Monday, April 11, 2011

Just Take Another Advil


Would you rather have a painful suffering or an ease into death? Many terminally ill patients question that very predicament, but for some there’s only one option. The right to die, otherwise known as physician assisted suicide (PAS) has been a controversy for over a decade now. While both sides of the debate fight for pro-choice or anti-AS (assisted suicide), the terminally ill who have either a few years or a few weeks to live wish to have an easy transition to death and zero pain. So why not give it to them? It’s their life. In the constitution, the fourteenth amendment and other PAS cases such as Terry Shiavo and Gonzales vs. Oregon all contain logical reasons why PAS should be permitted in the US. Every terminally ill patient, in any state, should have the right to PAS.

The 14th amendment states the rights of each individual person. Every person has the right to life and that no one will be deprived it. If one has the right to live, then why not have the right to die? It’s a patient’s own wish to die, and in most cases their quality of life has been diminished to nothing – depriving them of their happiness and liberty. The 14th amendment also states that each individual has the right of liberty; and therefore happiness. When a terminally ill patient is on machines to extend their life more than naturally possible, their quality of life is no longer what it happily used to be. The option to have PAS should be a terminally ill patient’s rights to pursue if he/she wishes to do so.

Terry Shiavo, demonstrates that there is no positive outcome being on life support for an extended period of time and that terminally ill patients, like Terry, should have the right to PAS in such cases. After a terrible car crash sent Terry Shiavo to the hospital, they diagnosed her with incurable brain trauma and was pronounced mentally incompetent. For fifteen years she was connected to machines to keep her alive. This is simply irrational. If PAS was an option for Terry, it would save her the dignity and pride she deserved, not to be dependent on machines. Her family and friends went through excruciating pain seeing Terry in the state she was in for fifteen years. Though, because the law prohibited them from any other options, they didn’t have any other choice but to watch Terry drown herself. By allowing PAS, these situations don’t have to happen. And the pain for both the patient and the patient’s friends and family doesn’t have to be a long sorrowful journey; the more the reason why every person should have the right to die.       

Gonzales vs. Oregon, a Supreme Court case, reveals that there is no real reason why PAS should be prohibited and the optimistic values of allowing the practice. During the debate, the State of Oregon argued that physician assisted suicide violated the Substance Abuse Act. However, there was no evidence in the constitution to justify it and Oregon, with a majority vote, was permitted to practice PAS. After the death with dignity act was initiated, it produced new jobs, an alternative option, and a more controlled way to die peacefully for the terminally ill. All these benefits were created just because of PAS. There is no legitimate reason why terminally ill patients shouldn’t have the right to die and if all the states were to allow physician assisted suicide, a similar outcome would occur.

Every terminally ill patient should have the right to die. The 14th amendment, Terry Shiavo, and the Supreme Court case of Gonzales vs. Oregon all share factual rationales why PAS should be practiced in every state. Though many states make the argument that assisted suicide is a form of homicide, it really it isn’t since it’s represented by the patient’s not the physicians. These laws prohibiting PAS for that specific reason should be ultimately changed. Ask yourself, wouldn’t you want the right for an alternative option if you were going to die or would you like to take pills and suffer before you do?

Wednesday, April 6, 2011

The Right To Die

The Right to die; or otherwise known as Euthanasia (a Greek term for 'well death' or 'dying without pain') has been a controversial debate for the past decades. The argument is that medical technology now a days prolongs life in ways never before possible. However, prolonging life doesn't always seem (morally) the RIGHT thing to do. So one might want to make a choice before his or her natural death occurs. This is where problems seep in. Religion, morals, and many other issues are brought up for and against euthanasia. The right to die is slowly making its way through state's hospitals. Currently only Washington and Oregon are the only states in the U.S that are licensed to for voluntary death. No matter how long this controversy last, there will always be different opinions on the topic.

 I only have a few question that i really would like to know right now but there are many i would soon like to find out. What is the difference between euthanasia and PAS (physician assisted suicided)? Why are people so against or strongly believe in it? Does religion, social, or other background impact a persons decision?

Current Interpretations: States that prohibit or permit PAS

Currently there are only three states that approve physician assisted suicide:

Oregon - Has a law that specifically authorizes physician assisted suicide and protects the rights of those terminally ill and have the right to die, and physicians in the act of committing the lethal injections.

Montana - Physician Assisted suicide is legal in the state under a 2009, Supreme Court Case. It allows physician to comply with terminally ill patience request for physician assisted suicide. Although euthanasia falls under the general homicide laws of Montana.

Washington - Has a law that specifically authorizes physician assisted suicide after ruling in favor of PAS, by a Supreme Court Case
http://www.nightingalealliance.org/pdf/state_grid.pdf
Of the 47 states that don't comply with PAS, nine states; Alabama, Ohio, Idaho, Mass, North Carolina, Vermont, Utah, West Virginia, and Wyoming have no legitimate law prohibiting physician assisted suicide. However, under common law PAS would fall under homicide in most cases. Euthanasia is prohibited in these sates.
http://www.nightingalealliance.org/pdf/state_grid.pdf
In the rest of the 38 states, there is a specific law prohibiting the act and use of physician assisted suicide. Considered homicide, physicians who proceed in the act may spend the rest of their life in prison.
http://www.nightingalealliance.org/pdf/state_grid.pdf

Stakeholders

Negatives: Also known as 'pro-life,' this group of physicians, lawyers, and the public are in complete disposition to that practice of physician assisted suicide. Many religions disprove and condemn physician assisted suicide as a form of murder, taking innocent human lives away. In the Catholic church; Suicide is always as morally objectionable as murder. The Church's tradition has always rejected it as a gravely evil choice: To concur with the intention of another person to commit suicide and to help in carrying it out through so-called "assisted suicide" means to cooperate in, and at times to be the actual perpetrator of, an injustice which can never be excused, even if it is requested. In a remarkably relevant passage Saint Augustine writes that "it is never licit to kill another: even if he should wish it, indeed if he request it because, hanging between life and death, he begs for help in freeing the soul struggling against the bonds of the body and longing to be released; nor is it licit even when a sick person is no longer able to live" (The Gospel of Life, no. 66). Another key argument - that physician assisted suicide is used to avoid excruciating pain and agony, is a false statement. Medical technology advancements are now able to manage pain and make it possible to control the pain effectively in dieing patience. However, pain control is not the top request in terminally ill. It's the concern of the loss of autonomy and control which medicine can now treat.

Positives: Also known as 'anti-life,' is the general public that approve the practice of assisted suicide. They argue that death and its agony and pain are justified by physician assisted suicide. That those suffering from a terminal, painful, debilitating illness can die with dignity and control. "The assistance of a physician is supposed to provide expertise to increase the likelihood of a successful suicide attempt and make the act "cleaner" — both literally and politically"(F. Michael Gloth, III, M.D.). That moves us to the next argument, that many are concerned with the fact of losing all control and an impaired quality of life. But, this can also be justified with physician assisted suicide. Making the patients next step more comfortable and easy. Another argument in favor of assisted suicide is the prevention of "botched" suicide. Patients who request for assisted suicide want to transition to death with medical help and ease. However, some patients who do not get this wish can put themselves in even more harm if they really want to die. In which self afflicted suicide could potentially be their outcome. -- This is similar to what Dr. Babbott told us in his introduction story. That his friends patient wasn't able to get the treatment he wanted and in a day, the patient was dead. Taking over one hundred pain pills -- If a person wants to die, they are going to find a way to kill themselves. By allowing the practice of P.A.S, patients can die in a nonviolent way.

http://www.nccbuscc.org/prolife/programs/rlp//03rlgloth.shtml

Physician Assisted Suicide Video: Craig Ewert explains his decision to end his own life

Yes or No? The Public and Physician opinion for Euthanasia/PAS

click to enlarge

Terry Shiavo, Living Yet Dead: Issue Explanation

Before
Life: The individual's right to life should be considered inviolable.. says the Democratic Ideals. Yes, life shouldn't be taken or even cut off but, imagine being neither living nor dead. You are simply in a vegetative state, known as PVS; persistent vegetative state. Of course you can't even ponder of being in a state like that but Terry Schiavo has. Terry was a Florida gal, who was living life just like the rest of us until she had a life changing heart attack following15 years of living off machines. Being mentally incompetent, her vegetative state forced her to be put on life-support till her feeding tube was finally pulled. Yet, we look at this situation and we feel guilty that one had to live life they way Terry did. But the question is, is it wrong to feel guilty? Morally ending someones life is a horrific decision for many people.Though, some now think that Terry is finally happy. 
After
The pursuit of happiness is an attempt to attain happiness in ones own way. Terry Schiavo was not happy. She was not sad. She was in a coma and mentally incompetent. The blindness of her struggles were past on to her loved ones which quickly expanded like a balloon after years and years of waiting. The pain they had to deal with was too much to handle so they picked a choice that utterly Terry would never know about. Terry is freed from being imprisoned -A voice says. Every person has the right of liberty as every person has the right of life or death. Freedom comes in many forms; war liberations, escaping a totalitarian government, etc. Soldiers in WW2 experienced things most people have't. They have watched their friends, one by one, die. Almost all living ex-WW2 soldiers will tell you that ending a fellow soldiers life because of the immense pain of their wounds is better than watching their friend die in agony. Is this not the same as euthanasia? There are many reason why people are against this liberation. The common good might view it as treason but ask yourself, would you want your loved ones to be in pain? 

Presciption drugs and assisted deaths under the Oregon Death with Dignity Act

click to enlarge

Gonzales Vs. Oregon. How P.A.S Was Prepelled Into The Media

In the case Gonzales v. Oregon,  Attorney General John Ashcroft declared that physician assisted suicide was not legitimate, meaning that doctors shouldn't comply with the act of PAS, and that any physician administrating the lethal drug for assisted suicide is violating the Controlled Substance Act. The petitioner was General John Ashcroft. The respondents were a group of Oregon resident's; a physician, pharmacist, and a handle-full of terminally ill patience. The court ruled for physician assisted suicide and the Oregon residents. The majority did not disagree that the government still needs to facilitate the regulation of substances but disagreed that the General and his statue tried to overrule state laws determining what constituted the appropriate use of substances. They found no evidence in the constitution that would support the Generals challenge. The Chevre Deference was used against the Generals challenge. Overall, physicians are allowed to proceed in that act of physician assisted suicide, under medical practices. Medical effects: Oregon doctors can continue to practice safe assisted suicide. Patience who are terminally ill have the right to die and to continue to advance in pain management and end of life care. Legal effects: Federal agents are prohibited from launching PAS investigations in the state of Oregon. Positives: Physician assisted suicide is still permitted to those that agree with it. Negatives: People who don't believe in it are still opposed by the ruling.

Deathwithdignity.org/history

Constitutional Connection

In the Constitution of The United States; Amendment 14: nor shall (in) any state deprive any person of life, liberty, or property, without due process of law, nor deny to any person within its jurisdiction the equal protection of laws. The key words, deprive any person of life, could be a potential argument for physician assisted suicide. If you were to decode that sentence, every person's life cannot be taken away, nor that person's freedom and property etc. Yet, it also says by law it could all be taken away. This relates to places such as Oregon, who have a Death With Dignity Act. Voters voted and the law allowed them to die with dignity and the law now protects every person in Oregon for that reason. All in all, lawyers and petitioners and respondents could bend and twist Amendment 14 for their outcome. It potentially alludes to both negative and positive aspects of PAS.

Washington vs. Glucksberg Supreme Court Case

In the case of Washington v. Glucksberg, the question presented in the case is whether Washington's prohibition against aiding a suicide, offends the fourteenth amendment. The petitioner was the state of Washington and its Attorney General. The respondents were (M.D) Harold Glucksberg, (M.D) Abigail Halperin, (M.D) Thomas Peterson, and (M.D) Peter Schail. All of which treat terminally ill and suffering patience. The decision of the court ruled that the prohibition be reversed. That a ban of physician assisted suicide would be in violation of the fourteenth amendment. The court decided for the rights of ill patience and their physicians assisting in their suicide. Overall effects: People in Washington can maintain in PAS, though those who disagree with PAS still have negative thoughts towards the act of assisting suicide.

http://law2.umkc.edu/faculty/projects/ftrials/conlaw/glucksberg.html

Annotated Bib

Link to Google Docs

Dr.Babbott, Davis. Trial Search. CVU Hinseburg, VT. March 28, 2011.

In response to the act of physician assisted suicide. Dr. Babbott, a retired medical doctor from Fletcher Allen, believes that P.A.S should be permitted, but only if the states law allows the act to be practiced. Dr. Babbott expressed confidently that P.A.S is not a form of murder, "Its not a form of murder because it's generated by the patients, and the physician is not doing anything against the patience will." Dr. Babbott also notes how a patient must be mentally competent if they even were thinking of dieing with dignity -Oregon. He also explains how the 14th Amendment proves why P.A.S should be permitted; that the life of one person and liberty, is that person right of life and liberty. Dr. Babbott though sees nothing positive of P.A.S unless the government permits it.

Dr. Macaulay, Robert. Trial Search. CVU Hinesburg, VT. March 28, 2011.

Dr. Robert Macaulay, a licensed medical doctor of Fletcher Allen Hospital, Vermont, responded to physician assisted suicide in a direct answer, no. Although he thought that it was a good option and should be permitted if the law in the state allows it. He believes that physician assisted suicide shouldn't be a main issue in today's medical setbacks. "We shouldn't be even pondering about P.A.S," Dr. Macaulay states. "We should be trying to better the health care forum." There are only a small portion of people who are terminally ill and actually might end up requesting physician assisted suicide. But, there's only a 1/5 chance that those terminally ill patience will go through with P.A.S. Though, a student asked if pets are allowed to get a lethal injection, why not humans? Macaulay affirmatively answered, we are not pets. The stakes are much different.

Dr. Kevorkian, Jack. "Understanding Controversy of P.A.S." Issues. Michigan, 1999.

Dr. Kevorkian, a retired pathologist and physician in Michigan, will tell you that physician assisted suicide is the right of the specific patient that requests it. Looking at the 14th Amendment, his controversy falls under the fact that every person has the right of life. "If they have the right to life, do they not have the right to death?" Although Kevorkian had the right intentions, he committed a major crime in the 90's. Helping numerous people who had requested the means to take their own lives. He was quickly was evicted of second degree murder and was sent to prison. Dr. Kevorkian doesn't regret his decision, and still believes P.A.S should be an option for any terminally ill person in pain who wants to end their life. His interview with Cooper Anderson justifies his reasoning's of P.A.S; that religion and other backgrounds stopping their decision of P.A.S is false. That all religions believe in eternal happiness and that's what P.A.S gives to most people.  

The American Foundation for Suicide Prevention (AFSP). "Understanding Controversy of P.A.S." Issues. 2011.

The American Foundation for Suicide Prevention, strongly believes that physician assisted suicide is a crime and should be restricted everywhere. Their belief, that religion has a major role in the crime against assisted suicide. In most cultures it is a sin to commit any form of suicide and AFSP backs this up, referring that "Self-murder, (is) a sin that commits their soul to eternal damnation." - Many religions share this same belief. They   
oppose its legislation, contending that with deeper understanding of terminal illness, more people would turn against assisted suicide.There are also some who fear that medical suicide may be abused, literally used to murder the sick and elderly who have become a burden to their families. All in all, their is no positive outcome in physician assisted suicide and they strongly believe it should be prohibited for the sake of life.

My interview

After interviewing Kunal Gupta, a medical doctor at the University of Vermont. I am now understanding PAS from a different view. It was interesting how his answers related to panelists on panel day. Maybe it was because they were all doctors, but it seemed that the general perception from a medical standpoint was that PAS should be an option. However if the state doesn't permit it then they must follow the law of the state. Dr. Gupta stated that PAS is a way for the patient to endure less pain and torture, unnecessary medical cost, and a decrease in medical resources. Also that the patient dieing would be in a more controlled environment; an easier way to transition to death. He agrees that people with a terminal illness or suffering with no other option should have the option of PAS. Though unlike what Dr. Babbott said on panel day, Dr. Gupta stated that neither family nor doctors have the right to decide for the patient if he or she is mentally incompetent. "It's the patients rights to live or die," he said. "Doctors have the right to control pain even if death is one of the risks." Overall, Dr. Gupta was for physician assisted suicide and that it should be an option for people in certain situations.
  I thought my interview was fun and informative. It was interesting to hear what a doctor had to say about the subject and his view on it. I felt it was a little tricky to actually set up a time for the interview since he was always busy but it worked out in the end. Dr. Gupta thought my questions were excellent, which was a bonus. It was easy to takes notes as well which was surprising because I'm not the best note taker - i was able to get across the main points and add in information when he elaborated. I've never done an interview like that before and it was great way to learn more about PAS. I would definitely do it again.

Panel Day

After hearing the panelists the other day, i have grasped a deeper knowledge of P.A.S and how it's perceived by different people. Dr. Babbott, a retired medical doctor at Fletcher Allen Hospital, talked about interesting views of P.A.S. Instead of just falling to one side, he used the law to determine which side he favored. For example, if the state didn't allow physician assisted suicide then Dr. Babbott did not agree with P.A.S in that state, though if it was permitted in another state he did agree with the practice of P.A.S. Personally, I was looking for a general yes or no response to the topic from most of the panelists but it was intriguing to hear how the law had a lot of influence on some of their decisions. Dr. Macaulay, had a different perspective. He thought that P.A.S is unpractical in today's society. Although it is a huge aspect from some people, there is such a small portions of people that are actually in a situation which P.A.S is an option. From a practical view, i completely agree with him. There are so many other bigger problems we have than P.A.S. I do think that P.A.S should be an option but it shouldn't be a main problem in our society. Dr. Babbott brought with him another panelists, Marnie Wood. She had no medical background but had an inspirational story of her life that related to P.A.S. In short, her sister had ALS and Marnie had to take care of her till she died. And the thought of having P.A.S as an option almost relieved her. It's interesting to view this type of scenario because I've been in a similar one but it was opposite to what Marnie was thinking. My grandfather had parkinson's and my family never knew if tomorrow would be his last day. However, my mom, who made most of the decisions, wanted to be with him as long as she could even though my grandfather wasn't the same person as he used to be at that state of being. I feel it really depends on your background and your emotions that pulls you toward one decision than another. I very much enjoyed hearing the panelists views on the topic, they were most knowledgeable.