Physician assisted suicide is legal in five states, Oregon, Vermont, Washington,California and Montana. But what is it? By definition physician assisted suicide is “the voluntarytermination of one’s own life by administration of a lethal substance with the direct or indirectassistance of of a physician”. Commonly misconceived as euthanasia, which is very different.Euthanasia is the act of the physician administering the drugs versus assisted suicide where thepatient has to take the drugs personally. There are various concerns about ethics, purpose, andwho is in charge of granting or denying you this “right”, but does one truly understand thecircumstance if they are not the individual suffering? To truly understand physician assistedsuicide, it is important to understand why someone would go through with this, and what canhappen in time leading up to this decision. Such that it is just as crucial to understand whathappens when you receive the injection and what is inside of this medication.Assisted death and what has been called physician assisted suicide and voluntary activeeuthanasia. The difference is the degree of involvement and behavior by the physician if thephysician was the one who administered it or only supplied the needed medication and did notdirectly administered them. Physician assisted suicide entails making lethal needs available tothe patient to be used at a time of the patient’s own choosing. By contrast, voluntary activeGerken 2euthanasia entails the physician taking an active role in carrying out the patient’s request, andusually involves intravenous delivery of a lethal substance. Physician assisted suicide is seen tobe much easier emotionally for the physician than euthanasia as the doctor does not have todirectly cause a death; he or she merely supplies the drugs needed for the patient’s personal use.Supporters of physician assisted suicide say that it carries an added benefit of allowing thepatient to determine the time of death and provides the opportunity for the patient to change hisor her mind allowing for more control from the patient. The use of self-administered oral lethaldrugs, while it provides a certain freedom of timing, does carry the risk of error, but needs to becompleted while the patient is still well enough to injest the medication and be able to hold itdown. Fear of this risk is widespread among patients and, because of this, some may act earlierthan necessary to avoid it. Which can be viewed as a bad thing because patients are cutting theirshort time, shorter. Euthanasia contains a much smaller chance for mistakes and may benecessary in cases where a patient is too sick for self-administration, or no longer capable ofswallowing, holding down food, or absorbing oral medication. If a patient knows that a physiciancan always intervene, the act of assisted death may be permanently postponed.There are strict requirements and regulations to protect the patient, family and even thedoctor. These requirements according to Oregon State legislation, the patient must be 18 years ofage and be a resident of Oregon. This is to ensure that the patient is of legal age to determinecourse of treatment, and that the are not being influenced by outside forces. They have to be aresident to make it legal. The law is trying to prohibit patients from outside states and usingOregon for their death with dignity act. The patient must be of sound mind and diagnosed with aterminal illness. The patient must be mentally competent and capable of making coherentGerken 3decision about their health. Why make such strict guidelines? This was enforced to ensure thepatient was making the decision for them and that this last and final decision is something onedecides to do on a whim. This requires long and careful thinking and processing.Physician assisted suicide is more than just a ingesting a pill and waiting for “it” tohappen. There are a series of barbiturates or sedatives prescribed to the patient that willeventually lead to death. Barbiturates are drugs the suppress the nervous system, it can beutilized as a mild sedation, full anesthesia or in dosage high enough, death. The drugs mostcommonly used are secobarbital and pentobarbital, the purpose of secobarbital is a sleep aid andpentobarbital serves as anticonvulsant. This then assists in the transition from life to death, but itis not as simple or peaceful as it sounds. There are reports from an Oregon study of numerousbotched suicides due to complications such as regurgitation and seizures. How would thishappen? Every body is anatomically different and other body systems respond differently to thedrugs, resulting in convulsions(seizures). Second to this, reports of patients waking up days afterconsuming the medication which means they awoke after they tried terminating their life. In that,recently a man with lung cancer was choosing to exercise his right of dying on his terms, thanksto the “Death with Dignity Act”. David Prueitt took a supposed lethal dose of medicationprescribed by one of his doctors but then arose from the “dead” three days later . But that is therisk you take when you agree to this. Although understandable why, he was enduring immensepain, is it worth risking a failed attempt and resulting with more injury than you already had?Physician assisted death is not as easy to conduct. It is a hard procedure that has flaws,complications and moral injustices to some. Many medical professionals do not agree with thepractice due to the already traumatizing event that is death,why put your family through anymoreGerken 4then they are? But what is more important, the exit that can free the patient of pain or saving thefamily from the emotional pain awaiting them after the patient’s decision?There are laws in place in certain states that have legalized assisted death but under strictcircumstances. These circumstances include having to write it, say it, and say it again after acertain amount of time and have to be in the right state of mind. For example court caseWashington v.s Glucksberg, challenged the constitutionality of the fourteenth amendment,wishing to grant three terminally ill patients the right to die on their terms due to their obstinatesuffering. They were denied, supreme court judge William Rehnquist disagreed and thosepatients were not able to go through with their last dying wish. They, those fighting forratification of the right to die, connected the ideology of refusing medical treatment or AMA toassisted suicide it is a choice that should be left to the patient, they concluded. Why should beallowed to govern who lives and dies, even if the patient is already terminally ill. There is a wayone must follow to legally do this, you have to be in a legal state, legal resident for 3 years, andhave met the requirements to even be considered for this course of treatment. In this next case adoctor injected a lethal dose of a drug upon the request of the patient. But was trialed for seconddegree murder and was affirmed. In the case ‘People v.s Kevorkian”, Dr. Kevorkian lost and wassentenced to jail and fined for killing his patient. Why would someone deny the right to die tosomeone else, what is the benefit of making them suffer more? There is no true benefit per say,more a protection of ethics. As a healthcare professional it is your duty to to keep your patientsalive and healthy, it goes against any morality a sane person has. But on the other hand wheredoes the line in the sand get drawn, do you make a suffering patient who is alreadyterminal(dying) live out there days in agony, or do you allow them to die on their terms, die withGerken 5dignity? There is a lot of grey area surrounding the topic of “physician assisted suicide” due tothe conflict of morals on the physician side and ignorance from congress who do not truly knowwhat the patient is going through.How could our government make a knowledgeable and sound decision about this topic ifthey truly do not know the severity of an individuals suffering to lead them to this request. Theycould not, not without knowing what are these people going through. Following are somereported cases and experiences of people who lived this and what lead up to their final decision.Firstly a man named John Close was diagnosed with motor neuron disorder(MND), which is adebilitating disease which affects your upper motor neurons. In his case, Close was no longerable to fend for himself in the sense of no longer capable of swallowing on his own, feedinghimself, stand nor communicate. The only way he was able to communicate was through acomputer. What kind of life is that? The family stated the john felt a sense of relief and comfortknowing they were in control of it. But dissenters asked why the family allowed this, what wouldthe family benefit or John by making him stay and wait for his terminal disease to eventually killhim “naturally”. If you were john would you wait until you died “naturally”, suffering andslowly losing control over everything you once never thought twice about or choose to go onyour own terms peacefully. Which was what this family was going through. They witnessed thetotal erosion of Close’s dignity, humanity and and sense of control. The family was not able towish John Close’s last wish before he died of his disease, a peaceful, comfortable and controlleddeath on his terms. Another man, Patrick Matheny had Lou Gehrig’s disease (ALS). For severalmonths, he struggled with a decision to end his life using a lethal prescription. He would setarbitrary deadlines, then, when the time came, would set new deadlines. At first, it was to beGerken 6after his 15-year-old son came to visit at Thanksgiving. Then it was to be when he could nolonger dress and wash himself. An article in the Oregonian put it, “Pat felt he would rather bedead than accept help to bathe and dress.” But when the time came, he was able to handle havinghis mother and hospice nurses help him so he set new deadlines. In March, Matheny tried toswallow the barbiturates mixed into a chocolate nutrition drink, sweetened with a boxful of sugarsubstitute. Reportedly, he experienced difficulty swallowing the concoction. The only personMatheny had asked to be with him in his trailer was his brother-in-law, Joe Hayes. Hayes toldthe Oregonian that he had to “help” Matheny to die, but would not say how. According to Hayes,it was too personal. “It doesn’t go smoothly for everyone,” Hayes explained. “For Pat it was ahuge problem. It would have not worked without help,” he added. Although strict requirementsare put in place to protect the patient, in this instance it hurt him because he did not self inject thedrugs, which could introduce foul play. This system is not perfect and has to be worked on.Another family had to encounter this, the question to ponder, is it fair and moral toprevent a person of sound mind, with a terminal disease, to choose to end their suffering at a timeand place that they want to? Second to that, if it was your pet dog, slowly dying, in pain, losingall independence slowly but surely, you as a owner would feel responsible to end their suffering.These questions are raised to fully understand why and what a family and patient must be goingthrough that leads them to this conclusion. This next family had to travel to germany with theirslowly dying mother, in order to grant her last wish of dying. She was able to die on her termsbefore her terminal cancer killed her after days, weeks of unnecessary suffering. A lot happens toa family during a death of natural causes, imagine having to watch your brother die from adisease that slowly takes away his ability to walk, then talk, eat, go to the bathroom without help,Gerken 7eventually breathe. Does one truly understand what happens? A lot of people question whetherthis is selfish or ethical decision from an outside perspective, like a family member it can beviewed as parsimonious because the passing loved one is cutting their already limited time,shorter. This is a gray area. There is no direct way of thinking especially on an issue, like the oneat hand. One has to live it and see it first hand to truly understand what families have to gothrough to finally conclude that physician assisted suicide is the answer.Physician assisted suicide is a common deliberation within the medical world. Theright-to-die idea is confrontational in more ways than one. For example, having the right togovern when you die as a terminal patient is a decision that not only affects you but the doctoradministering the drugs and the family. But as a physician takes the hippocratic oath, one vowsto do no harm and do everything to keep your patient alive, healthy and happy. To partake onthis practice goes against certain aspects of the hippocratic oath, such that it also agrees with it.The patient who is allowed to go through with this practice is dying and has no quality of life. Isthat a life a true doctor would want their patient living. Another controversial aspect of physicianassisted suicide is the belief of physician assisted suicide reprehend the value of a human life, tocounter that claim, it is believed that allowing patients to make decision about their autonomygives them a mere bit of control in their life, giving back some value that they, the patient havelost to their disease.Continuing controversial ideologies of physician assisted suicide would includebelieving, the doctor would be able to one, focus on healthier patients who need their attentionversus sharing concern for the terminal patients and tending to their comfort, but also perceivedthat if physician assisted suicide was legalized, this act would warrant abuse and unnecessaryGerken 8suicide. It is too believed that doctors would be given too much power. Such that, also it isthought that doctors would give up recovery treatment too early. Which is possible, this lawwould allow doctors to choose to continue recovery medicine or advise assisted suicide. Shouldwe allow another human being the right to determine when they, the family, should give up orkeep fighting till the patient cannot fight anymore. It can be concluded that there is a lot ofcontroversy surrounding the subject. This is so hard to form an opinion on because it depends onwhere you are in the situation. If one looks at this from an outside perspective it could be viewedas selfish but if one takes into account what the patient could be feeling could that outweigh theemotional pain the family is going through versus the pain the patient is feeling?Physician assisted suicide is a far from perfect solution but everyday the medical field isgrowing, changing and learning. Everyday new discoveries are being made to help advance themedical field. Especially on something like this. It is crucial that while researching a topic likethis to remain central and unbiased to be able to understand all data and understand what is reallyhappening to a family exercising their new right to die. The requirements are put into place toprotect the patients, but the system is flawed and sometimes more harm the good happens. Justlike health insurance or the welfare system. These systems were all put into place to do onething. Help people, but these systems are flawed and need to “work out the kinks” to accomplishonly helping people. No more hurting. As seen before, this is a very real incomburance anddifficult journey for a family to endure nor is it an easy decision. Question to ponder, what ismore pressing? Is the emotional health of the patient’s family more important than the patientsphysical pain, and who is charge of one’s life. Who should be allowed to make laws about one’slife if they do not understand it from their perspective? If it was you what would you do?