Euthanasia and physician-assisted suicide have been the subjects of religious, ethical, and legal debate for over 3,000 years. The word “euthanasia” is of Greek origin, and translates to “good death”. In this paper, I will be exploring both traditional and modern arguments about the permissibility of physician-assisted suicide, and our individual autonomy to decide when, and under what circumstances, our own physical lives should be terminated. When, and whether we choose to act upon the freedom to end our own life, is a personal decision that each one of us carries throughout the course of our lives. Suicide is not illegal. However, only when we are in our darkest hour, and unable to physically act for ourselves to end our own life to avoid a certain, painful, and/or extended death, does the law step in with prohibitions against our freedom to act. To force an individual to endure an existence of suffering, pain, or virtual unconsciousness for a period of time before certain death, is seemingly cruel. To allow individuals to choose to terminate their own certain and unnecessary suffering to avoid extended pain, deterioration, and familial agony, is to allow them their final act of personal autonomy. Physicians assisted suicide should not only be thought of as an act of grace, it should be legalized and regulated to ensure each of us has the right to choose to die with dignity.
Pope John Paul II once stated, “Euthanasia and assisted suicide are never acceptable acts of mercy. They always gravely exploit the suffering and desperate, extinguishing life in the name of the quality of life itself.” There has been a historic aversion to the notion of physician-assisted suicide steeped within theology since Medieval times. The sanctity of life is held at a high standard amongst religious communities, as well as the notion that our lives are a gift from God, and therefore, we have no personal right to terminate the gift God has bestowed upon us.
'Philosophers of the past often analyzed end-of-life situations by considering whether suicide or euthanasia would violate one of three fundamental moral obligations: those to God, those to oneself, or those to other people. The standard position on this was expressed 2,500 years ago by Pythagoras, the Greek philosopher, and mathematician, who stated: Like prisoners, we are confined by the life that the gods assign us, and are not free to depart from it through voluntary death.' (Simmons, Kevin M.)
Classic philosophers such as Plato, Aristotle, Pythagoras, and Socrates explored the meaning of human autonomy, existence, free will, and therefore the individual's right to live and die. Plato believed that when there was no effective treatment for an illness, and death was certain, it was justified for physicians to stop or refuse to administer continued medical care. To treat a patient in this physical and medical state would be of no benefit to society or the dying person. However, Plato stopped short of condoning overt acts to terminate life.
Clearly, in the days when Plato, Aquinas, and Pythagoras were grappling with the existence and purpose of personal autonomy, they did not have the advanced medical technology that we are fortunate to have today. With the advent of defibrillators, morphine drips, and Do Not Resuscitate Orders (DNRs), religious leaders are now forced to rethink and reformulate their positions on euthanasia, palliative care, and moderate medical care. Whether a particular brand of religion supports or condemns failure to administer emergency life-saving measures, the nature and scope of medical attention during palliative care have come to the forefront of the euthanasia debate. Interestingly, religious groups may have differing opinions on whether refusals to administer medical care, such as DNRs, comport with their historical positions on the broad euthanasia debate. For instance, the Buddhist religion teaches that it is morally wrong to destroy a human life, even if it is one's own life. Buddhists promote high respect for human life, even if a patient is in a vegetative state. However, some Buddhists approve of some forms of euthanasia and cessation of prolonged medical treatment so long as there is no intention to take a life. Catholicism teaches its followers that God is our Creator, and therefore, we have no right to take what God has given us. God would therefore be the only one who would be permitted to choose when and how we ultimately die.
Interestingly, the Catholic Church condones physicians to remove life-sustaining care to allow a person to die from natural causes, which they believe, does not constitute 'euthanasia'. A different sect of the same religion, Mormonism, teaches that the removal of life-sustaining care and letting the patient die from euthanasia does, in fact, fall under the category of outright killing. So how can we as a society decipher what should be the best answer to this age-old debate when Christians who purportedly believe in the same God, and read from the same Bible, do not have a consensus of opinion? Do we throw out this melting pot of opinions and turn to Plato's simple philosophy of self-autonomy?
According to the Merriam-Webster dictionary, autonomy is 'self-directing freedom and moral independence,' (“Autonomy.” Merriam-Webster). 'Put most simply, to be autonomous is to be one's own person, to be directed by considerations, desires, conditions, and characteristics that are not simply imposed externally upon one, but are part of what can somehow be considered one's authentic self.' (Christman, John. “Autonomy in Moral and Political Philosophy.”) This notion of self-autonomy and the ability to self-govern and exist as you please originated among religious scholars and philosophers thousands of years ago. If we are free to live and exist as we so choose, without infringing upon or causing harm to others, then the right to choose when and how to terminate our continued personal existence is a decision left up to the individual. If we, as a people are permitted the freedom to live our lives within the boundaries set by laws to protect the common good, the determination of when we choose to die should not be an issue delegated to any exterior force, entity, or individual. It is a matter of our own personal choice and a decision that should be made by each individual as an inherent and inalienable right. “Euthanasia is simply to be able to die with dignity at a moment when life is devoid of it.” - Marya Mannes.
Physician-assisted suicide is becoming more accepted in the medical community, not only because it gives the patients the opportunity to die with dignity, but also because it diminishes many fears people may have when death approaches. This provides peace of mind that can sometimes result in extending quality of life by and through emotional solace. “But the state of end-of-life care in this country is lacking according to a recent Institute of Medicine Report, (“Approaching Death: Improving Care at the End of Life”). The $28 million SUPPORT project (the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment) also provided evidence that Americans are not dying well. SUPPORT documented inadequate pain control, unwanted aggressive treatment at the end of life,” (Snyder, Lois.) Many may choose physician-assisted suicide in States where it may be legal because they fear physical deterioration, a total loss of lucidity and dignity, or do not want to become a burden on their family members. A physician’s respect for basic autonomy and a person's right to die is crucial because death, in and of itself, is an extremely personal and intimate event for individuals and their family members. We should promote personal autonomy and individual choice for terminally ill patients and their families in choosing the right time and circumstance to finalize the last chapter of their lives. This is a responsibility given to physicians who have taken the Hippocratic Oath, “I must not play at God.” (Jr, William C. Shiel)
Although only nine states and the District of Columbia have legalized physician-assisted suicide, the right to die with dignity and without prolonged pain and suffering should be left to individual choice, and not to State legislatures. We, as right-thinking people, do not think twice about putting a hurt animal down, yet we deny that same act of mercy to our fellow men and call it an act of intentional killing. Physicians may choose to participate in assisted suicides, and those who do not condone such acts should be permitted to opt out of administering such services. Many doctors are able to unite the basic tenets of the Hippocratic Oath with the act of physician-assisted suicide, as prolonged and unnecessary suffering of a terminally ill patient defies human decency. Further, Hippocratic verbiage is adaptable and revisions have been made throughout the years to adapt to different perspectives of the duties and obligations of the medical profession.
The decision of when and under what circumstances to end your own life when you are suffering from a terminal illness should be a sacred and personal choice left up to the patient. This is why it is just for the legalization of physician-assisted suicide so that those who are making a personal decision about their own death are not suddenly inhibited by the law. However as medicine keeps advancing and stances keep changing the argument stays the same, which makes many wonder if this debate will ever come to a resolution. “Far from definitively resolving the assisted suicide issue, the court's decisions seem to assure that the debate over assisted suicide and euthanasia is not yet over - and may have only begun.” - Neil Gorsuch
Resources
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