician Assisted Suicide

Izzy Lott

05/05/14

Red Group

Izzy Lott

Red Group

03/31/14

As advances in medical sciences continue to extend our life expectancy, each state-level

government must allow physician assisted suicide to address end-of-life concerns, including the

right to voluntarily terminate one’s own life, the need for clear separation of government

regulation and religious doctrine, and to better allocate healthcare resources. Physician assisted

suicide is the voluntary suicide of a patient with the help of a medical professional. During

physician assisted suicide, a medical professional provides a means of death to a patient, who

then completes the action. Physician assisted suicide allows an untreatable or older patient to

leave the world by their own means, giving them time to say goodbye to loved ones, and then die

without extending any physical or emotional suffering or deterioration. The legalization of

physician assisted suicide is not the same as legalizing suicide or murder, as the patient’s in

question are already aware that their conditions are terminal, and have the option of prolonging

their lives or ending them when they are ready.

Physician assisted suicide has been in debate since Greek and Roman times, in

which it “was centered [on] the Hippocratic oath and the condemnation of the practice” (Boyd

2). Debate over the topic of the Hippocratic Oath became more intense with the surge of

Christianity, leading to the modern problem of separation of church and state. Today, “a growing

number of physicians have come to feel that the Hippocratic Oath is inadequate to address the

realities of a medical world that has witnessed huge scientific, economic, political, and social

changes,” such as extended life span and increased prices of long term medical care (Tyson). So

far, Oregon is the only state to legalize physician assisted suicide, while the states of “Hawaii,

Nevada, Utah, and Wyoming have no controlling law on physician-assisted suicide” (Gloth). In

the other 45 states, physician assisted suicide is considered a crime in the same arena as

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Red Group

03/31/14

homicide and suicide. Although “in 1997, the U.S. Supreme Court ruled that state laws that

criminalize physician-assisted suicide are not unconstitutional,” the decision to criminalize

“physician assisted suicide is a matter that each state may decide for itself” (Gloth). This was

contested in the court cases Vacco v. Quill and Washington v. Glucksberg, in which the court

“upheld the right for states to criminalize physician-assisted suicide” (Boyd 3).

At the federal level, the Controlled Substance Act offers an argument that

“assisted suicide is not ‘a legitimate medical purpose’ for drugs controlled by the federal

government,” but private or state level distributed drugs are not under the scrutiny of this act

(Gloth). In order to increase the acceptability of using physician assisted suicide as a palliative

treatment, the House of Representatives passed the Pain Relief Promotion Act in 2000, but it was

not brought to vote in the Senate (Gloth). Historically, the federal government has allowed the

legalized distribution of drugs for palliative care and the criminalization of physician assisted

suicide to state-level governments and the people within those states.

The population which would be affected by the legalization of

physician assisted suicide would be terminally ill or “untreatable” patients who specifically ask

for end-of-life treatment. A state must respect that a patient who is only deteriorating often

wishes to end their life before they can no longer function as a healthy being. Along with this,

untreatable patients, who are not minorities under the protection and care of a guardian, must be

allowed to end the continuation of both physical and mental suffering brought on by a long term

illness. Unlike the suggestion by the slippery slope argument that says that physician assisted

suicide “will finally reach a point of involuntary euthanasia,” physician assisted suicide only

applies to volunteers, and a doctor cannot go on with the process without the consent of their

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Red Group

03/31/14

patient (Gloth). Unlike euthanasia, in which a medical professional directly places a lethal drug

inside a patient, in a physician assisted suicide situation a doctor gives a patient the means of

committing suicide and allows the patient to take the medication on their own (Gloth).

The legalization of physician assisted

suicide at state-levels directly allows for the right to voluntarily terminate one’s own life when

an untreatable patient is ready to end their suffering and die with dignity. Many people believe

that “legalizing assisted suicide offers no second chances,” but it is only a procedure used on a

terminally ill, or “untreatable” patient with no more second chances available (Golden). New

medical sciences ensure the ability to prolong the lives of untreatable and older patients, but “as

the population gets older we’ve got to think about issues of end-of-life care,” and that some

patients don’t want the promise of a longer life lived out in a hospital (Marker). In many

terminal cases, “death offers the only means of attaining comfort or dignity…from a terminal,

painful, debilitating illness” (Gloth). It is inhumane to deny a human the right to die when they

have an incurable form of suffering, and to take away the dignity of ending life while in

possession of a functioning mind and body. Another point that

arises from keeping physician assisted suicide illegal is that the patients are ready to die, and

may try to commit “botched” suicide. These “failed attempts can cause greater trauma for the

patient and caregivers,” than even the natural course of the disease itself (Gloth). Not only would

the legalization of physician assisted suicide allow for new individual liberties, it would also

decrease the stress and trauma caused to multiple parties in the process of a traditional suicide.

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Red Group

03/31/14

The legalization of physician assisted suicide would increase individual liberties and

autonomy that can only be completed when there is a clear separation of government regulation

and religious doctrine. The debate over physician assisted suicide mainly takes place in religious

forums at state levels, which declare that “the right to commit suicide goes against the idea of a

natural right” (Boyd 1). State-level governments have the obligation to act on the needs of the

majority of people and groups that they govern, and must realize that the rules written into

specific cultures and religious doctrines cannot be a basis for legislation. In a simple Google

search of “groups against physician assisted suicide,” a researcher can find the main outspoken

organizations against physician assisted suicide are the United States Conference of Catholic

Bishops and PewResearch, the religion and public life project. In a Michigan study, a state where

physician assisted suicide is still illegal, 66 percent of the public favored the legalization of

physician assisted suicide, showing that groups following a religious doctrine are in the minority

(Boyd 3). State-level governments must respect the needs of the majority over the minority

groups, and must respect the case-specific needs of the terminally ill.

In order to separate government regulation and religious doctrine, state-level

governments must look to the educated opinions of medical professionals and medical research

in the area of treating someone by physician assisted suicide. In Oregon, a majority of doctors

said they “believed that physician-assisted suicide should be legal” (Boyd 3). According to other

surveys, growing numbers of physicians have begun to feel that the Hippocratic Oath, a

document many use as argument against physician assisted suicide, “is inadequate to address the

realities of a medical world” that have continued to change with modern medicine and illnesses

(Tyson). The original Hippocratic Oath was written by Hippocrates himself in an era with a more

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Red Group

03/31/14

primitive grasp on medicine and terminal illnesses, and can no longer be considered a viable

source for which modern medical professionals can work from. In summary, modern medical

professionals are beginning to believe that physician assisted suicide is a necessity in a post-

Hippocratic world, in which many diseases are proven as of yet to be medically untreatable.

Physician assisted suicide can only be legalized when state-level governments begin to separate

the religious views of their states from their government regulation of individual liberties and

autonomy, and begin to base medical decisions on the research of medical professionals rather

than opinionated religious doctrine.

Physician assisted suicide creates an availability to use the resources of an untreatable

patient on someone that can be saved, rather than prolonging the lives of end-of-life patients. The

legalization of physician assisted suicide will allow for a more resourceful allocation of

healthcare resources, such as medicines and medical personnel. Although physician assisted

suicide is a personal issue for a patient, allowing the practice can be economically beneficial to

both the hospital at which a patient is staying, as well as the family of the patient. As Derek

Humphry suggests in Freedom to Die, “economics, not the quest for broadened individual

liberties or increased autonomy, will drive assisted suicide to the plateau of acceptable practice,”

which is why they must be discussed alongside the concept of individual liberties of a patient

(Marker). Although many families believe it is callous to consider the financial obligations of a

dying family member, the concern is valid. Walter Dellinger, acting solicitor general in 2000,

declared that “the least costly treatment for any illness is lethal medication” (Marker). Sources

can show that a prescription for lethal medication runs at around $35, while long term care can

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Red Group

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go into the thousands (Marker). According to one study, “the last month of life [of a terminally

ill patient] can consume 40% of the total spent on healthcare during the lifetime of an individual”

(Smith). In the last year Medicare spending reached close to $554 billion, or 21% of U.S.

healthcare spending. Within that 21%, almost 28% or $170 billion was spent on the last 6 months

of a patient’s life (Pasternak).

The fear of considering costs of treatment or “pressures from the family and

public have spawned “the ‘slippery slope’ claim…that the right to physician-assisted suicide will

slowly spread to the disabled or mentally competent adults who are not terminally ill,” or that it

“will finally reach a point of involuntary euthanasia” (Boyd 2). However, in physician assisted

suicide, “the physician provides a potentially lethal medication…aware that the patient may

commit suicide,” but the physician does not have the final say in ending the life of the patient

(Gloth). In this way, physician assisted suicide is fully voluntary. As Leonard Fleck, a professor

of philosophy, medical ethics and health policy at Michigan State University puts it, “the

argument is that the government wants to save money by denying the elderly the health care they

need. The truth is that rationing is inescapable if we’re going to control costs” (Pasternak).

Although physician assisted suicide is a case-specific and personal procedure, financial concerns

are valid for hospitals and families to consider when elongating the life of a terminally ill patient.

Although many issues about physician assisted suicide remain, studies

done in Oregon show that physician assisted suicide has been helpful to patients, and that many

medical professionals believe it should be legal. In Oregon, “60 percent of physicians believed

that physician-assisted suicide should be legal,” and that “46 percent said they would prescribe a

lethal dose,” to a terminally ill patient (Boyd 3).

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Red Group

03/31/14

Keeping physician assisted suicide as an illegal practice will only lead to those same

patients being forced to prolong lives of suffering, or committing forms of “botched” suicide,

which can lead to traumatic experiences for the family of the patient and the doctor. Although

there is always the chance of the misuse of physician assisted suicide in hospitals, its benefits

outweigh its faults, and so far its repercussions have been almost completely beneficial, and will

continue in that fashion and at a greater extent if it is legalized.

As medical science continues to grow, each state-level government must legalize

the procedure of physician assisted suicide to address the right to voluntarily terminate one’s

own life, the separation of government regulation and religious doctrine, and a more resourceful

allocation of healthcare resources. Early use of physician assisted suicide in Oregon has yielded

supporting results, and in states such as Michigan the majority of the public are behind the

legalization of physician assisted suicide. Arguments against physician assisted suicide are at

best slippery slopes, and are solely argued through religious doctrine that cannot be used as a

basis for creating government regulations. Physician assisted suicide will increase individual

liberties, separation of “church and state,” and resourceful use of healthcare resources for the

terminally ill towards the end of life.

Izzy Lott

Red Group

03/31/14

Works Cited

Boyd, Andrew D. Physician-Assisted Suicide: For and Against. N.p.: American Medical Student

Association, n.d. Print.

Gloth, F. Michael, III. "Physician-assisted Suicide: The Wrong Approach to End of Life Care."

United States Conf. of Catholic Bishops. N.p., n.d. Web. 29 Mar. 2014.

<http://www.usccb.org/issues-and-action/human-life-and-dignity/assisted-suicide/to-live-

each-day/physician-assisted-sucide-wrong-approach.cfm>.

Golden, Marilyn. "Another View: Assisted Suicide Fraught with Consequences." The

Sacramento Bee: n. pag. Print.

Marker, Rita L. "Assisted Suicide and Cost Containment." Patients Rights Council. N.p., n.d.

Web. 29 Mar. 2014. <http://www.patientsrightscouncil.org/site/cost-containment/>.

Pasternak, Susan. "End-of-Life Care Constitutes Third Rail of U.S. Health Care Policy Debate."

The Medicare Newsgroup. N.p., n.d. Web. 4 May 2014.

<http://www.medicarenewsgroup.com/context/understanding-medicare-blog/

understanding-medicare-blog/2013/06/03/end-of-life-care-constitutes-third-rail-of-u.s.-

health-care-policy-debate>.

Smith, Nicole. "The Positive Aspects of Physician Assisted Suicide." Article Myriad. N.p., n.d.

Web. 30 Mar. 2014. <http://www.articlemyriad.com/positive-aspects-physician-assisted-

suicide/>.

Tyson, Peter. "The Hippocratic Oath Today." PBS. N.p., n.d. Web. 29 Mar. 2014.

<http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html>.

Izzy Lott

Red Group

03/31/14

Annotated Bibliography

Boyd, Andrew D. Physician-Assisted Suicide: For and Against. N.p.: American Medical Student

Association, n.d. Print. The source gives a historical look at the ethical and legal pros and

cons of physician-assisted suicide. The author references statistics from studies done in

Oregon. The source comes from a report published by the American Medical Student

Association.

"Death with Dignity Around the U.S." Death with Dignity National Center. Death with Dignity,

n.d. Web. 23 Feb. 2014. <http://www.deathwithdignity.org/>. The Death with Dignity

site explains the reasons for the Death with Dignity National Center, which works to

legalize physician assisted suicide in the United States. The site provides statistical and

ethical reasons for physician assisted suicide, as well as the bills involved in legalizing

the process.

"Euthanasia and Assisted Suicide." Minnesota Citizens Concerned for Life. N.p., n.d. Web. 29

Mar. 2014. <http://www.mccl.org/euthanasia-and-assisted-suicide.html>. This source

outlines arguments against physician assisted suicide. It educates my arguments in each

paragraph, allowing me to counter arguments made by groups against physician assisted

suicide. 

Gloth, F. Michael, III. "Physician-assisted Suicide: The Wrong Approach to End of Life Care."

United States Conf. of Catholic Bishops. N.p., n.d. Web. 29 Mar. 2014.

<http://www.usccb.org/issues-and-action/human-life-and-dignity/assisted-suicide/to-live-

each-day/physician-assisted-sucide-wrong-approach.cfm>. This source gives useful

distinctions between euthanasia and physician assisted suicide. It also gives the in depth

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Red Group

03/31/14

history of physician assisted suicide in the federal and state-level courts, showing its

progress as of late. 

Golden, Marilyn. "Another View: Assisted Suicide Fraught with Consequences." The

Sacramento Bee: n. pag. Print. This article gives information on the opposing view that

states that physician assisted suicide should not be legalized. It gives background

information on the views of the opposing side, which I used to find better combatting

sources. 

"Hippocratic Oath, Modern Version." Johns Hopkins Sheridan Libraries. N.p., n.d. Web. 29

Mar. 2014. <http://guides.library.jhu.edu/content.php?pid=23699&sid=190964>. This

source shows the modernized version of the Hippocratic Oath, which helps to argue

certain points within my paper. It shows how outdated the Oath is today, and how it

should be changed to allow for physician assisted suicide. 

Marker, Rita L. "Assisted Suicide and Cost Containment." Patients Rights Council. N.p., n.d.

Web. 29 Mar. 2014. <http://www.patientsrightscouncil.org/site/cost-containment/>. This

site gives detailed information on the cost benefits of giving lethal medication rather than

prolonging end-of-life treatment. It informs the paragraphs in which I discuss the

economic benefits of legalizing physician assisted suicide. 

Messerli, Joe. "Should an Incurably Ill Patient Be Able to Commit Physician Assisted Suicide."

Balanced Politics. N.p., n.d. Web. 23 Feb. 2014.

<http://www.balancedpolitics.org/assisted_suicide.htm>. This website gives both pros

and cons for physician assisted suicide. It uses statistics from other sites and reports, as

well as a general overview of the ethical and legal stance of both sides on the subject.

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Red Group

03/31/14

Pasternak, Susan. "End-of-Life Care Constitutes Third Rail of U.S. Health Care Policy Debate."

The Medicare Newsgroup. N.p., n.d. Web. 4 May 2014.

<http://www.medicarenewsgroup.com/context/understanding-medicare-blog/

understanding-medicare-blog/2013/06/03/end-of-life-care-constitutes-third-rail-of-u.s.-

health-care-policy-debate>. This website gives useful data on the amount of federal

spending that has gone into end-of-life care in the last few years. 

Smith, Nicole. "The Positive Aspects of Physician Assisted Suicide." Article Myriad. N.p., n.d.

Web. 30 Mar. 2014. <http://www.articlemyriad.com/positive-aspects-physician-assisted-

suicide/>. This site discusses the economic benefits of physician assisted suicide in

hospitals, giving data from multiple credible sources. This is useful when I discuss the

economic benefits of palliative end-of-life treatment.

Tyson, Peter. "The Hippocratic Oath Today." PBS. N.p., n.d. Web. 29 Mar. 2014.

<http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html>. This source shows

how the Hippocratic Oath has no real valid standing in the modern medical world. It

helps when I argue about the separation of religious doctrine from government

regulation, as well as the individual liberties of a patient.