Journal of Medical Ethics, 2017

Several distinct arguments conclude that terminally ill patients have a right to a medically assisted death; two are especially influential: the autonomy argument and the non-harm argument. Both have proven convincing to many, but not to those who view the duty not to kill as an (almost) absolute constraint. Some philosophers see the source of such a constraint in general (deontological) moral principles, other in the nature of the medical profession. My aim in this paper is not to add one further argument in favour of medically assisted death. Rather, I want to shed light on a kind of reason that, to my mind, has not been previously highlighted or defended, and that might shake the principled conviction that doctors are never allowed to actively assist their patients to die. Specifically, my purpose is to show that doctors (as members of the medical profession) have a special duty to provide medically assisted death to consenting terminally ill patients, because (and insofar as) they have been participants in the process leading to the situation in which a patient can reasonably ask to die. In some specific ways (to be explained), they are involved in the tragic fate of those patients and, therefore, are not morally allowed to straightforwardly refuse to assist them to die.

One of the topics that have defined medical ethics within the past several decades is with regards to what is become known as physician-assisted​ suicide. Whereas suicide has been an alternative for individuals in their decision towards lives since the dawn of human history, physician-assisted suicide is something of a new paradigm that allows for individuals who are otherwise terminally ill or have little hope of surviving a particular disease or illness to terminate their lives in what has been deemed as a dignified manner. However, regardless of what definition the process itself seeks to define, the reality of the fact is that a certain level of ethics, legalities, and contentious debate exists around such an option. As a function of analyzing these factors, the preceding analysis will seek to demonstrate to the reader how each of these determinants impact upon the way in which physician-assisted suicide is practiced and viewed within the current society. Moreover, the analysis will be specifically centered on attempting to answer whether or not physician-assisted suicide is permissible within the bioethical interpretation of maximizing the good to the patient. This is of course a tricky subject and one that bioethicists have continued to argue about for a great deal of time. In such a way, it is not the intent of this author to proudly state that a simple research analysis can answer the question once and for all; however, it is the belief of this student that seeking to weigh the determinants of physician-assisted suicide as compared to their drawbacks will help the reader to come to a more informed interpretation of bioethics and the practice itself.

There are few issues more emotional and divisive than what has become known as “the right to die.” One camp advocates the “death with dignity” approach, according to which the patient is an autonomous being who can form his or her own judgment on the timing and process of dying. The other camp advocates the sanctity of life approach, in which life is intrinsically valuable and should be sustained as long as possible. Is there a right answer? In The Right to Die With Dignity, Raphael Cohen-Almagor takes a balanced approach in analyzing this emotionally charged debate, viewing the dispute uniquely from public policy and international perspectives. This book offers an interdisciplinary, compelling study in medicine, law, religion and ethics. It is, arguably, the most comprehensive book yet to be written on the fascinating question of whether physician-assisted suicide should be allowed. Cohen-Almagor delineates the distinctions between active and passive euthanasia and discusses some of the legal measures that have been invoked in the United States and abroad. He outlines the reasons non-blood relatives should be given a role in deciding a patients’ last wishes. He examines euthanasia policies in the Netherlands and the 1994 Oregon Death with Dignity Act, suggesting improvements to each. Finally, he makes a circumscribed plea for voluntary physician-assisted suicide.

This paper argues for the permissibility of Physician-Assisted Suicide. First, based on the Thomson/Scanlon thesis on permissibility, it argues against the Doctrine of Double Effect. Second, it argues against the view held by Kant and David Velleman that because one has dignity it is impermissible to commit suicide under any circumstances. Third, it argues against both the theoretical and practical versions of the Slippery Slope Argument. Finally, it explains why the argument from abuse is not a good one. If contractualism is correct, the claims to PAS held by terminally ill patients who are in excruciating pain and want to die should override the claims of patients who would be pressurized into accepting PAS.

Global journal of health science, 2012

Assisting or hastening death is a dilemma with many ethical as well as practical issues facing healthcare practitioners in many countries worldwide now. Various arguments for and against assisted dying have been made over time but the call from the public for legalisation of euthanasia or assisted suicide has never been stronger. While many studies have documented the reluctance of medical and other health professionals to be involved in the practice of assisted dying or euthanasia, there is still much open debate in the public domain. Those who have the most experience of palliative care are strongest in their opposition to assisted death or euthanasia. This paper explores salient practical and ethical considerations for healthcare practitioners associated with assisted death, with a focus on examining the concepts of autonomy for patients and healthcare practitioners. The role of the healthcare practitioner has clearly and undoubtedly changed over time with advances in healthcare ...

Annals of the New York Academy of Sciences, 2006

The question of whether a framework legalising physician assisted dying ought to be adopted in the UK engages conflicting ethical ideologies towards the value of life and the rights of individuals. Currently the law in the UK prohibits ‘mercy killing’, absolutely on the grounds of murder, irrespective of permission or good will . The law surrounding assisted suicide is however enshrined in Statute as a particular offence. The Suicide Act 1961 criminalises “an act capable of encouraging or assisting the suicide or attempted suicide of another person” . This law is unique in that it renders an accessory liable to conviction when the principal individual does not themselves commit a criminal offence . However, following a number of high profile cases involving individuals with debilitating illnesses who wished assistance in committing suicide and a growing public consensus on the desirability of pro-assistance legislation , Parliament is reviewing Lord Falconer’s ‘Assisted Dying Bill’ which aims to legalise the practice in limited circumstances. In this essay it will be asserted that the ethical desirability of legalising physician assisted suicide (PAS) and active voluntary suicide (AVE) rests upon the value of life and the ethics of suicide itself. Consequently, before any consideration of the ethics on legislation can be accurately made it must first be shown whether suicide itself can be ethically justified. This essay will address this issue by considering the conflicting ethical concepts of the inherent sanctity of life and theories on the importance of autonomy and self-determination. Upon concluding that it is indeed the latter aspects of human life that give it value, it will be argued that an ethical continuum exists that allows for the extrapolation of the ethical justifiability of suicide to PAS and AVE.

2008

Ms. Tucker is a graduate of Georgetown University Law Center. Ms. Tucker was counsel in a number of cases discussed in this article, including Vacco v. Quill, Washington v. Glucksberg (representing the plaintiffs claiming a right to choose a humane hastened death with physician assistance), Oregon v. Ashcroft (representing terminally ill patients challenging the Ashcroft Directive), In the Matter of the Accusation Against: Eugene B. Whitney (counsel to the patient's survivors in seeking accountability in proceeding before the medical board and tort suit), and Bergman v. Eden Med. Ctr. (representing the patient's survivors), and was a principal author of California's law requiring continuing medical education in pain management and palliative care. The author gratefully acknowledges the assistance of Aaron S. Jacobs, an associate with Heller Ehrman White & McAuliffe LLP, and Darin Sands, a 3L at Harvard Law School, for their assistance in the preparation of this article. Thanks also to