Informative Essay on Doctor Assisted Suicide

Throughout the years, as a topic of hot debate, euthanasia has garnered much attention – rightly so, being an “act of deliberately ending a person’s life to relieve suffering” – and with it assisted suicide, a point of discussion of this essay. Thus, this essay will consider and critically analyze why it may now be time, following the failed attempts to persuade the courts to change the law on assisted suicide, to accept the opposing ethical arguments to understand why the law has remained, in a sense, static considering the ethical issues which arise from the current regulation, or lack of on assisted suicide.

Euthanasia, being classed as murder, carries a sentence of life imprisonment as the doctor or health care satisfies the actus reus and the mens rea for the crime of murder by intentionally ending the life of her patient. Assisted Suicide, on the other hand, entails the doctor making lethal means available for his patient, “to be used at a time of the patient’s own” and, like euthanasia, is illegal. Assisted suicide is governed by the Suicide Act 1961, which holds the defendant (D) accountable if he encourages, assists, or attempts the suicide or another, and if D’s act was intended to encourage, assist or attempt the suicide. This act carries imprisonment for a term of 14 years.

With regulation being a rule of order, possessing the force of law – directed by an authority to those under its control, the UK, unlike other countries such as Luxembourg and the like, appears to be comprised of a lack of regulations on assisted suicide – the reason being that was there to be regulations in place regarding it, then it would assume assisted suicide is legalized when it is to the contrary. While proponents of legalizing assisted suicide will argue about the ethical benefits of regulations, maintaining that its legalization would enable the state to regulate it through the threat of prosecution – commentators such as Margaret Pabst argue “bringing euthanasia and related practices out into the open is a way of gaining control…”. She thus argued the Dutch had legalized it for this very reason. This demonstrates how bringing the practice into public view enables control to be exercised over “an open secret [which]… takes place, [without] prosecutions and disciplinary actions” – as evidence has been found that between 4 and 12% of all doctors have assisted in bringing about the death of a patient.

As there have been numerous debates on whether euthanasia and/or assisted suicide should be legalized, advocates often consider whether a person might benefit from assisted dying – finding a way out of their intolerable suffering. Commentators such as Joseph Raz argue it benefits a wider group of people as “shaping one’s dying contributes to giving shape… the form and meaning one’s life has”. Although Raz was referring to euthanasia, it is hard to see how the same argument cannot be used for assisted suicide – with even patients, such as Noel Conway, arguing they would want control over the way they die. In his case, Conway wanted a doctor to prescribe him a lethal dose when his health deteriorates and said, “he wanted to say goodbye to loved ones at the right time, not to be in a zombie-like condition suffering… physically and psychologically’”. In contrast, the opponents of assisted dying to maintain that the interests of the vulnerable members of society would be harmed by this legislation – as emphasized by John Finnis, who highlighted there was a public interest in maintaining “a clear and exceptionless prohibition of assisting suicides”.

It is no secret, there have been several attempts to legalize assisted suicide in the UK, (the latest) The Assisted Dying Bill 2015, was ultimately defeated in the House of Commons, with MPs such as Liam Fox arguing it is “[i]n practice… impossible to differentiate between assisted dying and euthanasia” and thus would “open Pandora’s box that will… change who we are… and how we relate to the medical profession” were it to be legalized. It is clear, that Individuals like Fox were invoking the slippery slope argument – that is the claim of a number of compassionate killings would inevitably lead to difficulty in preventing those with altruistic motives from ending a patient’s life – making it impossible to police the boundary between acceptable and unacceptable medical killings – as Dieter Giesen commented that “we would… become progressively desensitized to the horror of murder” as “Once on the slope we will be unable to get off…”.

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With Keown and Gieson being convinced the Dutch have already slid down the slope – the former exclaims the … Dutch experience lends… support to the slippery slope argument… the so-called strict safeguards… proved… ineffectual; non-voluntary euthanasia is… widely practiced… increasingly condoned…” However, it must be questioned how this trend is actually identified, as it does not mean there is a “casual connection” with the increase of the practice with its legalization. Such a point is raised by…: The simple fact… something occurs something else does not indicate… the first action logically required the second to happen… Especially in the realm of human actions… preceding action by a first action does not indicate they must be connected in any logical way.

As a result, the Dutch and other countries’ experience may lend support to the fact that it may be time to accept the opposing arguments to make an acceptable solution possible, as the regulations on those borders present an opportunity for patient autonomy and is in line with the doctrine of double effect – which ensures that while one action “will have two effects, one that is considered a good effect, the other a bad effect” – as a result, the good cause will ultimately outweigh the negative effect as indeed the doctor is only intending a benefit to his patient, allowing him to die in a “peaceful and dignified” way and has a respect for his autonomy. Thus, there is no other issue – no doubt a result of the strict eligibility test for the patients, young or old, in those countries which have legalized assisted suicide, as, to be eligible, the number of criteria includes patient having to suffer unbearable pain or distress which cannot be alleviated, and consent must be given. In addition, a second doctor must also confirm the first’s decision after examination. Switzerland has further preconditions, which the doctor has a “responsibility to check”.

Assisted suicide, as it results in the patient “[losing] control of [the] most significant aspects of his or her life” – among the ethical issues which arise from a lack of regulations concerning it, is the effect it has on the patient’s autonomy. Indeed, when a patient decides that they want the assistance of their doctor, or physician, in their suicide, it can be argued this supports their right to patient autonomy – allowing the patient “as dignified a passing as achievable”. Consequently, an individual’s decision is respected because it is their own choice, regardless of whether the “mentally competent patient… for any reason… or for no reason at all, even where that decision may lead to his or her own death” came to this resolve. Enjoying an absolute right to refuse, the patient’s independence – which “is paramount” – is respected. This is further supported by MacDonald J, who held that “in accordance with the provisions of the Mental Capacity Act 2005…a capacitors individual C is… sovereign.”. Thus, with the principle of autonomy playing an important part in today’s right to receive medication, it is arguably wrong for the law to not be changed on assisted suicide – as, in light of the ethical principle of autonomy, it causes an issue with the lack of regulation in this area. This is due to the principle of autonomy being in line with the virtue ethics of compassion, which is to be maintained as it is depicted through the doctor having an understanding of the patient’s wishes and situation complies with his requests. Furthermore, supporters of assisted suicide arguing the compassion principle entails the doctor ‘to do good’ to help relieve the patient’s suffering when it has become unbearable and untreatable. A doctor would thus “only be acting beneficently in helping a patient to die if she has reasonable grounds for believing… the patient’s life has ceased to be a benefit to her”. Thus, the use of compassion as a justification for legalizing assisted suicide might be “compatible with… justice and charity” – but only where its “purpose is to benefit the one who dies”

As a consequence, perhaps it must be questioned ‘Why isn’t assisted suicide legalized when the principle of double effect exists?’ – a principle holding that painkilling drugs can be administered even though they “may simultaneously hasten the moment of death… This, as a result, begs the question posed prior, as the doctrine of double effect seems to permit the doctor to deliberately end his patient’s life – as one does not cause any ethical issues regarding its regulation, why should there be an ethical issue regarding assisted suicide? However, it must be noted, the doctrine of double effect applies to the interest of pain relief overriding the prolongation of life, it has an overall result of demonstrating the autonomous nature of the patient being an important concern for the doctor. Thus, the teleological approach of consequentialism seems in line with patient autonomy – as the approach is based on the result which will produce the most ‘good’, it allows the patient’s discretion to choose the treatment they deem best for them – catering it to their own circumstance.

However, it is conceivable that this ‘right to choose’, by the exercising of personal autonomy by an individual, “is… meaningless… [serving] as a slogan and a powerful emotional tool…” – this being the case as it can be questioned whether refusing necessary medical treatment can be regarded as suicide, thereby raising a key ethical issue. This is perhaps exemplified by the fact that 90 percent of those who die from suicide have a diagnosed mental disorder, thus demonstrating how patients are not able to truly make an ‘autonomous decision’.Thus while the supporters of its legalization suggest that regulation of euthanasia would allow it to be monitored, it, in practice, would be too difficult to do, risking the ‘privacy of the doctor=patient relationship’ – as the control over the doctor’s discussions with their patients would prove difficult and ‘must… be physician self-regulated’. Indeed, as a result, legalization may be unnecessary as the loss of autonomy itself is a reason for seeking assisted suicide, which is even the case in Oregon and Washington State. Thus, legalizing assisted suicide might have a negative consequence as a whole.

Furthermore, a problem lies in the risk legalization has towards abuse, with it granting an understanding of why there is no ethical issue from the current lack of regulation, but there would be an issue had there been, and there are ethical issues with the current regulation within the regions it has been legalized. This argument is linked with the slippery slope as it essentially pertains to the fact that it could lead to an abuse of the vulnerable. As there is a concern that the elderly community, or rather patients, would be under pressure to choose death over receiving ongoing healthcare. This is particularly so, as there is a desire to avoid becoming a burden for these