Introduction
The Oregon law on Aiding Commission of Suicide not Murder which is categorized under the Offences Against Persons laws of the State, makes it illegal for any person to willingly assist another person to commit murder that would not have otherwise been possible without such an input (Lawonecle.com, 2008). In October 1997, the State of Oregon approved and made into law the Death with Dignity Act (DWDA) as a way of addressing the inherent limitations and weaknesses that were present in the above mentioned law on suicide assisted deaths (Oregon.gov, 2009).
The enactment of the Death with Dignity Act repealed some sections of the previous law on suicide assisted deaths and made it legal to aid terminally ill patients in suicide but only when undertaken by a physician. By limiting the persons authorized to assist in suicide deaths to physicians only the enactment of the DDA law failed to address the major weaknesses in the Aiding Commission of Suicide not Murder law that had prompted it amendment in the first paper. In this paper I am going to argue why the enactment of the Death with Dignity act failed to rectify the failings of the Aiding Commission of Suicide not Murder law which should entirely be repealed and also show how enactment of DDA law created more problems than it solved.
Euthanasia and Physician Assisted Deaths
Euthanasia is Greek word that when directly translated refers to the “good death”, in reference to the well intentioned reasons of a person deliberate actions of causing death of another person out of compassion (Rawls, 2001 ).
More specifically euthanasia is a term that is used to describe death under circumstances that have been undertaken deliberately for purposes of alleviating suffering of an individual usually from a terminal illness for which no recovery is expected. Hence, for euthanasia to be defined to have occurred three conditions must be met i.e. it should be deliberate, must involve taking life and should be with intention of relieving “intractable” suffering (Feinberg, 1997).
Now compare this to the definition of physician assisted death (PAD) commonly referred as PAD which is when a “physician provides competent, terminally ill patient with a prescription for a lethal dose of medication, upon the patient’s request, which the patient intends to use to end their life” (Feinberg, 1997).
It would appear that both definitions are similar probably because these two concepts are essentially the same but they are not; in fact euthanasia would seem to be more humane since it is entirely initiated to alleviate pain from patients who are not expected to recover from their condition while PAD is undertaken under the same circumstances but without necessarily with the element of pain and suffering present. Yet, the Death with Dignity Act fails to legalize euthanasia but instead legalizes PAD which is legally, morally and ethically faulty.
Constraints of PAD
The arguments that I beg to lay ground work for is that PAD should not be legalized as happened with the enactment of the Death with Dignity Act because of two reasons. One, because the consent to initiate the merciful killing emanates from the patient and two, that such consent is made by a person with stable mind who is not necessarily under any form of pain to warrant the need of death were it not for the fact they are terminally ill.
If we were to remove the element of terminal diagnosis in this equation what we are left with is a purposeful orchestrated suicide that utilizes the legal and healthcare institutions as a way of excusing the ethical and legal principles that are being flaunted in the process. The compelling reason why death should not be allowed under this circumstances is because the element of pain and suffering are notably not present. The way that DWDA is structured is fundamentally flawed and might tempt one to ask whether HIV AIDS suffering patient who are about to die should also be eligible for PAD.
What I support and indeed recommend for the DWDA law to adopt is the principle of euthanasia for reasons that I am going to discuss in detail later in this paper. The principles of euthanasia if adopted would ultimately allow other persons especially the family members and friends of the patient to aid in “merciful killing” which is my major contention with the existing Aiding Commission of Suicide not Murder law since it does not allow this and with DDA law because it specifically exempts this group of persons.
A fundamental concept that the advocates of PAD fails to realize is the sanctity of life and the relevance of family members in judging when the “good death” should be initiated (Borry, Schotsmans and Dierickx, 2006). It is from this level that the idea of PAD as legalized in the Oregon Death with Dignity Act as well as the Aiding Commission of Suicide not Murder law can be faulted. It is clear in the way that DDA law has been structured that it disregards the sanctity of life in that patient are given liberty of choosing whether to continue living just because of diagnosis of a terminal illness regardless of any evidence of physical suffering in what would amount to suicide, which is in fact a felony.
According to Feinberg “the desire to commit suicide must always be presumed to be both non-voluntary and harmful to others until shown otherwise” when that otherwise is a legal PAD then the institutions concerned are at fault and must be corrected (1997).
Given that a patient is not in complete control of all the mental faculties as a result of the disease that inflicts them it would be unreasonable to expect them to make unbiased and informed decision that is probably arbitrary. My argument is that the only time when merciful death should be initiated is only when it is clear that the patient is experiencing great deal of pain as a result of their condition which can only best be relieved through death. But this is clearly not the case for PAD, since quite often as aptly stated by Bernadi and Lee after Oregon enacted the DWDA law “the right to die may now very well become the duty to die” (2003).
Euthanasia and the Role of Family Members
To better understand inherent distinction of merciful killing under euthanasia and PAD let us briefly summarize the circumstances under which euthanasia should be undertaken. In general euthanasia cases are usually divided into two groups; the first group describes patients that are in vegetative form i.e. are conscious but are unaware of their environment with very low brain functions and are therefore sustained through life supporting machines (Graber, 1988). The other category of euthanasia cases include patients that have terminal illness but are not necessarily on life support machine, but whom due to their medical condition experience extreme suffering or loss of dignity to justify taking their life (Hassan, 2006).
The implication of these circumstances is that most often the prerogative to initiate euthanasia will therefore rest with the family members who usually experience the suffering of the patient indirectly and quite often are in a position to undertake euthanasia given that they are usually the caretakers.
The fact that family members and close personal friends of the patient are excluded in this business of PAD means that a crucial element of good judgment has been omitted in this process. This is because family and close friends are among the most reliable persons that could be expected to provide insight on the condition of the patient having spent a great deal of time with them in their healthy years. This makes them the most informed persons to give judgment on the patient emotional and physical suffering in a reliable way that could accurately determine the point at which the merciful killing should be initiated.
This is especially the case where the patient is not in a position to make their wish known, which should as a matter of fact always be the case before euthanasia can be approved. In an article by Kimsma and Leeuwen the authors describe the importance of involving the family members in decision making concerning euthanasia despite the fact that such a requirement is hardly ever required from legal standpoints (Kimsma and Leeuwen, 2007). In a research study by Thomasma et al described in the article, family involvement during the decision making on euthanasia largely seemed to comfort them after they were counseled (Kimsma and Leeuwen, 2007).
Relevance of Euthanasia in Contemporary Society
There is no doubt that the circumstances of modern life provide more compelling reason why the government should embrace the idea of euthanasia as compared to PAD. The typical diseases of modern lifestyle appear to favor the concept of euthanasia more than is the case of PAD. In Euthanasia, when it happens the physician if involved is acting for purposes of alleviating suffering and pain that the patient is suffering, this is in contrast to PAD whereby the physicians are involved in soliciting suicides from patients or providing them with such options at very early stage where neither the pain nor suffering is present to justify suicide.
It is on this fact that I base my submission to have the Oregon Death with Dignity Act as well as Aiding Commission of Suicide not Murder law repealed to illegalize PDA and instead legalize euthanasia and allow family members and friends to be involved in euthanasia and besides the physicians.
References
Bernardi, J. &Lee, D. (2003). Physician-Assisted Suicide: A Conservative Critique of Intervention. Hastings Center Report, 33(1): 17-19.
Borry, P., Schotsmans, P. & Dierickx, K. (2006). Empirical Research in Bioethical Journals. A quantitative analysis. J Med Ethics 32(4):240–245.
Feinberg, J. (1997). Social Philosophy. New York: Prentice-Hall, Inc.
Graber, C. (1988). Bio-ethics. New York, NY: Harcourt Brace Jovanovich, Publishers.
Hassan, O. (2006). Euthanasia: Ethic-Legal Issues. Web.
Kimsma, G. & Leeuwen, E. (2007). The Role of Family in Euthanasia Decision making. Web.
Lawonecle.com. (2008). Oregon Statutes – Chapter 163 – Offenses Against Persons – Section 163.117 – Aiding Commission of Suicide not Murder. Web.
Oregon.gov. (2009). Oregon’s Death with Dignity Act (DWDA). Web.
Rawls, J. (2001). A Theory of Justice. Washington, DC: Harvard University Press.