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A Merciful Alternative for the Terminally IllIn normal everyday life, we do not really thinkabout how we are going to die. We try to live our days one day at a time.Rarely do we ever plan or look forward into the future unless somethingabnormal or unpleasant forces us to.

For many people,terminal illness is one of those circumstances that force them to think aboutwhat lies ahead. In a season of the show AmericanHorror Story, a man by the name of Edward Philippe Mott tells a couple who are runningfor their lives: “The living cling tolife above all, but the trophy misprized is to die in peace” (“So, Is ItOver?”). This quote strongly supports the idea that humans spend too much timetrying to live longer, that they forget to think about how they wish to die. Deathis inevitable and we all want to die peacefully, whether that is in our sleepor by a sudden heart attack. We might be suffering in some way as we prolongour life and we might even find that our lives haveless value because of the specific kind of suffering that we are going through.But there comes a time when we have to decide how we would like to go out.

Dowe want to spend the last months of our lives suffering and in pain or do wewant to be able to control how and when it happens? Of course, we want to avoidas much suffering as possible. What Edward did was give them a choice to letthem decide on a peaceful way to die compared to a death filled with agony.Similarly, physician-assisted suicide should be a possible alternative forterminally ill patients.Physician-assisted suicide (PAS) refers to when a physician aids acompetent, usually terminally ill, patient end their life with a painlesslethal dose of medication.

The patient then decides when and if to take thelethal dose to end their life. For the past half century the topic of PAS hasbecome increasingly talked about and controversial. There have been variouscourt cases and public opinion disputes related to this topic. It has been so talked about that we have seen theconventional stance become more challenged; so much that the state of Oregonvoted to fully legalize PAS.

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A couple more have followed then after andnow as of this year; PAS is legal in 6 American states (Oregon, Washington,Colorado, California, Montana, and Vermont) and the District of Columbia. Thisis a very controversial topic that seems to be almost divided in two by thepublic eye. The main proponents of these disputes are individuals who are male,young, and white, while the main opponents are religious organizations such asthe Roman Catholic Church and advocates for Disability Rights. Competency,life, and abuse are at the very root of this debate.

Life is a beautiful andunique thing that should not be easily thrown away, but what is the purpose of livingif it is spent suffering? PAS is a merciful procedure which should be an optionfor the terminally ill to pursue with the assistance of their doctors in theUnited States because it can be compassionate, cost-effective, and it is acivil right.            The “right to die” movement in the United States has beengoing on for quite some time. A hallmark of this movement was the Death withDignity Act (DWDA) which was passed by Oregon in 1994. As an article from the SouthernCalifornia Interdisciplinary Law Journal states:                         “Oregon became the first state to allow doctors toprescribe a lethal dose of                                 medicine to terminallyill patients who request it.

Under this law, those seeking                              assisted suicidefrom a physician must be “18 years of age or older.” A patient                                 seekingthis assistance must be diagnosed with a terminal illness, which is a                                    determination made by an attending physicianand a consulting physician. For the                                    purposesof this act, a terminal illness isdefined as “an incurable and irreversible                                 diseasethat has been medically confirmed, andwill, within reasonable medical                              judgment, producedeath within six months” (Stillman 276).            This quote helps us understand how specific this act ismeant to be since this is a serious topic. The rest of the Act is much moredetailed explaining the procedure and much more. The DWDA paved the way forother states to develop their own Acts legalizing PAS with Oregon’s as a model.California’s End of Life Option Act and Washington’s Death with Dignity Actboth parallel Oregon’s in the fact that the “patient seeking treatment iseighteen years of age or older, that there are two doctor requests, and thepatient is six months away from death” (277).

In addition, the “right to die”movement has been heavily influenced by the type of language and terminologypeople use to describe it. Both proponents and opponents change the terms foror against their views. PAS is usually considered as physician aid-in-dying by theproponents because death is usually already imminent and the option to choosewhen and where is offered, while opponents focus on the negative connotation of”suicide” because we usually perceive suicide to be negative. A commonmisconception is that people do not think there is a difference betweeneuthanasia and PAS, however, euthanasiainvolves another person, whether that be a physician or not, actively giving alethal substance to a patient. Muscle relaxants are a common form of the lethal substance in which a physician mightuse.             One of the first faces of the “right to die” movement wasDr. Jacob “Jack” Kevorkian.

He was a “humane hero who courageously fought forthe rights of suffering people to fulfilltheir death wishes” (Stafford par. 2) by the methods of active euthanasia. Dr.Kevorkian was compassionate for patients who had terminal situations andbelieved in absolute autonomy of humans and specifically females when talkingabout abortion.

After Kevorkian’s passing, Brittany Maynard became the new facefor the “right to die” movement and gained increased media coverage andattention. She was a young, 29-year-oldwoman who was recently married and soon found out that she had terminal braincancer. After being diagnosed she decided to become an advocate for otherterminally ill Americans by joining the end of life choice organization,Compassion, & Choices. She statesthat: “We had to uproot fromCalifornia to Oregon, because Oregon isone of only five states where death withdignity is authorized. I met the criteria for death with  dignity in Oregon, but establishing residency            in thestate to make use of the law    required a monumental number of changes. I had to find newphysicians, establish    residency in Portland, search for a new home, obtain a newdriver’s license,            change my voter registration and enlist people to take careof our animals, and my husband, Dan, had to take a leave of         absence from his job. The vast majority of     families do nothave the flexibility, resources and time to make all these changes”(Maynard par.

11-12).That is why she wanted to make it easier for others who have beendiagnosed with a terminal illness so that they donot have to go through all of the difficulties that she had to go through.Brittany Maynard’s story inspired and aided California in the legalization of PAS. The lives of terminally ill patients change drastically after theyare diagnosed, and more change soon follows. More often than not patients aregoing to be going through a lot of difficulties.

A group of bioethics andhumanities professors from the University of Washington School of Medicinepublished an article which states: “Sufferingmeans more than pain; there are other physical, existential, social andpsychological burdens such as the loss of independence, loss of sense of self,and functional capacities that some patients feel jeopardize their dignity” (Starkset al par. 13). As healthcare providersphysicians need to focus on their patient’swell-being and how they can best ease their pain. It is important to have goodcommunication skills to understand the needs of the patients and theirfamilies. Through listening, physicians will be able to accurately understandand comfort patients if needed.

Similarly, compassion is an important part ofany healthcare job and giving patients options helps immensely. Givingcompassionate medical care not only means that you are a kind and respectfulhealthcare worker who values the wishes of the patient, but it also means thatyou do not treat people as if they are just a number or “the next patient”.Physicians should be able to understand and empathize with their patients andput themselves in their patient’s shoes while also being sensitive to the waythat they may be feeling. Physicians must be ready to offer the patient a widevariety of options for them to choose from, thus giving them a greater sense ofagency. This will help the patient feel more independent during a time when hemight feel like he is not in control. PAS can bea compassionate alternative for the sake of reducing all manner of suffering.Modern day medical technology can do a great job at elongating a patient’s lifespan for a certain amount of time, but thepain persists. Terminally ill patients must live with the continuous pain andsuffering until they pass away.

Physicians must then respect and properlyassess the wishes of the patient to determine if it is justifiable.Furthermore, this alternative is also immenselycost-effective. As we all know, life is expensive and so the technology thatmedical facilities use to prolong life can also be very expensive.

The processof identifying the cause and treating the illness is also a long one. There areusually many tests and examinations which all might not be essential,especially if the diagnosis is terminal. An article from The Journal of Law, Medicine & Ethics informs us that”persons with chronicillnesses require more health care services, are costlier to treat, and are asignificant factor in the rise of health care spending.

And the likelihood ofincurring an additional chronic illness increases with age.” (Artnak et al140). This increase of more and costlier health care services makes itfinancially difficult for families to keep their loved ones alive and relievedof suffering. To be more specific, “nearly $7,900 is spent each year for everyAmerican with a chronic disease such as diabetes, cancer, or heart disease” (141).All throughout America, there arehundreds of people who have spent tens of thousands of dollars in the last fewmonths of a loved one’s life. Sadly, they may have prolonged their life butthere might have been no quality of life.

This alternative will save patientsfamilies large amounts of money from end-of-life care. Patients wouldessentially be easing their families financial burdens and suffering in theprocess.             Above all, we should all be able to choose how to liveour lives. The pursuit of happiness is one of the fundamental rights that ourfounders declared for us. The rights of competent adults should not be limitedwhen it comes to the right to die.

Accordingly, Dr. Kevorkian agrees that terminallyill patients should be allowed the right to pursue the motives they believewill be best for themselves and their families. In one of Dr. Kevorkian’s courtcases, attorney Geoffrey N. Fieger stated that:                        “This is not a right to commit suicide, it isabout the right not to suffer. At the                                end oflife when the disease process has won, death is certain, and pain cannot be                                 controlled,how the state has an interest in prolonging suffering is beyond me.

                                  Saying thata law which does not make anybody do anything, that gives people                             theright to decide, and prevents the state from prosecuting you for exercising                                    yourfreedom not to suffer, violates somebody else’s constitutional rights is                         insane”(Cotton 364). If competent terminally ill adults have the right to refusemedical treatment then they should also have the right to have a physician aidthem in painlessly ending their lives. Similarly, many believe that in the 9thAmendment of the U.S. Constitution, the people have the right to do whateverthey want with their bodies as long as it does not affect anybody else oranyone else’s property. Additionally, anarticle from The New York Timesrecalls a U.S. District judge stating: “like the abortion decision, thedecision of a terminally ill person to end his or her life involves the mostintimate and personal choices a person may make in a lifetime and constitutes achoice central to personal dignity and autonomy” (Egan par.

10). Thisalternative is not an easy one to make but it is an option that must be offeredto those who require it. Competent terminally ill patients deserve to die withdignity if they so choose to. Incontrast, a common argument that many opponents of end-of-life rights billshave is that it leads physicians and the health care system to devalue life. Asan article from the Arkansas Law Reviewadds:             “opponents of thelegalization of physician-assisted suicide contend that, in order                          toreduce health care costs,physiciansand insurance companies may aggressively                   encourage elderly anddisabled patients to request prescriptions for the lethal dose                         ofmedication… moreover, if the disability requires long-term treatment, the                            insurancecompany may be willing to cover the cost of physician-assisted suicide                               inorder to reduce costs” (Lewis 40-41).Thisis by no means a good way of empowering a patient. An example which stronglyrelates to this topic is that “the insurance company of a woman in California stoppedcovering her prescribed pain medications, and offered end-of-life medicationfor just $1.

20″ (Chereb par. 13). We should never penalize patients who chooseor prefer pain management instead of end-of-life medications. To prevent thiswe need protections for the vulnerable people, such as the elderly or disabled,making these decisions.

For example, just because someone is a certain age andhas a specific condition does not mean that they are eligible for PAS. These things need to be handled on a case-by-case basis due to varyingcircumstances. Another possible solution would be the attendance of animpartial third party member being in the room, such as another physician, whenconversations between the doctor and patient are occurring. In reality, PAS provides patients with anotherchoice in which they can decide when or if they would like to have aconversation about PAS, but having it available is the point. Having thisalternative available would empower the patients even more and give them somecontrol over their illness and death.

In the long run, PAS will be helping a lot more patients than it will beharming them. Similarly, an article from TheJournal of the American Medical Association, which has been collecting datafrom surveys, official state and country databases, interview studies, anddeath certificate studies, states: “physician-assistedsuicide is increasingly being legalized, remains relatively rare, andprimarily involve patients with cancer. Existing data do not indicate widespreadabuse of these practices” (Emanuel et al 88). This tells us that very fewpeople actually go through with this alternative and that there has been no current widespread or major abuseof PAS.Allthings considered, PAS is a merciful alternative to the pain and sufferingterminally ill patients can undergo. This alternative cangive patients the freedom and peace that they deserve after many of theiroptions have dwindled. It is also a cost-effective choice compared to theexpensive options that may not give patients the quality of life that theydeserve. For terminally ill patients expenses usually become a burden on thewhole family, even after the loved one has passed away.

Additionally, the rightto the pursuit of happiness should alsoaccount for those who would like to decide on whether to suffer or not. It isfor these reasons that PAS should be legalized in more American states comparedto the 6 few states that we currently already have. Currently, in four U.S.

states (Nevada, North Carolina, Utah, and Wyoming) there are no specific lawsthat specifically involve or prohibit PAS. These states should be the nextpossible legalization playing field for the “right to die” movement.                    Works CitedArtnak et al. “HealthCare Accessibility for Chronic Illness Management and End-of-Life Care:               A View from Rural America.” TheJournal of Law, Medicine & Ethics, Blackwell                            Publishing Ltd, May 11, 2011.Chereb, Sandra. “Foes ofNevada Right-to-Die Bill Turn Out in Force for Protest.” Las Vegas      Review-Journal, reviewjournal.

com, April12, 2017.Cotton, Paul.”Medicine’s Position is Both Pivotal and Precarious in Assisted SuicideDebate.”               The Journal of the AmericanMedical Association, jamanetwork.com, 273:5, February 1,                       1995, pp. 363-64.

Egan, Timothy. “FederalJudge Says Ban on Suicide Aid Is Unconstitutional.” The New York       Times, May4, 1994.Emanuel et al.

“Attitudes and Practices of Euthanasia and Physician-Assisted Suicide in the                     United States, Canada, andEurope.” The Journal of the American Medical Association,                jamanetwork.com, 316:1, July 5,2016, pp. 79–90.Lewis, Browne. “ADeliberate Departure: Making Physician-Assisted Suicide Comfortable for                 Vulnerable Patients.

” ArkansasLaw Review, 70:1, March, 2017.Maynard, Brittany. “MyRight to Die with Dignity at 29.

” Cable News Network, November 2,                 2014.Stafford, Ned.”Obituaries: Jack Kevorkian.” British Medical Journal, June 29, 2011.

Starkset al. “Physician Aid-in-Dying.” University of Washington School of Medicine.April,                      2013.

Stillman,Adam. “Moving the Needle: A Call to Change Age Restrictions in American                             Physician-Assisted Suicide Laws.” Southern CaliforniaInterdisciplinary Law Journal,                       26:1,September, 2016.”So,Is It Over?” American Horror Story, created by Ryan Murphy and BradFalchuk,                              performanceby Evan Peters, season 6, episode 5, FX, 2016, time: 17:45.


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