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5-2 Final Project: Milestone Three: Rough Draft Amanda Thomas February 10, 2024 Southern New-Hampshire University 5-2 Final Project: Milestone Three: Rough Draft

5-2 Final Project: Milestone Three: Rough Draft Physician-Assisted Suicide For a long time, the inquiry of physician-assisted suicide has been discussed worldwide. Many individuals acknowledge that terminating one's own life is a citizen's right, particularly for those with end-stage disease. It is indisputable that those closest to an ailing loved one are best suited to make decisions regarding their care, especially when the individual cannot do so themselves. There can be no substitute for the intimate knowledge of the patient that family members possess. Relying on others to make such decisions can introduce an unnecessary element of uncertainty that can prove detrimental to the patient's health. Therefore, we must empower family members to take charge of these critical decisions and ensure our loved ones receive the highest quality care possible. It is indisputable that a doctor's top priority is to alleviate the suffering and discomfort of their patients. While there are proponents of hospice or palliative care as a means of offering satisfactory treatment to the terminally ill, it is essential to recognize that these options may not be effective for every patient. “Physician-assisted suicide should not be considered a deviant act because most people receiving a prescription for lethal medication have support from their families.” (Braverman et al., 2017). Physician-assisted dying (PAD) is an established medical practice that involves a physician prescribing medication to a terminally ill patient to alleviate their pain and discomfort. Despite being a controversial topic, many areas recognize the legitimacy of PAD as a form of end-of-life care. Healthcare providers must be well-versed in PAD's legal and ethical implications, as it is a highly debated issue. It is important to note that the primary intention of PAD is to provide compassionate relief from the patient's suffering, not to hasten their death. Staying informed about PAD's legal and ethical aspects is crucial for healthcare providers to make sure that patients acquire the finest feasible care at the end of their lives. “Some opponents disagree with PAD and believe that killing patients to relieve suffering differs from allowing natural death.” (Sprung et al.,2018). Rest assured that individuals must have both a terminal illness and a prognosis of six months or less to live to be eligible for PAS. “Physicians cannot be prosecuted for prescribing medications

5-2 Final Project: Milestone Three: Rough Draft to hasten death.” (CNN, 2022). Without a doubt, an individual who meets the criterion of having a terminal illness and a prognosis of six months or less to live is eligible for PAS. This is a well- established and non-negotiable requirement. Physician-assisted suicide is permitted in ten U.S. states and the District of Columbia. We must acknowledge that the term "suicide" is outdated and insensitive. It is time to replace it with the more appropriate and respectful phrase "PAD." This shift is crucial for creating a more empathetic and understanding society. By using language that aligns with our dedication to progress and social justice, we can boldly promote positive change. Another point is that PAS is not euthanasia; We firmly uphold the belief that every person has the right to end their suffering through death. Although there may not be a governing body to oversee this, we can support those seeking it. Our commitment to helping is rooted in compassion and respect for the sanctity of human life. We trust in our collective ability to act swiftly and alleviate pain. Until we have ensured that every individual has access to the aid they require, we will continue our tireless efforts. "If people can refuse life-saving treatment, they should be free to end their lives.” (Weir, 2017). Supporters of assisted suicide laws believe that mentally competent individuals suffering and having no chance of prolonged-term survival should have the right to die if they choose. “California statistics reported that 2,858 individuals received a prescription; 1,816 individuals died after taking a prescribed lethal dose of medication from 2016 to 2020.” (Department of Public Health, 2020). Colorado State Department of Public Health and Environment (2021) reported that physicians prescribed 222 prescriptions for aid-in-dying medication and 156 pick- up medications from a pharmacy. Since 1997 in Oregon, there has been a steady increase in prescription recipients and the number of deaths. The 2021 Data Summary reported that as of January 22, 2022, physicians prescribed a lethal dose of medication for 3,280 patients; 2,159 chose to end their lives. Extensive research has confirmed that despite PAD availability, many people still need access to it. We must take a decisive stand and make sure that anyone who needs a PAD can receive it. We must act confidently and determined to address this issue and ensure everyone has the necessary care. In numerous states, aided dying laws are not used very frequently, and patients have power over their lives and choices for a gracious and tranquil death. “Many terminally ill patients cannot care for themselves and rely on medical devices.” (Zhang et al., 2023). It is unacceptable that anyone is subjected to confinement and degrading conditions, and made to feel like a burden on their loved ones. is subjected to confinement,

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5-2 Final Project: Milestone Three: Rough Draft degrading conditions, addressed immediately.is subjected to confinement and degrading conditions, one receives the necessary care and resources to lead a life of dignity and respect.is subjected to confinement and degrading conditions, one gets the necessary care and resources to lead a life of dignity and respect. Includes the marginalized and vulnerable communities often facing social, economic, and health-related challenges. It is time for us to take bold action and demand that these individuals receive the support they need to overcome these challenges in a more equitable and just society where everyone can live a fulfilling life. No one should ever have to endure such a degrading and inhumane existence, and we must ensure that they are provided with the necessary support to live fulfilling lives. No one should be subjected to degrading living conditions or forced into confinement. It is a fundamental human right to live with dignity and independence. We must stand together to ensure that our loved ones are not burdened with the responsibility of caring for us in such unacceptable circumstances. "Many people view physician- assisted suicide and euthanasia as tools to guard their sense of dignity and regain their right to autonomy.” (Zhang et al., 2023). Writers across the globe have been expressing their apprehension regarding the legalization of assisted dying, as they are concerned about the possibility of it being manipulated. These writers argue that if assisted dying becomes legal, it may lead to an increase in cases where vulnerable individuals are exploited or coerced into choosing death instead of receiving proper medical care. This has led to a heated debate among healthcare professionals, policymakers, and the public about the ethical implications of assisted dying and the need for stringent regulations to prevent any such misuse. We must recognize the significant impact of financial struggles on those considering physician-assisted suicide. Our society is responsible for offering tangible support to those facing these challenges. By taking concrete steps to provide financial assistance and resources, we can ensure that individuals are not forced to make decisions based on financial constraints. Let us work together to create a system that provides compassionate care and support for all those in need. ” These individuals felt that the burdensome cost of care contributed to motivation for assisted dying inspiration. Individuals suffering from depression and hopelessness are at higher risk of suicidal thoughts and hastened death.” (Zhang et al., 2023). “Even though Oregon, Washington, Vermont, California, and Colorado have legalized PAS, most states in the U.S. prohibit physician-assisted suicide.” (Regoli, 2019). This comprehensive report delves into the complex issue of legalizing PAS, highlighting its multifaceted nature. The report

5-2 Final Project: Milestone Three: Rough Draft presents a balanced view of the subject, acknowledging the advantages and disadvantages of legalizing PAS. It emphasizes the importance of a well-informed and firm decision by carefully weighing the pros and cons of legalizing PAS. Physician-assisted suicide (PAS) should only be considered when all other options have been exhausted. It is a fact that the number of deaths caused by chosen patients for PAS is significantly lower when compared to other methods since individuals have the choice to take a lethal dose of medication prescribed by a physician. It is important to note that the decision to pursue PAS should be made cautiously and only after thorough consultation with medical professionals and loved ones. This solution allows patients to exert agency over their end-of-life decisions. By enabling patients to make the ultimate judgment, they are afforded more significant control over their lives until their ultimate moments. " Examples of cons of legalizing PAS are ignoring palliative care and offering someone to die against the healing code.” (Regoli, 2019). Meeting these demands is crucial to secure PAS approval. Your compliance with these requirements ensures that the approval process is efficient and successful. “Over the decades, researchers observed changes in rates of non-assisted suicides and the total number of suicides before and after the legalization of PAS.” (Jones & Paton, 2019). Investigators established that making legal physician-assisted suicide was affiliated with a 6.3 % growth in total suicides, involving PAS, establishing that the quantity expanded in people aged 65 years by 14.5 %. “The presentation of PAS was not associated with a reduction in non-assisted suicide rates nor with an increase in the average age of non-assisted suicide.” (Jones & Paton, 2015). There is a faction of religious conservatives that firmly maintains the belief that end-of-life decisions should be entirely subject to the absolute control of God. It is a matter of contention amongst religious liberals that individuals diagnosed with a terminal illness are entitled to autonomy and have the right to make their own decisions regarding life and death. The presence of medical advancements that can prolong the lives of terminally ill patients, while undoubtedly beneficial, can also create thorny and complex situations for patients and their families. Investigators utilized the General Social Survey from 1998 to exhibit that traditional and reasonable Protestants are less receiving of PAS and terminal end-of-life care than unbiased. While medical advances permit terminal care sick individuals to extend their lives, they draw challenging conclusions for families and patients. "Many religious leaders address end-of-life

5-2 Final Project: Milestone Three: Rough Draft concerns as moral and political problems.” (Burdette et al., 2005). “Still, religious affiliates experience pressure to conform to group ideology.” (Burdette et al., 2005). This re's main purpose is to explore and identify the demographic and health-related factors associated with acts of PAS. It is well-documented that physicians in the United States have reported receiving and respecting requests from patients for PAS, which has resulted in a hastened death. 1,902 doctors interested in terminally ill patients were asked to explain sickness factors, diagnoses, and demographics of the most current patients who asked for PAS. The influential result of the analysis is that patients acquiring doctors' help in quickening their death are making recommendations, have a burden of misery and despair, and are at the end of life. People obtaining a fatal drug have power over their lives. The survey conducted has yielded a significant finding that patients who receive assistance from physicians to hasten their death exhibit a clear burden of pain and distress and are approaching the end of their lives. The survey highlights that the patients who opt for physician-assisted death requests are in a state of distress and are experiencing severe pain and discomfort. The report underlines that the patients in question are at the end of their lives and are seeking to alleviate their suffering. The study underscores the need for greater attention to the specific needs and challenges of end-of-life care, particularly for patients who are experiencing pain and distress. Individuals receiving a lethal prescription have control over their lives. “On the other hand, physicians must honor their patient's request for lethal medication among many patients with terminal illnesses.” (Meier et al., 2003). In the Netherlands, euthanasia or PAS is deemed average for anyone over 70, and it is "tired of life." The article exposes a severe problem in certain areas where laws and safeguards are blatantly disregarded, and those who violate them are allowed to go unpunished. Shockingly, it has been revealed that about 900 individuals are given lethal substances annually without their consent. This is an unacceptable violation of human rights and must be addressed immediately. " In another jurisdiction, almost 50 % of euthanasia cases are not reported.” (Pieria, 2011). It is worth noting that despite the initial intention of restricting euthanasia and PAS to a few terminally ill individuals as a last-resort option, many areas have expanded the procedure to include newborns, children, and people with dementia. Furthermore, it should be highlighted that terminal illness is no longer considered a prerequisite for these procedures in some places. “

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5-2 Final Project: Milestone Three: Rough Draft Legalizing euthanasia or PAS puts many people at risk, affects society's values over time, and does not provide safeguards and controls.” (Pieria, 2011). In closing, there will still be advantages and disadvantages and disagreements about PAS, and no group prefers assisted suicide to be their last choice. Medical aid in dying is a crucial option for individuals who are in distress from an incurable sickness and facing intolerable pain and a mediocre quality of life. It is unacceptable that our medical science has not kept pace with our modern possibilities for long life, leaving many to suffer needlessly. We must ensure that those facing an end-of-life situation have access to compassionate care, including medical aid in dying. It is a matter of basic human dignity and respect for individual autonomy. It is unequivocally unacceptable to take someone's life. However, it is a fundamental human right to die with dignity when one is terminally ill and suffering. No one deserves to endure pain and agony in their final days. We must recognize and uphold this right for those suffering and without hope of recovery. We must provide them with a peaceful and dignified death and not shy away from this responsibility.

5-2 Final Project: Milestone Three: Rough Draft References: Braverman D, Marcus B, Wakim P, Mercurio M, Kopf G. (2017). Healthcare professionals' attitudes about physician-assisted death: An analysis of their justifications and the roles of terminology and patient competency. Journal of Pain and Symptom Management. 54(4):538-545.e3. doi: 10.1016/j.jpainsymman.2017.07.024 Burdette, A. M., Hill, T. D., & Moulton, B. E. (2005). Religion and attitudes toward physician‐ assisted suicide and terminal palliative care. Journal for the Scientific Study of Religion, 44(1), 79-93. CNN Editorial Research, (2022). Physician-Assisted Suicide Fast Facts. CNN.com https://www.cnn.com/2014/11/26/us/physician-assisted-suicide-fast- facts/index.html#Statistics Jones, D. A., & Paton, D. (2015). How Does Legalization of Physician-Assisted Suicide Effect Rates of Suicide? Southern medical journal, 108(10), 599–604. https://doi.org/10.14423/SMJ.0000000000000349 Meier, D., Emmons, C. A., & Litke, A. (2003). Characteristics of Patients Requesting and Receiving Physician-Assisted Death. JAMA Network. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/215798 Pereira J. (2011). Legalizing euthanasia or assisted suicide: the illusion of safeguards and

5-2 Final Project: Milestone Three: Rough Draft controls. Current oncology (Toronto, Ont.), 18(2), e38–e45. https://doi.org/10.3747/co.v18i2.883 Regoli, N. (2019). 19 Main Pros and Cons of Legalizing Physician-Assisted Suicide. ConnectUS. https://connectusfund.org/8-main-pros-and-cons-of-legalizing-physician-assisted-suicide

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