Physician Aid-in-Dying Case Study

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May 28, 2024

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Physician Aid-in-Dying Case Study Katelynn Sheline College of Science in Healthcare Administration HLT-305: Legal and Ethical Principles In Healthcare Shawn Buhrow April 28, 2024 1

Physician Aid-in-Dying Case Study If someone is facing a serious illness with no chance of recovery, they might consider the choice of Physician Aid-in-Dying. This term means a doctor gives the patient medication to peacefully end their life when they decide, rather than when fate decides. In this study, we will explore why someone like Zachary might choose this option and its legality. We will discuss the requirements patients must meet, the importance of mental health considerations, the role of others in making medical decisions, and the future of this practice in healthcare. In Oregon, there are rules for using Physician Aid-in-Dying (PAD) (Oregon Health Authority : Oregon’s Death With Dignity Act : Death With Dignity Act : State of Oregon, n.d.), and Zachary meets them all. The first requirement is that you have to be at least 18 years old while also living in Oregon to consider PAD. Additionally, you have to be able to make decisions about your healthcare independently, as well as most importantly, you need to have a terminal illness that doctors think will cause death within six months. It is overall the doctor's job to check if you meet these requirements. If you do not meet these requirements, then you cannot use the Death with Dignity Act (DWDA), which has been the law in Oregon since 1997. This law is similar to PAD, allowing people to choose when they want to die if they're terminally ill. Zachary is in a position to use PAD because he's 35 years old, he has lived in Oregon for more than 20 years, and he has advanced brain cancer with about six months left to live. Because his illness fits the criteria, Zachary can think about using PAD under Oregon's DWDA if he chooses. Meeting these conditions means Zachary can be part of the program. But let's say Zachary met all the other rules except for being diagnosed as terminally ill. Even if he had something serious like cancer that was expected to cause death within a year, he still could not opt-in to use PAD. 2

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That is an example to show just how strict the rules are in Oregon when it comes to PAD (Oregon Health Authority : Oregon’s Death With Dignity Act : Death With Dignity Act : State of Oregon, n.d.). When we discuss Death with Dignity laws, it's crucial to consider mental well-being too. These laws assess mental health to determine if someone can choose this option. Doctors explain the process, discuss other options, and talk about the risks involved. If a patient decides to proceed, they are checked out to ensure they fully understand everything. Before these laws existed, many people had little control over how they wanted to be treated at the end of their lives. A study discovered that almost half of the participants felt that patients' wishes regarding end-of-life care were not taken seriously as they had wished. This means that what patients wanted for pain relief and medication wasn't always considered (Hoffman, 2024). For instance, in Oregon, nearly half of patients' end-of-life preferences were not respected enough, indicating a lack of regard for their decisions. Authorities must listen to what patients want as they approach the end of their lives, particularly concerning Death with Dignity laws. If patients had more control over what happens towards the end, there would be better checks and more consideration for their wishes. I support Death with Dignity laws because they enhance end-of-life care. They also offer people the option to peacefully end their lives without suffering if they are very ill. When someone gets sick and can't make decisions about their medical care anymore, another person, known as a surrogate, steps in to help make the choices for them (Elevationweb, 2024b). This is part of a law called the Health Care Consent Act (HCCA). The surrogate makes choices for the sick person when they can't do it themselves. Sometimes, when a sick person is 3

very close to dying, their doctor might talk to them about something called Physician Aid-in- Dying (PAD). This means the doctor can give them medicine to help them pass peacefully and, on their terms, if they ask for it. But what if the sick person can't talk or decide because they're too ill? That's where the surrogate comes in. Together with the doctors, they look at something called an advance directive. This is a legal document that states what the patient wants, especially when it comes to PAD. If the patient says they want PAD in the advance directive, then the doctors can give them the medicine to end their life. A surrogate plays a big role in PAD because it helps with all of the steps that lead to giving the medicine that can end someone's life if that's what the patient decides. This means the surrogate is a part of the Physician's Aid-in- Dying decision too. In the future, how we handle tricky situations in healthcare may vary. However, one thing that will keep popping up is the idea of patient autonomy, which means patients have the power to make choices about their own medical care. This is super important because it lets people know all about their treatment options and allows them to pick what they think is best for them. Patients have to agree to any medical procedures after they've been told everything about them and are at an understanding. This makes sure that patients have all the facts before they decide on their care. Doctors must make sure patients understand everything before they choose what to do about their health. Patients must know about any risks involved as well. So, it is wise for doctors to always use safe medical practices, especially if patients might not have been told everything they need to know. This shows that doctors have an important job in making sure patients are looked after properly, in a way that's unique to them. In the future, patient autonomy might cause 4

debates, especially when it comes to Physician Aid-in-Dying. This raises questions about what patients want, what is the best choice for them, and what their rights are in these situations. In healthcare, Physician Aid-in-Dying lets very sick patients choose to end their lives calmly to stop their pain. It is important to honor each patient's desires, even if it means using PAD. Checking if patients qualify for PAD, dealing with mental health laws about dying with dignity, making medical choices for patients who can't decide, and planning for PAD's future in healthcare are all super important processes in this area. 5

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References Hoffman, B. (2024, January 31). Frequently Asked Questions About Death with Dignity. Death With Dignity. https://deathwithdignity.org/resources/faqs/ Oregon Health Authority : Oregon’s Death with Dignity Act : Death with Dignity Act : State of Oregon. (n.d.-b). Oregon’s Death With Dignity Act : Oregon Health Authority. https://www.oregon.gov/oha/ph/providerpartnerresources/evaluationresearch/ deathwithdignityact/pages/index.aspx Elevationweb. (2024b, April 4). Psychiatric Advance Directives (PADS) - Treatment Advocacy Center. Treatment Advocacy Center -. https://www.treatmentadvocacycenter.org/resources/pad/ 6

Physician Aid-in-Dying Case Study

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