Showing posts with label physician-assisted suicide. Show all posts
Showing posts with label physician-assisted suicide. Show all posts

Wednesday, November 19, 2014

Should individual freedom extend to suicide?

Recent map of states allowing assisted suicide or where it is under serious discussion
Carol Forsloff - In America it appears the most vocal argument about life involves abortion. Around the world, including the United States, the debate is
especially keen over a person’s right to take his/her own life personally or with aid just because of being tired of living or having lived a "completed life."
 

The argument continues and has broadened in the Netherlands where some people maintain that once an individual has lived what they deem to be a "completed life" they should be able to commit suicide in a legal fashion.

Physician-assisted suicide has been legal in the Netherlands since the 1990's.

It's one thing to be able to do it if you are ill, and a doctor approves; it becomes quite another for a perfectly healthy human being. So it has raised considerable debate in the Netherlands, known for its somewhat liberal views in a number of social areas.

Indeed it has also bee found that assisted suicide laws around the world are written specifically to require a physician's involvement.  And Norway, the neighbor of the Netherlands, considers even that a crime.

One of the newspapers DW World wrote about the issue in 2010, pointing out
how some of the citizens of the Netherlands had set forth a petition
asking the Dutch parliament to debate whether all people over 70 have a
right to suicide that gathered more than 117,000 signatures.  


This debate about suicide raises an ongoing issue, often one that many people begin to discuss with increased fervor when they are elderly or have an illness where they are expected to die within six months time.  The debates concern whether anyone has the ultimate right to make a choice in how to either live or die and when. It is an ethical argument that various groups have made over
the years, that becomes an ever-widening one.


Those in favor of assisted suicide believe they should be able to take their own lives if they have a depressing condition such as Alzheimers, have no friends or family and believe their lives are so unsatisfactory and painful that
they have lived a "completed life."


Those who oppose any legislation to change the laws to allow people to kill themselves if they are in severe pain or will die of some painful disease or have a medical condition that does not allow them to live a quality life.  They say society should work towards inclusion of people so they don't have these fears and worries and want to  kill themselves.

That public argument heated up in Great Britain in early 2009 when a man killed himself publicly. Most places have controversial laws or don’t enforce them.  Only four of them allow the taking of one’s own life with assistance
legally and openly.


Craig Ewert’s death at age 59 was broadcast on television December 14, 2009 following a serious controversy over the documentary which was shown on Sky Real Lives channel. Ewert had a motor neurone disease and no longer wished to remain alive and trapped in what he labeled as a “living tomb.”

The maker of the documentary, John Zaritsky, maintained the film was an “important contribution to a vital debate.” The debate in Great Britain was indeed intense. Ewert’s own MP in the House of Commons raised objection to the showing of the film. Gordon Brown, Prime Minister of Great Britain, made
his own statement:

“I believe that it is necessary to ensure that there is never a case in
this country where a sick or elderly person feels under pressure to
agree to an assisted death or somehow feels it is the expected thing to do.”
It is presently against the law in Great Britain to help a person commit suicide. The silliness of this country’s law, as citizens maintain, that causes considerable argument within the country, is that it is not illegal for a person to kill themselves but it is for another person to aid the process.

The penalty for doing so without that aid is 14 years in prison,
but no one has been prosecuted under the law. 


The laws about assisted suicide are ambiguous in many places if the laws even exist. Many people assume that it is an individual act of freedom and don’t know that there are laws against it.

A great many people instinctively feel that suicide and assisted suicide are such individual acts of freedom and free will that they assume there are no legal prohibitions. Sweden has no law specifically against euthanasia but prosecuted Berit Hedeby for helping someone to die.

Compassion, or the lack of it, for assisted suicide varies around the world with Uruguay being the most sensitive about the issue and reluctant to administer punishment and Russia and Hungary being one of the strictest about it.

Hungary,that has the highest suicide rate in the world, has one of the harshest
laws, with five years in prison the punishment. Russia is particularly
intolerant, with its 1993 law outlining specifically its opposition to
mercy killing.


There are only four places documented by assisted suicide proponents where a person can openly and legally be allowed to die through active assistance by another. They include the following: 1. Oregon (which has had its law since 1997 upheld by the Supreme Court in 2006) 2. Switzerland (1941, physician and non-physician assisted suicide only); 3. Belgium (2002, allows euthanasia' but does not define the method; 4. Netherlands (voluntary euthanasia and
physician-assisted suicide has been legal since April of 2002 although
the courts have allowed it since 1984)


Only in Switzerland is one able to take one’s own life without several doctors involved in determining an individual’s competency and need to do so. Others require two physicians and a psychologist.

Oregon’s law was targeted by the Bush administration in the United States, but most other states have chosen not to introduce legislation on euthanasia because it is considered too controversial a topic.

Religious factions within the states have opposed the taking of one’s own life by any means. The Catholics have been one group solidly against euthanasia.

Despite the hue and cry about euthanasia, a review of the Oregon experience shows that the concern that many people will rush right out and kill themselves when they have a terminal illness is not borne out by the facts.  Relatively few take their own lives, or ask for someone to aid them in the process, even when they have the right.

In 2014 Brittany Maynard, an incurably ill woman with only months to live and looking forward to a painful death and an extended period of suffering, spoke out in defense of terminally ill patients who needed a choice in whether to continue life or not.  She moved to Oregon and took her own life in November.  Only Oregon, Vermont and Washington allow physician assisted suicide, while 34 states criminalize assisted suicide or any kind of individual attempt by someone to help another take his or her own life, regardless of condition.

In 2006 only 46 people took the final exit with assistance. Nevertheless, it is likely that around the world the debate will continue about euthanasia with very different laws and opinions about it while the four places that allow it will continue to collect data to show euthanasia is rare and continues to be very controversial.

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Thursday, November 11, 2010

Ethics a struggle for doctors with nearly half supportingphysician-assisted suicide

NEW
YORK - PRN - Carol Forsloff - Studies have shown medical personnel reluctant
to participate in executions because of medical ethics, but ethical
decision-making is the major struggle for doctors involved in the
practice of medicine in general.





WebMD
Health Corp. conducted a survey made by Medscape, a doctor's resource
site that examined physician attitudes about some of the most difficult
decisions they have to make.  10,000 doctors were used to determine the
results.



The August 2010 survey explored ethical
issues including end-of-life, pain treatment, insurance reimbursement,
colleague relations, withholding information from a patient, patient
privacy, and other issues that present moral dilemmas. 




"What came through loud and clear through this survey
is that by and large, doctors try to do what they believe is right,"
said Dr. Steven Zatz, Executive Vice
President, WebMD Professional Services.  "However, the results also
highlight the complex ethical issues confronting physicians and their
efforts to make appropriate decisions."


"Today's doctors face more frequent and more complex bioethical dilemmas than in former times," said Thomas H. Murray, PhD, President of The Hastings Center, a bioethical research institute in Garrison, New York.  "In medicine, the increased power to intervene now requires that doctors make choices whether to do so or not."

One of the hardest decisions for doctors to
make is the literal decision of life or death involved in
physician-assisted suicide.  Green Heritage News editor Forsloff
discussed this with several doctors in Hawaii during the late 1990's,
finding that most doctors provide large doses of medicine to family
members with terminal illnesses, even when they know patients will die
from it.  Surveys of doctors reveal a high percentage of doctors will do that.


The following shows some of the survey findings.  An
additional 16 questions dealing with other crucial physician ethical
dilemmas and the special series can be found at www.medscape.com.


End of Life Care  

When asked whether physician-assisted
suicide be allowed in some cases – results were mixed with 45.8% of
respondents answering "yes"; 40.7% said "no"; and the other 13.5% said
"it depends."


Liability and Medical Error Issues :  

The
majority of doctors 60.1% answered "no" when asked if it was acceptable
to cover up or avoid revealing a mistake if that mistake would not
cause harm to the patient, 19% of respondents said "yes" it was
acceptable, and the remaining 20.9% said it "depends."


Patient Treatment Issues

When
asked whether they would hide information from a patient about a
terminal or preterminal diagnosis in an effort to bolster their spirit
or attitude – 59.8% of physicians would tell it exactly like they see
it; 14.6% admitted they would soften it and give hope even if there's
little chance; 1.7% wouldn't tell a patient how bad it was – unless they
were going to die immediately; and the other 23.8% said it would
depend.


Other Ethical Issues :



On
the subject of whether buying organs for transplant should be legal for
people if they would not be able to receive an organ by waiting their
turn through the national database – nearly 20% of doctors said "yes",
but the majority (66.5%) said "no."  The remaining 13.6% said "it
depends."



Murray
concludes, in reference to these findings, "If a physician recognizes
that he or she is having a tough ethical dilemma, it shows that this is a


morally conscious individual trying to do the right thing."