WK 4 OUTLINE-N434. (1)
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Week 4 Term Paper Outline Susana Boateng
West Coast University
PHIL 434: Medical Ethics and Issues
Ian McDougall
11/26/2023.
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Week 2 Term Paper: Outline
I.
Introduction: Physician Assisted Suicide is the act of taking a patient's life in order to end their suffering and it done by a physician (Goligher et al, 2017). The patient in question would frequently be in extreme pain or be afflicted with a dreadful sickness. When it was once considered normal in ancient Greece, and Rome. However, the modern era of PAS began when it was originally proposed as a way to alleviate the pain of terminally sick patients around the turn of the 20th century.
The Euthanasia Society of America, the first proponent of the right to die, was established in 1938 to advance PAS legalization (Goligher et al, 2017). PAS was met with strong criticism, though, and in 1994 Oregon became the first state to only allow it under specific conditions. Since then, numerous more nations and states have done the same. One of the most well-known PAS incidents is that of Dr. Jack Kevorkian, a Michigan physician who assisted in the deaths of over 100 terminally sick patients. Following his conviction for second-degree murder, Kevorkian received an eight-year prison sentence. His case raised awareness of PAS among the public and started a conversation regarding the technique's ethics. PAS is opposed because it goes against the Hippocratic Oath, which prohibits doctors from doing harm to their patients. Furthermore, they argue that legalizing PAS could lead to abuses such as forcing the old or crippled to take their own lives. Advocates of PAS argue that it is a compassionate means of easing the pain and suffering of those who are terminally ill and have
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little chance of survival. Additionally, they contend that it is a matter of
personal autonomy and the right to pass away in dignity. In the PAS debate today, proponents on both sides are still voicing passionate points. Some nations, including the Netherlands and Belgium, have even legalized euthanasia, allowing medical professionals to give terminally ill patients who request it lethal doses of medication. State laws still control the issue in the US; some states explicitly prohibit PAS, while others only recognize it under certain circumstances. The PAS controversy is expected to go on as advancements in medical technology allow people to survive longer even in cases where there is no possibility of recovery (Goligher et al, 2017).
II.
Explanation of Physician Assisted Suicide terminologies.
III.
physician-assisted suicide" is the term for actively performed, willingly performed assisted suicide in which a medical professional provides help to the patient. The doctor provides the patient with the means to end their lives, such as adequate drugs (
Goligher et al, 2017)
IV.
Body Paragraph 1 – Technical aspects of your topic
a.
Topic Sentence: Individuals who choose to end their lives have access to a wide variety of lethal drug combinations.
i.
Supporting detail 1: Oral ingestion
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1.
Professionals often used lethal amounts of barbiturates, mainly pentobarbital or secobarbital, to aid with suicide (Worthington et al, 2022). The use of very large doses of barbiturates as a common assisted suicide technique is supported by both the Canadian Association of MAiD Assessors and Providers' oral MAiD medication protocol and the Netherlands' Guidelines for the Practice of Euthanasia and Physician-Assisted Suicide (Worthington et al, 2022).
ii.
Supporting detail 2: Before administering an assisted suicide, medical personnel usually give a general anesthesia, usually a barbiturate or another sedative like propofol, to induce unconsciousness (Worthington et al, 2022). Additionally, some provide a benzodiazepine anxiolytic prior to the coma-inducing medication and, occasionally, to alleviate the discomfort caused by propofol (Worthington et al, 2022).
iii.
Supporting detail 3: After the anesthesia, a neuromuscular blocking drug is administered. These drugs block all striated muscles, preventing any movement, to lessen the effort required to breathe and to get rid of muscle spasms that family may perceive as signs of distress (Worthington et al, 2022).
V.
Body Paragraph 2
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a.
Transition: There are many public policy debates surrounding the ethics of euthanasia and physician assisted suicide here in the United States and in other countries. 1.
Topic Sentence: Euthanasia and physician-assisted suicide are not regulated under federal
legislation.
i.
Supporting detail 1: The federal government and all 50 states prohibit euthanasia under general murder laws. In the federal government, assisted suicide is not illegal under any legislation. These laws are frequently dealt with by state governments (Pereira, 2018). ii.
Supporting detail 2: Nine states do not allow the practice of physician assisted suicide, and they include California, Colorado, Hawaii, Maine, New Jersey, New Mexico, Oregon, Washington in addition to District of Columbia. In one state (Montana), performing a physician-assisted suicide
and having it approved by the court requires an order from the court (Americans United for Life, n.d). iii.
Supporting detail 3: California End of Life Act. A terminally ill adult Californian citizen may request a life-ending prescription from their physician under this statute. People who choose to end their life in this manner and meticulously adhere to the legal requirements won't be regarded as having committed suicide. As long as all legal standards are met, physicians who prescribe medications that expedite death will not be accountable to professional or legal penalties. This is an end-of-life option in which doctors and patients can choose not to participate.
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1.
VI.
Body Paragraph 3 – Pro Arguments
a.
Transition: The options of physician assisted suicide and euthanasia should be available to any patient receiving end-of-life care. Nobody should have to live in constant pain until they pass away on their own.
b.
Topic Sentence: The relief of suffering, safe medical procedures, and respect for patient autonomy are common arguments for euthanasia and physician-assisted suicide.
i.
Supporting detail 1 : The ability to manage one's own affairs is known as autonomy. Patients in healthcare settings have the choice of accepting or rejecting medical procedures (American Medical Association, 2021). Informed consent is justified by the patient's autonomy, which can only be
maintained following a full explanation of the advantages and disadvantages of a therapy or involvement in medical research (Pereira, 2018). ii.
Supporting detail 2: At its fundamental level, medicine has always sought to alleviate suffering brought on by sickness and illness. Supporters of physician Assisted Suicide, however, assert that it is humane and considerate to ease a patient's suffering by ingestion if they are terminally ill and their suffering is irreversible (Pereira, 2018). In fact, some of the
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strongest justifications for Physician Assisted Suicide come from persons who suffer from grave conditions.
iii.
Supporting detail 3: Advocates of assisted suicide hail it as a safe medical practice because it allows doctors to guarantee death in a way that other methods of suicide cannot.
VII.
Body Paragraph 4 – Con Arguments
a.
Transition: Everyone has the right to their own unique opinion on the most effective ways to protect and sustain human life.
b.
Topic Sentence: Physician-assisted suicide are frequently opposed by the claims of accidental deaths, slippery slope theory, and suicide contagion.
i.
Supporting detail 1: Brittan Maynard, high profile death However, the number of people in a comparable situation who killed themselves in Oregon via fatal ingesting more than doubled in the months preceding Maynard's widely reported death in November 2014, according to statistics that are available to the public (Oregon.gov, n.d). Some claim that the growing number of reasons why people opt for assisted dying is the greatest way to illustrate the slope.
ii.
Supporting detail 2: Some opponents of assisted dying fear that if doctors begin to aid in hastening patients' deaths, they are embarking on a dangerous path. Refractory physical pain is no longer the strongest argument for consuming anything toxic to end one's life. Based on all
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Oregon statistics, the vast majority of patients select assisted dying due to concerns about "losing autonomy" (90.6%) or being "less able to engage in activities making life joyful" (89.1%). Others fear "losing their sense of dignity" (74.4%), "being a burden on family, friends, or caretakers" (44.8%), or "losing control of physical functions" (44.3%) (Oregon.gov, 2023). iii.
Supporting detail 3: Up to 50% of cancer patients have signs of depression. Depressive and suicidal thoughts are prevalent among senior citizens. Since depression frequently manifests somatically, doctors miss 50% of all cases of clinical depression if patients are not investigated. Euthanasia and physician-assisted suicide are major concerns.
VIII.
Opinion and Conclusion
a.
Transition: I support physician assisted suicide, because I think everyone has the right to their own views. I support it because I don't believe a critically or terminally sick patient should have to suffer during their final six to eight months of life. Although I think both sides have merit, I believe the advantages exceed the
disadvantages. In order to be eligible for physician-assisted suicide, strict guidelines must be followed. In my opinion, the patient has the final say if the protocol and requirements are fulfilled. Every person has the right to autonomy over their life and medical decisions; no one should be able to determine whether a patient must suffer relentlessly beside them.
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References
American Medical Association. (2021). What’s the Role of Autonomy in Patient- and Family-
Centered Care When Patients and Family Members Don’t Agree? Retrieved From: https://journalofethics.ama-assn.org/article/whats-role-autonomy-patient-and-family-
centered-care-when-patients-and-family-members-dont-agree/2016-01#:~:text=Patient
%20Autonomy%20and%20Informed%20Consent,clinicians'%20recommendations
%20%5B1%5D
.
American United For Life. (n.d). We Owe Each Other Suicide Prevention, Never Suicide Assistance. Retrieved From: https://aul.org/physician-assisted-suicide/
Goligher E et al. (2017).
Physician-Assisted Suicide and Euthanasia in the Intensive Care Unit: A Dialogue on Core Ethical Issues. Retrieved From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5245170/
Oregon.gov. (2021). Oregon Death with Dignity. Retrieved From:
https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATION
RESEARCH/DEATHWITHDIGNITYACT/Documents/year23.pdf
Pereira J. (2018). Legalizing euthanasia or assisted suicide: the illusion of safeguards and
controls. Retrieved From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070710/
Worthington et al. (2022). Efficacy and safety of drugs used for ‘assisted dying.’ Retrieved
From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9270985/
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