Medical Aid in Dying Be Legalized in the United States
Introduction
The practice of medical aid in dying had initially been rejected by many healthcare practitioners and the general public, but in recent years, the tide has shifted, for there has been increased support for medical aid in dying in many states in the United States (Orentlicher et al.). Medical aid in dying is defined as the process by which a patient who is critically sick asks for a doctor’s help in ending his/her life, mostly in the form of a lethal subscription to alleviate unbearable pain and avoid more suffering. The doctor provides the means but is not involved in the killing directly; the patient takes the lethal prescription him/herself once the suffering becomes unbearable.
Patients should be afforded their right to control their last days, and as such, medical aid in dying should be legalized in the United States. This paper presents an analysis of the issue, discussing the various reasons why this practice should be made legal. The paper takes into account all the parties affected by the practice, which include the patients themselves, their families, and the medical practitioners who receive the medical aid in dying requests from patients, process them, and either grant or deny the requests.
Medical Aid in Dying
Medical aid in dying is often confused with euthanasia, but the two differ in that euthanasia involves a third party, other than the patient, for example, a doctor performing the life-ending action killing the patient. Euthanasia, however, remains illegal in the United States, while medical aid in dying is getting more public and physicians’ support. Passive euthanasia, which involves the withdrawal of a life-supporting machine and consequent natural death of the patient, has been a universally accepted practice and commonly practiced one (Breitbart).
Ten states in the US have already legalized medical aid in dying. These are Vermont, California, Hawaii, Colorado, Maine, Washington, Montana, District of Columbia, New Jersey, and Oregon, which was the first state to legalize medical aid in dying in 1994 under its Death with Dignity Act. In these states, the term medical aid in dying is used rather than assisted suicide or Physician-Assisted Suicide (PAS). This was recommended by the American Public Health Association to avoid terminologies that may cause guilt.
Why Patients Request Medical Aid in Dying
When a physician confirms that a patient has six or fewer months to live, patients want an early respite from this agony because terminal illness can cause unbearable pain and suffering. Death, in this case, is inevitable, and medical aid in dying offers them a way out when the pain gets too much. However, pain from the illness in most cases is not the main reason why patients make medical aid in dying requests. Data shows that the loss of control over one’s condition and loss of dignity because of the condition is the main reason many patients request medical aid in dying (Breitbart). For example, losing control over one’s bowel functions makes one dependent on others to clean him/herself. This robs the patient of their dignity, and they may want an early death to end it all. Medical aid in dying thus honors the patients’ wish to avoid unnecessary pain and suffering and have a peaceful death while they still can.
How Medical Aid in Death Impact Families and Physicians
To the families and friends of terminally ill patients, watching as life fade away from their loved ones during their last months can be very painful and emotionally draining. Some patients may opt for medical aid in death to save their loved ones from witnessing them slowly die. Those on intensive care units or need special attention will leave behind huge medical bills, which would strain their families further. Patients reason that trying to hold on to life is futile since their deaths are imminent. For this reason, patients may request medical aid in dying to cut the hospital bills. This, however, has been largely criticized as it opens up opportunities for coercion to request medical aid in dying (Frost et al.).
To the physicians, some of them may be ethically conflicted to grant medical aid in dying requests. Physicians typically address the problem of human suffering by finding solutions, not eliminating the patients who are unfortunate to have these problems. When patients ask for medical aid in dying, they are, in essence, crying for help from a situation they cannot control and expressing their fear of losing their dignity due to the terminal illness. Without a doubt, when this occurs, it calls for support, compassion, and counseling from their doctors, not assistance in ending their lives, making some physicians uncomfortable with the practice. Physicians who feel conflicted with participating in medical aid in dying are allowed to refuse and hand over the case to another physician without fear of victimization. It is especially hard for those physicians who had established a long-term doctor-patient relationship with their patients. It is, however, important that doctors put the needs of their patients first and provide objective guidance regarding their condition and decision. If no other solution is found, the doctor can end his/her patient-doctor relationship with the patient and allow another physician to take over the patient (Frost et al.). In the states where medical aid in dying is still not legalized, willing physicians are prevented from offering this service to patients who need it. Legalizing medical aid in dying will go a long way in ensuring that patients’ wishes are honored, and much suffering can be avoided.
Regulations on Medical Aid in Dying
In states where medical aid in dying is legal, some laws and regulations provide checks and balances to ensure that the practice is not misused. Critics of the practice have voiced the possibility of medical aid in dying being misused to affect the vulnerable and those mentally incapacitated. These are uncalled for fears because the Death with Dignity Act of Oregon, which provides these regulations, is reviewed every year, and for two decades, it has been airtight and never needed to be adjusted (Emanuel et al.).
For instance, there exist laws and regulations that determine patients who qualify for medical aid in dying. These laws are put in place to ensure that the patients or even physicians themselves do not abuse this provision. In the ten states where medical aid in dying is legalized, for patients to qualify to be granted a request of a lethal prescription, they have to meet the minimum requirements by the respective states.
For example, before a medical aid in dying request is granted, a doctor must have given a diagnosis that the patient has about six or fewer months to live. This, according to supporters of medical aid in dying, justifies the aid in dying since the death of the patient was inevitable, whether assisted or by natural causes. The patient must also be determined capable of making his/her own medical decisions. The law requires that at least two doctors and two witnesses confirm that a patient’s request for assisted suicide means was not forced or influenced by other people but an independent patient decision. Patients should also submit two oral requests that are 15 days apart, to give the patient time to think about their decision and one written request. After that, the patient’s request is processed and either approved or denied.
This rigorous vetting process ensures that only patients who have made up their minds and show signs of worsening symptoms and increased pain are granted the medical aid in dying request (Emanuel et al.). It should also be noted that not all patients who request medical aid in dying end up taking the lethal prescription. Many just take comfort in knowing that there is an option for a peaceful death if they can no longer tolerate the pain and suffering.
To conclude, medical aid in dying should be, for the above-discussed reasons, legalized in all states in the United States. The practice gives terminally ill patients control over the remaining days of their lives. It affords them the option for an early death if the pains get unbearable. It also puts the families of these patients of their misery both psychologically and financially. Psychologically, they are saved from witnessing the slow, agonizing deaths of their loved ones; financially, the patient unburdens the family by cutting hospital bills, which would accumulate to huge amounts if they spend their remaining time in the hospital. Finally, it allows physicians to provide this service to their patients who need it. The remaining states should, therefore, follow Oregon’s way and legalize medical aid in dying.
Works Cited
Breitbart, William S. “Suicide, Assisted Suicide, and Desire for Hastened Death.” Psychosocial Palliative Care, 2014, pp. 49-54.
Emanuel EJ, et al. “The Practice of Euthanasia and Physician-assisted Suicide in the United States: Adherence to Proposed Safeguards and Effects on Physicians. – PubMed – NCBI.” National Center for Biotechnology Information, 2016, www.ncbi.nlm.nih.gov/pubmed/9707132.
Frost, Thomas D., et al. “Should assisted dying be legalized?” Philosophy, Ethics, and Humanities in Medicine, vol. 9, no. 1, 2014, p. 3.
Orentlicher, David, et al. “The Changing Legal Climate for Physician Aid in Dying.” JAMA, vol. 311, no. 19, 2014, p. 1961.