Examining Physician Assisted Suicide: An Ethical and Legal Essay

This essay delves into the complex ethical and legal debates surrounding physician-assisted suicide, examining arguments both for and against its practice. It discusses the historical context, different types of euthanasia, and the moral dilemmas faced by physicians. The essay weighs the principles of patient autonomy, the right to life, and the potential for abuse, referencing legal precedents and philosophical viewpoints. It explores the conflict between a doctor's duty to preserve life and the desire to alleviate suffering, considering the implications of physician-assisted suicide on the doctor-patient relationship and the broader societal values concerning life and death. The conclusion reflects on the balance between individual freedom and the protection of vulnerable individuals within the context of end-of-life decisions.

Running head: LEGAL ESSAY
Legal essay
Name of the Student
Name of the University
Author Note

1LEGAL ESSAY
There has always been a debate regarding the morality and immorality encompassing
physician assisted suicide and also euthanasia. The articles, journals as well as the human rights
advocates have put forward their views both in favour of and against the principles of human
rights and the right to live1. In this paper, the discussions shall be encompassing both the
morality and the immorality of physician assisted suicide and then both sides of the debate shall
be weighed and evaluated to reach a conclusion regarding the strength and the weakness of this
concept. There has been both ethical as well as legal constraints regarding the legalization of
physician assisted suicide. The enormity of the topic can be broken to ethical concepts like
morality, the standard of living and then a little emphasis can be put on the legality of the topic,
that is right to life and the legality of taking lives by a physician. The question to be pondered
upon while discussing the topic is the very term of suicide and why is it called so, even though it
is done in the presence of a qualified physician. The issues shall be dealt with subsequently.
Physician assisted suicide: Arguments in favour
In the ancient past, assisted suicide was norm where the dying or ailing patient’s life was
taken to preserve his honour and it was not seen as a crime. In the recent age of modern
technology and advanced medicine, it has become imperative on the physician to keep fighting
to keep the patient alive. The question that keeps on getting repeated is what is the purpose of
keeping a patient alive knowing that the patient will be subject to tremendous pain and there is
no way of prolonging the life span. The modern medicine has progressed to include different
techniques to ensure that the patient lives on life support. This is an expensive process, the costs
of which need to be borne by the patient party. These medicines intend to force the patient to live
a longer life, knowing that the patient will not survive for a very long time. On one hand, there is
1 Battin, Margaret P. "Physician–Assisted Suicide: Safe, Legal, Rare?." Physician Assisted Suicide. Routledge, 2015.
63-72.

2LEGAL ESSAY
a utility of these medicines, as these prolong the life of the patients. On the other hand, some
human rights activists have also rebutted the point of prolonging life by stating that it is a process
of prolonging death, making the process of dying very painful and excruciating. Euthanasia and
assisted suicide are not the same thing but they are undertaken with the intention of taking away
a patient’s life so as to relieve the pain2. Euthanasia can be classified into two types on the basis
of the ability of the patient to give consent. Voluntary euthanasia is defined as euthanasia
conducted with the consent of the patient. Involuntary euthanasia on the other hand is defined
as euthanasia conducted without the consent of the patient as the patient is not in the position to
give any consent. The decision in case of passive euthanasia is taken by another person on behalf
of the patient. Euthanasia is conducted with the help of a medical practitioner, and therefore
based on the procedure in which euthanasia is conducted, it is classified into active and passive
euthanasia. Passive euthanasia is said to be conducted when the medicines or equipment on
which the patient is surviving are withheld. Whenever life sustaining treatment that are keeping
the patient alive are taken away, the patient ultimately dies. Active euthanasia is the use of legal
medicines or substances to end a patient’s life3. The question of active euthanasia involves many
moral and ethical considerations and starts debates as to whether it shall be a legal method that
can be implemented by the physician. Taking the definitions of active and passive euthanasia, the
question of assisted suicide can be inferred because the intention in both the two methods is to
relieve a patient of his sufferings and ensure that he does not suffer. The physician helps the
patient by recommending medicines so that the patient can administer it at his own volition. The
moral dilemma that the physician is faced with is, how can a doctor take the life of his patient
where his profession demands that he save lives. The ethical dilemma in case of physician
2 Salubre, Jobel Angelica Therese. "Physician Assisted Suicide." (2015).
3 NZIMANDE, DR KHAYA. "PHYSICIAN ASSISTED SUICIDE." (2016).

3LEGAL ESSAY
assisted suicide is immense as it is always argued that a doctor participates in the death of his
patients which is against his morals4. There are many historical references to physician assisted
suicide as in one of his deliberations Plato claimed that the sick people should be abandoned to
death and that the Hindus always believed in entrusting the elderly to take the suffering patients
to the Ganges river. In cases of people trying to commit themselves to death, it is also important
to take the reference of Eskimos, who exposed themselves to severe cold weather so that they
could die in the cold when they understood that they were not competent to live any longer.
Physician assisted suicide is considered legal in some of the states of the United States of
America, like Oregon, Montana etc. in those states, the laws favours the physician in cases when
the patient is ailing and severely ill. The patients have to request the lethal dosage and the doctor
has to ensure that the patient is in a mentally stable condition to make sure that he is capable of
making the decision that he does not want to live any longer. The question of merely living and
surviving and a life full of happiness are two different things and that is what the debate tries to
encompass. A life full of sufferings is not a life fully lived. Merely having brain activity could be
a good way to gauge that the patient is living, but if the patient cannot enjoy the beauty of life
and become a liability on others even for the basic functions of life, that is rarely a life.
Opinion:
In my opinion, assisted suicide is ethical as it respects the wishes of a patient and his
choice to end his life. The patient has the choice to live his life according to his own wishes. It is
essential to respect an individual’s autonomy over his life. The choice entirely vests on the
individual as to whether he wants to prolong his suffering or put an end to it. Elements of
privacy, freedom and lastly autonomy are essential factors that should be give due credit. The
4 Kamm, Frances M. "Physician-assisted suicide, euthanasia, and intending death." Physician assisted suicide.
Routledge, 2015. 28-62.

4LEGAL ESSAY
utilitarian argument is an important argument that needs to be considered in this perspective that
will help in the solving the mystery and also settling the issue of physician assisted suicide.
Jeremy Bentham in his theory had said that it is more important to promote individual
happiness and there is also a need to decrease unhappiness and suffering. Therefore, taking cue
from the concept of maximum happiness of maximum number, it is wise to state that if the
patient wants to reduce his suffering along with the suffering of his family, the caretakers by
taking his life, the choice should be respected5. By denying the patient to make the choice is
denying the basic freedom that every individual should have6. The notion that the doctor being
the healer is turning into a murderer by abetting suicide should not be encouraged as there is no
moral culpability as the doctor is merely assisting in the process of reducing the pain of the
patient7. The role of the doctor is to keep the interest of the patient way ahead of his own interest
and therefore I believe that the doctor should act as a healer in a way that will end the suffering
of the patient and also take away the life peacefully8.
Physician assisted suicide- Arguments Against
The biggest rebuttal to the argument of physician assisted suicide is that the doctor will
act immorally if he allows a patient to die and also plays an active role in taking away a life. The
opponents to physician assisted suicide claim that the role of the doctor is to act in the best
interest of the patient and has to also fight to keep a patient healthy and happy9. The argument
that the opponents put forward is that life has been created by God and that mere humans should
5 Emanuel, Ezekiel J., et al. "Attitudes and practices of euthanasia and physician-assisted suicide in the United
States, Canada, and Europe." Jama 316.1 (2016): 79-90.
6 Vandenbroucke, Amy. "Physician Assisted Suicide." DePaul Journal of Health Care Law 9.1 (2015): 893.
7 Radbruch, Lukas, et al. "Euthanasia and physician-assisted suicide: a white paper from the European Association
for Palliative Care." Palliative medicine 30.2 (2016): 104-116.
8 Vaughn, Lewis. Doing ethics: Moral reasoning and contemporary issues. WW Norton & Company, 2015.
9 Bhat, Rouf Ahmad, and Shakoor Ahmad Darand Anita Deshpande. "LEGAL AND ETHICAL CONSIDERATION
OF EUTHANASIA IN INDIA: A CHOICE BETWEEN LIFE AND DEATH." (2017).

5LEGAL ESSAY
not be given the right to take away a life that has not been created by them. The relation that
exists between a doctor and patient is based entirely on trust and the relationship is that of
“fiduciary”10. By allowing a patient to die naturally in natural cause is the best to escape moral
culpability and that if the doctor takes the role of an “executioner”, the role that he plays that of a
moral healer will get negated. The relation of the doctor and the patient shall be corrupted and
that the doctor will not live up to his reputation of healing a patient11.
Another argument against physician assisted suicide is that the doctors take the
Hippocratic oath, where if the doctor sees that a patient needs attention and care, it is the moral
duty of the doctor to assists the patient and secure a safe recovery. The Hippocratic Oath states
that the patient shall not give any deadly drug to a patient that will claim his life and that the
doctor shall not give any suggestion to any patient knowing that might claim his life. The
question that doctors who have been the power to save lives and play God every day, should not
misuse the power they have been given by virtue of their degree. Can it be claimed that the
doctor is also playing God when he is taking lives or assisting in the death of his patients. Is the
doctor defying his morals and duties when he is taking lives12. The vow that a doctor at the
inception of his professional career is that the doctor will do no harm to the patient. Therefore,
the use of the terms suicide means that the doctor is helping ending a life and when death
happens at the hands of another person, does it still remain moral is the biggest question that the
debate tries to solve13.
10 Nair-Collins, Michael. "Medical Futility and Involuntary Passive Euthanasia." Perspectives in biology and
medicine 60.3 (2018): 415-422.
11 Nordqvist, Christian. "Euthanasia and assisted suicide." Medical News Today (2016).
12 Emanuel, Ezekiel. "Euthanasia and physician-assisted suicide: focus on the data." The Medical Journal of
Australia206.8 (2017): 339-340.
13 Bickenbach, Jerome E. "Disability and life-ending decisions." Physician Assisted Suicide. Routledge, 2015. 123-
132.

6LEGAL ESSAY
There is an adage that states that power has the potential to corrupt completely and that
when the person is given absolute power and authority, he shall misuse that power and that might
affect the patients14. Not only the doctor can abuse, the power also shifts to the relatives or
anyone who has some relation to the patient to abuse that power and then exploit the authority
that has been entrusted to him.15 If the physician assisted suicide is allowed, it might so happen
that the dying and sick patients might fall prey to the abuse of the relatives. Though pain
regulation is a method of regulating the excruciating suffering that the patient has to undergo, it
is essential to state that there are various palliative care that are available to the patients.16 Many
training techniques are adopted by physicians that help in the curing of pain and suffering of
patients. Many times it happens that pain comes from wrong treatment, wrong medicines and
wrong diagnosis and doctors are humans and they can makes mistakes as they are not infallible17.
Therefore, sometimes, it so happens that care and love can work wonders for the patients and
that patients will recover if they are kept in a happy surrounding18.
Patients who are undergoing treatment may sometimes feel very disappointed and they
might have despair. Therefore, when a patient claims that he does not want to live anymore and
that he wishes to die, it is because he might be feeling trapped in a situation and has no way of
getting out. It is the duty of the doctor to distinguish between depression and suffering and
sometimes the patient might just be suffering from depression, even though they are thinking that
14 Baker, David, G. Sharpe, and R. Lauks. "Federal and Provincial Responsibilities to Implement Physician Assisted
Suicide." Health law in Canada 36.3 (2016): 148.
15 De Lima, Liliana, et al. "International Association for Hospice and Palliative Care position statement: euthanasia
and physician-assisted suicide." Journal of palliative medicine 20.1 (2017): 8-14.
16 Sulmasy, Daniel P., et al. "Physician-Assisted Suicide: Why Neutrality by Organized Medicine Is Neither Neutral
Nor Appropriate." Journal of general internal medicine (2018): 1-6.
17 Trappe, Hans-Joachim. "Ethics in intensive care and euthanasia: With respect to inactivating defibrillators at the
end of life in terminally ill patients." Medizinische Klinik, Intensivmedizin und Notfallmedizin 112.3 (2017): 214-
221.
18 Sulmasy, Lois Snyder, and Paul S. Mueller. "Ethics and the legalization of physician-assisted suicide: an
American College of Physicians position paper." Annals of internal medicine 167.8 (2017): 576-578.

7LEGAL ESSAY
they might not live anymore. In such cases, taking away the life can be wrong and immoral19. Do
humans have the power to alter nature’s course is another way of looking at this debate20. By just
ending the treatment that is ongoing or by withdrawing life support, is the doctor simply ending
the life or ending the suffering of the patient, thereby ensuring that he does not suffer any
longer. From the point of legislature, it is imperative that there be a strong mechanism to stop the
absolute misuse of power that might befall a doctor. The physician assisted suicide should have
strong safeguards that state that doctors cannot be allowed to misuse that power. The ambiance
should be created where the patients feel at home and not distressed. By allowing physician
assisted suicide, it might so happen that the floodgates open for unethical practices to crop up
and the patients fall in the hands of unscrupulous doctors who are driven by power and money
and they do not have the moral high ground to care for the interests of the patients21.
Opinion
The argument that can be advocated against physician assisted suicide is that without
taking the extreme step of ending life, the technology needs to develop so that new methods can
be achieved where the difficult to manage pain can be treated. Though there are many
untreatable situations, it so happens that the palliative care might alleviate the situations and
might help the patient live a better life without lesser suffering. The physician assisted suicide
should be the last resort and the patients with disabilities shall not be treated like they are dying
and that there is no hope left for them. The disabled people should not physician assisted suicide
be threatened whereby they feel that they are dying of humiliation. Physician assisted suicide is a
last method to deal with a suffering that is so acute that only death can resolve. But in no way
19 Katz, Jonathan, and Hiroshi Mitsumoto. "ALS and physician-assisted suicide." Neurology (2016): 10-1212.
20 Buckley, Terra. "Physician Assisted Suicide: An End of Life Care Option that Should be Available to all Dying
Patients." (2018).
21 Tomlinson, Emily, et al. "Euthanasia and physician-assisted suicide in dementia: a qualitative study of the views
of former dementia carers." Palliative medicine 29.8 (2015): 720-726.

8LEGAL ESSAY
should physician assisted suicide be treated as a method to promote suicide where any
humiliation should not be an incentive to end a life. Physician assisted suicide should not in any
way promote that suicide is a moral situation that can be ended. Physician assisted suicide is
against morality and human dignity as it is the moral duty of every doctor to ensure that the
patients live happily. By allowing physician assisted suicide, doctors will question and
undermine that key principles that hover around medical ethics. The aim of the government
should be to allow palliative care at affordable prices so that patients might have the opportunity
and the option to opt for these techniques and that they do not end their lives. It shall be very
difficult to ensure checkpoints for ensuring that there is no misuse of physician assisted suicide.
Taking the example of Netherlands, it has been notices and reported that there have been
instances when doctors have used lethal injections and those have gone unreported. Therefore, it
is vital to keep in mind that doctors should not be given absolute power in taking a patient’s life.

9LEGAL ESSAY
References
Baker, David, G. Sharpe, and R. Lauks. "Federal and Provincial Responsibilities to Implement
Physician Assisted Suicide." Health law in Canada 36.3 (2016): 148.
Battin, Margaret P. "Physician–Assisted Suicide: Safe, Legal, Rare?." Physician Assisted
Suicide. Routledge, 2015. 63-72.
Bhat, Rouf Ahmad, and Shakoor Ahmad Darand Anita Deshpande. "LEGAL AND ETHICAL
CONSIDERATION OF EUTHANASIA IN INDIA: A CHOICE BETWEEN LIFE AND
DEATH." (2017).
Bickenbach, Jerome E. "Disability and life-ending decisions." Physician Assisted Suicide.
Routledge, 2015. 123-132.
Buckley, Terra. "Physician Assisted Suicide: An End of Life Care Option that Should be
Available to all Dying Patients." (2018).
De Lima, Liliana, et al. "International Association for Hospice and Palliative Care position
statement: euthanasia and physician-assisted suicide." Journal of palliative medicine 20.1 (2017):
8-14.
Emanuel, Ezekiel J., et al. "Attitudes and practices of euthanasia and physician-assisted suicide
in the United States, Canada, and Europe." Jama 316.1 (2016): 79-90.
Emanuel, Ezekiel. "Euthanasia and physician-assisted suicide: focus on the data." The Medical
Journal of Australia206.8 (2017): 339-340.
Kamm, Frances M. "Physician-assisted suicide, euthanasia, and intending death." Physician
assisted suicide. Routledge, 2015. 28-62.

10LEGAL ESSAY
Katz, Jonathan, and Hiroshi Mitsumoto. "ALS and physician-assisted suicide." Neurology
(2016): 10-1212.
Nair-Collins, Michael. "Medical Futility and Involuntary Passive Euthanasia." Perspectives in
biology and medicine 60.3 (2018): 415-422.
Nordqvist, Christian. "Euthanasia and assisted suicide." Medical News Today (2016).
NZIMANDE, DR KHAYA. "PHYSICIAN ASSISTED SUICIDE." (2016).
Radbruch, Lukas, et al. "Euthanasia and physician-assisted suicide: a white paper from the
European Association for Palliative Care." Palliative medicine 30.2 (2016): 104-116.
Salubre, Jobel Angelica Therese. "Physician Assisted Suicide." (2015).
Sulmasy, Daniel P., et al. "Physician-Assisted Suicide: Why Neutrality by Organized Medicine
Is Neither Neutral Nor Appropriate." Journal of general internal medicine (2018): 1-6.
Sulmasy, Lois Snyder, and Paul S. Mueller. "Ethics and the legalization of physician-assisted
suicide: an American College of Physicians position paper." Annals of internal medicine 167.8
(2017): 576-578.
Tomlinson, Emily, et al. "Euthanasia and physician-assisted suicide in dementia: a qualitative
study of the views of former dementia carers." Palliative medicine 29.8 (2015): 720-726.
Trappe, Hans-Joachim. "Ethics in intensive care and euthanasia: With respect to inactivating
defibrillators at the end of life in terminally ill patients." Medizinische Klinik, Intensivmedizin
und Notfallmedizin 112.3 (2017): 214-221.
Vandenbroucke, Amy. "Physician Assisted Suicide." DePaul Journal of Health Care Law 9.1
(2015): 893.

11LEGAL ESSAY
Vaughn, Lewis. Doing ethics: Moral reasoning and contemporary issues. WW Norton &
Company, 2015.