PHIL 235 Final paper
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Cégep John Abbott College *
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235
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Philosophy
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Feb 20, 2024
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Uploaded by ProfessorProton15939
Tatyana Pillay – Noel
ID: 40291166
PHIL 235 Should patients be given an option to end their own lives or to request PAD (physician
assisted death)? And if so, when and under what conditions?
Would you not choose active euthanasia if you were faced with a medical choice that would result in a poor quality of life and you saw the suffering it would cause your family? This has been a highly controversial topic of debate for as long as medicine treatments have existed. The questions of whether the patient is truly in their right mind to make a decision as big as ending their own life, whether this goes against a physician’s morals even though the patient has a right to autonomy or after how many treatments or alternative medications is it allowed to be considered “ok” to end one’s life assisted by a physician? In addition to ensuring that doctors' moral duties are not entirely disregarded when it comes to euthanasia, patients should have the autonomy to make decisions about their medical care. To make things easier for the doctors in charge, there should be specific requirements that a patient must fulfill. In my opinion, euthanasia should be carried out actively in order to respect the patient’s autonomy and beneficence, but it should also adhere to regulations in order to ensure that the physician’s moral obligations are upheld.
When it comes to euthanasia, most people are against it because they believe a physician’s obligations are to save or keep someone alive as long as possible. In instances however where someone has no more alternative medical options and they are stuck with an
incurable disease; wouldn’t it be immoral to continue to keep this patient alive knowing they are suffering? This was the case for a 34-year-old named Samantha O’Neill, she was diagnosed with stage 4 cervical cancer that was inoperable and terminal. She was being treated at a catholic run hospital who didn’t believe in PAD and therefore refused her wishes as an already dying patient because of their own beliefs and not the patients right to autonomy. In the article it states, “O’Neill had chemotherapy and radiation to prolong her life, but by February, the pain was so debilitating, she began considering PAD.” (DeRosa, 2023). O'Neill needed to transfer to a different hospital because the one she was receiving treatment at had refused to allow her to die by physician assisted means. However, this would deprive her of her last moments with her loved ones because, prior to the transfer, she had been in so much pain from cracked ribs, that she needed to be medicated, which rendered her unconscious even as the life-ending medication was being administered. The hospital that initially cared for O'Neill followed their professional ethics and beliefs, but this went against O'Neill's wishes, and as a result, her right to patient autonomy was completely disregarded. As keeping a patient alive causes them to suffer far more than if they ended their own life with some dignity alongside their family, who would then no longer have to witness their suffering, patients should have the last say in situations like O'Neill's, even if it goes against the hospital's direct beliefs. Many patients experience mental distress when they receive life-altering diagnoses or have undergone numerous treatments, which
can exacerbate their conditions and increase their tendency to consider euthanasia. Even though it may be decided that a person experiencing mental distress is not competent to make such a decision, I think every case should be considered because, if the person is already going to die, they are just accelerating the process of meeting their predestined fate.
Many people find it difficult to distinguish between active and passive euthanasia and to determine which would produce the best results. Active euthanasia is the practice of administering a patient a lethal dose of medication; which is also known as physician assisted death. Passive euthanasia is when the patient eventually dies when life support or life-sustaining medication is discontinued. “The distinction between the two are very important when it comes to medical ethics”
(Rachels, 1975). This is because, in most cases, active euthanasia would be considered unethical from a medical ethical standpoint, but passive euthanasia might not be. However, Rachels accurately pointed out that the majority believe there is a moral distinction between active and passive euthanasia, and that distinction is that killing someone is considered to be worse than allowing them to die. This seems biased to me because I think that consenting to end someone's life is not nearly as horrible as letting them endure unnecessary suffering or discomfort. When you consider that passive euthanasia only involves withholding life support, which can cause them to suffer more before they pass away gradually, it is actually more inhumane. On the other hand, since the patient would receive the dosage of medication at their request, active euthanasia eliminates both the agony and the long wait since it only takes a few minutes to take effect. People who are born with incurable painful diseases, such as ALS, for which they will undoubtedly require strenuous and drawn-out medical treatments, may find active euthanasia helpful. That being said, most people believe that they would be better off with assisted death because it would relieve their family of financial burdens and spare them from having to endure pain. Such cases demonstrate even more the rationale behind considering active
euthanasia as a last resort for patients with few or no other options and a poor life prognosis.
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Strict rules should be put in place to protect the patient's autonomy while also, to some extent, protecting the doctor's moral beliefs, for the sake of both the patient and the doctor. In order to fully explain the consequences and help the patient understand what they are about to go
through, the doctors who are guiding them through the process should possess an abundance of knowledge in the issue at hand. The following requirements for qualifying for PAD are outlined in regulations highlighted in Bill-C14: “1. Being an adult at least 18 and older who is mentally competent to make health care decisions, 2. Having a grievous medical condition, 3. Making a voluntary request for medical assistance in dying which does not result from external pressure, 4.
Giving informed consent to receive medical assistance in dying, 5. Being eligible for health services funded but the government” (Canadian Government, 2023). It's critical to emphasize the
significance of each requirement in preserving a doctor's autonomy when assessing them. Regarding point #1, it is evident that the purpose of the request was to ensure that the patient is not acting irrationally and that it is morally right for the doctor to grant these requests. The second criteria ensure that the patient's life will end in death or unending suffering, so if a doctor performs PAD, the patient's suffering will be ended and their life won't end prematurely, giving the doctor confidence in their decision. Regarding point #3, this enables the physician to recognize that the patient is the only one making this decision and to do so without worrying that
they would be acting contrary to their genuine emotions. These requirements not only let the government establish safe practices, but they also give the doctors performing these procedures peace of mind because they know that the patients are fully aware of the potential risks. This permits the doctors' autonomy to be respected as well, enabling them to decline these procedures in the event that the patient does not meet these requirements. I think this is a bit more of a sensitive topic when children are involved, but I also think children should be allowed if they can
demonstrate that they understand exactly what would happen if they went through with it. In my opinion, a court would then need to become involved to make sure that there was no coercion on anyone's part. The court would then make the ultimate decision based on the fact that if the child is already dying and there is no way to prolong their life, they are still in pain just by continuing to live. In conclusion, a patient has a right to choose freely how they would like the end of their life to play out whether this means to die by means of withholding life sustaining treatment or by
actively ending their own life for their own dignity. As long as a patient is deemed to be in their right of mind, they should have patient autonomy over their decisions. Nonetheless, doctors should not be placed in a position where they are not sure if it is ethically sound to actively euthanize a patient because there are lack or regulations or information for the doctors to use in order to best help a patient make a decision.
Euthanasia, also known as physician assisted suicide, is still a contentious topic and is only legal in some states at this point. As a result, there will undoubtedly be situations where a doctor feels they have violated their morals and where a patient feels their autonomy has been taken away, but overall, I think we are contributing as long
as we are making progress and clearing the path for the legalization of these practices in other states. Thus, in my opinion, euthanasia should be carried out actively in order to respect the patient’s autonomy and beneficence, but it should also adhere to regulations in order to ensure that the physician’s moral obligations are upheld.
Resources
1.
Government of Canada, Department of Justice. “Legislative Background: Medical Assistance in Dying (Bill C-14).” Part 1 - Description of Proposed Legislation on Medical Assistance in Dying
, 2 Feb. 2023, www.justice.gc.ca/eng/rp-pr/other-autre/ad-
am/p2.html
. 2.
Woman with Terminal Cancer Forced to Transfer from St. Paul’s Hospital ...
, vancouversun.com/news/local-news/woman-with-terminal-cancer-forced-to-family-
upset-by-st-pauls-hospital-maid-policy. Accessed 8 Dec. 2023. 3.
“Euthanasia.” Euthanasia - MU School of Medicine
, medicine.missouri.edu/centers-
institutes-labs/health-ethics/faq/euthanasia#:~:text=Active%20euthanasia%3A%20killing
%20a%20patient,a%20ventilator%20or%20feeding%20tube. Accessed 7 Dec. 2023. 4.
Active and Passive Euthanasia James Rachels - University of Alberta
, sites.ualberta.ca/~bleier/Rachels_Euthanasia.pdf. Accessed 8 Dec. 2023. 5.
Fontalis, Andreas, et al. “Euthanasia and Assisted Dying: What Is the Current Position and What Are the Key Arguments Informing the Debate?” Journal of the Royal Society of Medicine
, U.S. National Library of Medicine, Nov. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6243437/.
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