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Is Death with Dignity a Right or Unethical?


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Aug 3, 2018

Is Death with Dignity a Right or Unethical?

A recent CNN opinion piece by Robert Klitzman brings to light an issue that has been long debated in the medical, religious, and governmental fields: physician aid-in-death (PAD).  Klitzman’s father was diagnosed with leukemia and was being treated with chemotherapy.  Two months after his diagnosis, he decided he did not want to live his life in this state anymore.  Medicine was unhelpful in reducing his adverse symptoms to the chemotherapy, and he sadly died a month later.  His death provided Klitzman with thoughts about physician-assisted suicide, or physician aid-in-dying (PAD), as it has now been called.  A few years ago, Brittany Maynard made headlines when she went to Oregon to die with the “death with dignity” laws.  This started this a serious conversation about PAD in California.   More recently, David Goodall (a 104-year-old Australian scientist) traveled to Switzerland back in May for doctors to end his life.  He was not happy with the state of his life in his old age and decided he would prefer to end it.

This is a controversial debate with many different viewpoints.  Some believe individuals suffering from a terminal illness should have the decision to keep on living or end their life when/how they want.  The term “death with dignity” has come up many times in this debate.  Moreover, those who experience a family member’s suffering understand that their loved one is struggling on an enormous level.  Only six states and Washington, D.C. have legalized PAD.  Thus, terminally ill people tend to move to one of them to die with the help of a physician.  Two of these states are Oregon and Washington.  In the two of them combined, PAD has only resulted in approximately 1% of all deaths, a smaller number than some expect.  According to a 2016 Medscape Poll, over 50% of physicians in the United States support PAD for those with terminal illnesses; however, the American Medical Association (AMA) does not promote or support PAD.

Opponents believe that life is valuable until the point of natural death, and doctors should not have the ability to step in.  There are many end-of-life care plans and pain-reducing/relieving drugs which can make a person comfortable at the end of their life.  Hospice workers (in hospitals, treatment centers, nursing homes, etc.) also work to provide peace and comfort to the individual with the illness in addition to their loved ones.  Following the AMA opposition, doctors are oftentimes hesitant to adhere to PAD.  Klitzman, the author of this opinion piece, is a doctor himself, and before his father’s suffering, he was “uncomfortable” with PAD since “(his) medical education inculcated the need always to help patients as much as possible.  During (his) medical training, I treated several patients who said they just wanted to die.  Yet they seemed depressed, distressed or, I sensed, didn’t fully understand that we were trying to help.”  He goes on to say that “many doctors have trouble addressing this issue, often finding it difficult to speak of death as part of life.  We generally see death as failure, not part of an ongoing process or trajectory.”

PAD also complicates many end-of-life decisions.  A person may be inclined to go through with PAD if they know their suffering is consequently increasing the suffering of their family.  It also brings up difficult questions and circumstances.  For example, if a person has a terminal disease and is either unconscious or not in a right state of mind, who will decide for them?  How will doctors know if a person is in “sound mind” enough to make this end-of-life decision?  Thus, there are a lot of underlying questions, concerns, and confusion regarding decisions about PAD.

What is your opinion on PAD?  Do you think it should be legalized in all 50 states? What are its costs and benefits; do the benefits outweigh the costs?  Are there other options for end-of-life treatment?  Let me know your thoughts!


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