A moderated blog for the electronic mentor program at Wingate University School of Pharmacy
Tuesday, November 1, 2011
Physician Assisted Suicide
This article presents both sides of this argument. Controversial subject, and I'm sure we'll have lively discussion of it.
35 comments:
Coleman Inman
said...
In patient assisted suicide I believe that it is the patients right to receive this act if it is what they want. In each topic we have had we have always pushed for the patient’s rights to be respected. Why not now?
To start off, I want to give a breakdown of what the process of PAS is like in Oregon because it seems as though many classmates are worried about patients demanding this service because they're simply depressed..so here is the process that patients must go through in Oregon in order to receive a prescription to assist with dying:
1- must have a dignosed terminal illness (6 months to live) 2- patient must initiate written request to doctor 3- Patients request must be confirmed by 2 witnesses (at least one of whom is not related to the patient, is not entitled to any portion of the patient's estate, is not the patient's physician, and is not employed by a health care facility caring for the patient) 5- Physician must examine the patient's medical records and confirm the diagnosis (patient must be free of a mental condition impairing judgment) 6- If the request is authorized, the patient must wait at least fifteen days 7- Following the 15 days, a second oral request must be made by the patient 8- The patient has a right to rescind the request at any time.
So, basically it would be very unlikely that a patient would be granted permission for Physician Assisted Suicide (PAS) unless the entire process is successfully completely. By the process, a depressed person wouldn't be able to participate.
We always talk about the oath, "above all else, do no harm" and this was also brought up today in class. However, I've always believed that there are worse things than death. I think it should be legalized because of this, but I also think there should be tight regulations on it. Like Coleman said, it's all about patients' rights and it's hard to put boundaries on that. If I were a physician I don't know that I would be able to do it, but that patient should have the right to receive care from someone that would.
To me, physician assisted suicide is taking someone's life, and I do not believe a health professional has the right to do that. Personally, I know I would not be able to participate in the facilitation of suicide. It's perfectly fine for the patient to have a choice, but I see no reason to get a physician, pharmacist, or any other health professional involved. If the patient wants to take their own life, let them fill out a DNR and do it themselves, and if they are unable, they can have someone other than a health professional do it for them. I just think that there is too much liability and immorality involved. Plus there is always a chance that the "terminally ill" patient survives. I would have trouble taking someone's life, no matter how old or the condition they are in. Fortunately I can say that I have never had an experience with someone close to me wanting PAS, and until I do I guess my opinion remains one without certainty or any personal emotional attachment. I do know that there is a huge difference between putting down an animal and a human, the main reason being the difference in species therefore I see that as an irrelevant comparison.
I think physician assisted suicide is a hard subject to come to a complete yes or no answer for. I believe it has to be decided from the details of the specific situation. Some people are always going to have a problem with it and maybe even classify it as murder, but if that is truly what someone wants to do, is it really your right to tell them no because you do not agree? I do not believe so.
In terminal illnesses I can see why physician assisted suicide would be a desired thing. The person ends up suffering so much. I have witnessed it first hand of a terminally ill patient who was on a respirator and had feeding tubes have to starve to death. Not only did that cause him to suffer it also caused his family to suffer. However, I think it goes back to conscientious objection. I know I would not feel right dispensing the medication for a physician assisted suicide.
I believe PAS is something that can help patients die gracefully. Oregon has some great things in their laws that would prevent rash suicide attempts but this should be something you can choose to have in place in the event something happens, ie, debilitating accident/sudden illness. I have a grandparent who had a debilitating stroke 2 years ago who I know whould sign up PAS given the chance. He is unable to speak clearly, has had many stints since then in hospitals because he intracted MRSA inpatient, and has had amputations which are causing phantom pain. He was a very strong, proud, and independent man. Since, all of which is gone and feels as if his soul was gone a few months after the stroke. He is incapable of doing anything on his own and is constantly crying and yelling in pain. It has been horrendous for our family to watch him suffer physically and emotionally.
This is a decision that the patient and their family should be making. Medical staff should not be the ones suggesting PAS but simply a realistic reasoning voice should questions be asked.
I believe Physician Assisted Suicide it is the patient's right. This act should only be used for patients who are terminally ill or who have a very progressive and debilitating disease for which there is no cure. The mindset of a patient with these ailments may seek Physician Assited Suicide as the best choice for not only themselves bur for their family as well. The patient may seek to alleviate further financial burden that would be taken on if the patient were to live out their days under hospital care. The patient's quality of life may also be so negatively effected by their ailment that they can save themselves from agony by choosing physician Assited Suicide. I believe for this act the patient would have to be evaluated for mental defect. If the patient was deemed fit it would be their choice and their decision. Having a physician help them along in the process would also be helpful as opposed to the patient trying to take their own life where they have a higher chance of making a mistake and hurting others in the process.
I believe the patient should have the right to PAS but there should be strict guidelines that are implemented to make sure PAS is used correctly. I thought the breakdown of the Oregon guideline that Ashley posted was very interesting and is definitely a good start to something that could be implemented throughout the country.
If the patient can communicate on their own I think that those cases could be much easier than the ones where the patient can't communicate their wishes and then it depends on their family members. If a law is ever passes for the whole country there needs to be a lot of details about the cases that a family member is making the decision because they may want to end someone's life for the wrong reasons.
I believe that physician assisted suicide is not immoral whatsoever. From personal experience, I feel that this is a good thing. For weeks I watched my grandfather suffer in pain in which he could never overcome. It was tormenting to my family because we knew that the doctors were just delaying the inevitable. The doctors prescribed him so much pain medication to where he barely knew who I was. I cannot justify delaying a person’s death who is not aware of their surroundings or capable of making decisions due to the pain they are experiencing. When my grandfather passed, my family had mixed feelings. We all dearly missed him, but we also knew that he was not suffering anymore. From what I have learned, I believe that physicians should honor valid requests from patients, or the patient’s family members, during times such as these.
When talking about patient assisted suicide, I believe the patient should have the right to determine if this is what they want. I think there should be measures in place however to prevent spur of the moment decisions from occurring. You don't want someone who is depressed coming in right after something tragic and just wanting to die; something similar to Ashley's post would be appropriate. I have actually heard of "assisted suicide hotels" that they have in Europe. This is pretty much a medical bed and breakfast that the patient goes and spends the night. Their friends and family can come spend some last moments together, they eat a last meal and then the physician administers the suicide medication. This is a more peaceful way to go out in my opinion. The only thing that is controversial in my opinion is deciding for people who are not able to speak their wishes and have not signed a DNR or talked about the situation with a spouse or family member previously. I am not sure how this would be handled because you are not sure what the patient wants.
I believe that the only way physician assisted suicide is ethically right is if the patient is terminally ill and gives written consent to the physician. This should not be allowed for patients who are severely depressed, have other mental/emotional issues or have a disease or condition that may improve over time. I believe it is more unethical and immoral to allow the patient to live in such significant pain any longer than he/she wishes. If there is no chance that the patient will recover, then I support the decision to allow the patient to die with dignity. However, there should be very strict regulations to make sure this is the right decision for the patient.
I like the process that Ashley says that Oregon goes through if a patient would like to receive a prescription aiding in their request to die. I feel those who don't agree with subject, sometimes can't understand what a patient is going through. There are some disease/terminal illness that changes a person life permanently. We may or may not be able to understand, but we definitely can't feel what they are going through.
Some patients maybe able to live with this same disease, but others may not. It varies per individual and we can't just say get over it to the patient who cannot deal. We must take in consideration how this has affected the patient quality of life and help their family members understand that they should do of what is best for their love one, not what's best for themselves. And first and foremost, these patients who would like to go through this should not feel as if they are being selfish and leave this world without guilt.
I also like the process Ashley described for Oregon. I think patients should have the right to this service, but there would obviously need to be many procedures, rules, and sign offs to prevent it from getting abused. I like the idea of it only being available to a terminally ill patient with severe documented pain. Physician assisted suicide would allow these types of patients to choose to die with dignity and side step an unnecessary amount of pain before their inevitable death.
I understand what people are saying about PAS, and I agree that each individual has a right to make decisions concerning their lives. Still, a part of me just doesn't feel it's right to take another's life. The patient may be suffering to a degree no one could even understand and if they want to die, they'll find a way. The physicians don't need the responsibility of allowing suicide under their watch. I believe it totally changes the relationship between patient and physician, and that's not good! Besides, who is to say the patient's state won't improve? All the stuff about the patient's rights aside, I hate to see anyone give up hope.
I believe that patients have the right to choose if they want physician assisted suicide. If this were to be implemented everywhere I think strict regulations need to be established, such as the restrictions used in the state of Oregon. We have seen that physician assisted suicide works in some countries, there is no reason it cannot work here if implemented correctly.
I think that this is an extremely difficult topic to have a set in stone answer to. There are always circumstances in which a person might feel fully justified in saying yes to something they would normally say no way to. I don't know that I could personally every assist in a suicide, but there are instances in which I wouldn't blame or judge someone who did. The oaths and laws and beliefs that we govern our profession by are not set up to help us deal with situations such as assisted suicide.
I was unable to find the specific article I mentioned in class, but I did find this really good summary of the Death with Dignity Act: http://www.doh.wa.gov/dwda/faq.htm#what
From what I have read, Oregon's law is very similar to Washington's described on this website. There are some key differences from what we discussed last week. The patient can self-administer the medication where they choose, and a physician does not need to be present, for example.
I also found this article pretty interesting: "Forced Abandonment and Euthanasia: A Question from Katrina" by Kenneth Kipnis http://findarticles.com/p/articles/mi_m2267/is_1_74/ai_n19094727/?tag=content;col1
Sorry for leaving these on here so late! I hope you get a chance to read these if you're interested.
I personally don't agree with the physician assisted suicide. I completely understand that it's patients' choice to decide whatever about their life but at the same time, but I don't think it should be legalized. One of the problems with making it legal is that PAS will be an easier way out of treating a terminal disease. The other problem is that it will raise a moral issue among physicians. There will be a lot of physicians who don't want to do this because they consider it as killing someone.
I agree with what a number of people have already stated - in the end, it should be the patient's right to choose whether or not PAS is something they want. I feel that the process in Oregon as illustrated by Ashley above is very reasonable - that makes it a process that takes a certain amount of time and thought, and therefore not something that a patient can just decide to go through with on the spur of the moment. Beyond all else, I feel that a patient should have the right to do with their life whatever they want to do with it (outside of endangering others or other things that don't fall into the realm of reason, of course). If a patient does not want to spend what they have been told is their last few months of life suffering, who are we to make that choice for them? I also think the question needs to be asked - if we refuse to help them die, are they going to try and do it themselves by other means?
I also agree with Bess's comment about some things being worse than death. I feel that the fear of what you know is coming could fall into this - let's say you know exactly what your next six months are going to entail. Might include unbearable agony (worse than the pain said patient might already have), increasing symptoms of whatever illness you have, slow loss of functions that once came easily to you, losing the ability to do things on your own or even take care of yourself in the most basic of ways. Pride is always going to be a big part of who we are as people and I can see how having all of that slowly and painfully stripped away, as well as the fear of leaving behind a large medical debt to their family could make dying on their own terms seem a preferable alternative.
Physician Assisted Suicide is something that I believe should be a patients right. However, for me personally it would be very hard to come to grips in taking someone's life. After all, isn't part of our oath doing no harm? In my opinion, if I were take a patient life even with there consent I would feel as if I went against the oath.
I believe that if the patient wants this service, they should be able to receive it. If a patient wants to end their life, they can do it with or without the assistance of a physician. Why not then help them make it an easier process. When I say easier, I am not solely thinking just for the patients needs, but also for the families needs. PAS let's the patient die on their own time, in a clean manner. Why not let them do this, as opposed to having to take their own life with a gun, or overdose and having to have a family member discover their dead body. This is one extreme example, but for me I believe it is relevant.
I hate to seem short-sighted and realize that all medical professions are intertwined, but I do not see how this topic will directly affect my professional career. As a citizen and an active voting member of our society I might have views on the issue, but I do not see the point of taking a professional stance on something that I will not have to directly deal with. It is highly unlikely that I would be called upon to fill a euthanasia prescription or IV specifically. If I was I doubt that I would be informed that that is what I was doing, though I might have reason to suspect it. If anyone can think of a reason I am misguided on my understanding please help me see that. It seems like this is between a patient and their doctor, and therefore their moral conundrum or lack thereof.
I think this is a subject that will people will never be able to completely agree on. It is very controversial and will continue to cause arguments for years to come. I find myself midway between the two extreme views on the subject. I feel that physician assisted suicide is appropriate in certain situation however when there is any doubt it should be avoided. If the patient requests for physician assisted suicide and they have been assessed and deemed terminal then it should be permitted. However, if no approval can be received from the patient or family of the patient then physician assisted suicide should not be performed. Ultimately, physician assisted suicide kills the patient and therefore cannot be reversed so it is important that it is carried out in situations where there is no doubt in either the physician or the patient.
I feel like being for or against PAS is a hard choice because you never know what kind of situation you are going to be placed in during your career as a pharmacist. I think that its hard to say what choice you will take until a patient is actually there in front of you begging for you to help them.
I think that patients should have the choice of physician assisted suicide, but so should the physician. Even knowing that it is what the patient wants, ending someone's life is a hard action to deal with so physicians should be allowed to conscientiously object. I think the process Ashley Harris laid out is a good way to ensure that PAS is a patient's well thought out decision and not a fleeting whim brought on by a sudden bout of pain or frustration.
When we talk about how a physician should never harm a patient, but harming a patient could mean other things than death. Forcing a patient to go through months of severe pain in my opinion is more harmful to them and their quality of life than to let them go peacefully. Being able to schedule their time to go allows them to make reconciliations and say goodbye to loved ones. In many cases, people who are terminally ill are too sick by the time they actually pass on naturally to be able to say the goodbyes that they may want to say to those that are special to them. A patient has the right to be able to decide what they feel is the best decision for them.
At what point do we draw that line that it's immoral for a physician to assist someone with their last wishes? How can we say that it's legal to have an abortion, but that it's illegal for someone to ask a doctor to terminate their life? I don't think that we should be able to dictate what decisions can or cannot be made between a patient and their physician.
This should soley be based on the decisions of the patient no matter how experienced the practioner may think he or she is. however, we will have to watch out for the situation where if we consider this as a right there could be the potential of individuals who may not even have terminal illness but would want to end their lives by such suicide assistance. this is a very delicate issue that has so many things tied to it especially in the ethical point of view.
At what point do we get to draw the line whether it is immoral or not for a physician to assist a patient with the termination of their life? Like some have said, it can save a patient's dignity, save them pain, and spare them unnecessary suffering. How can we say that it's legal for a woman to have an abortion and end a life that has no choice, but say that ending the life of a person that CAN choose is illegal? I don't think that we have the right to dictate what decisions a patient and their physician reach between themselves. That's part of the physician responsibility - to determine what is the best for each patient in each specific situation. Until you are in the situation yourself, I don't think you can truly say that you wouldn't help someone.
Physician assisted suicide is a very serious issue and should not be taken lightly. I don't think this should be available for everyone. However, if someone is diagnosed will a terminal illness I think this should be an option. Someone should not have to suffer if they chose not to. I think if we don't allow this, people may take it into their own hands.
Physician assisted suicide can be a controversial issue, but it is better than individuals killing themselves using homemade methods and possibly botching the job. Physicians should be responsible enough to perform a clean and preferably painless assisted suicide. As a drug addict comes into a pharmacy looking for needles and receiving them based on the fact that it is better to use clean needles than dirty ones, the same applies to those who want to commit suicide. They should get the best possible help available. They will probably commit suicide no matter what the circumstances, so why not assist them for a clean and painless suicide.
Physician assisted suicide to me is a way out for patients that goes against our ethical code. We are required to help patients live the best life possible, not the help them end it. Now if a sound-minded patient (not their spouse) requested a DNR, then we should honor that request, but asking us to help them to that point crosses the line. I believe that we personally should do everything within our power to keep a patient alive until all options have been exhausted, and if their time has come then it has come, but I'm not going to be the one to do it to them.
People make many decisions a day. Many of which are small, and sometimes made subconsciously, however, some decisions that are made are life changing. Deciding to commit suicide takes more thought than what is required when deciding whether to eat food from Subway or McDonalds. The truth of the matter is, no matter how much thought goes into a decision, there is a potential for future regret. People who decide they want their life to end are influenced by an underlying reason. The way to handle this, in my opinion, is to assist the patient in resolving any issues that may be affecting their stress levels enough to decide suicide is the only way to go. I understand some people who would consider suicide may be terminally ill, and the thought of 'leaving it all behind' may seem ideal to them. We need to reiterate that suicide is not necessarily the best option available for these patients. Somebody with the fire and willpower to fight and get through any adversity they are experiencing will never give up. Instead of blowing out the candle, we as healthcare professionals must use every resource to keep that flame burning. It's amazing what love and support can do to somebody who is considering ending their life.
I thought this was a really interesting article about the director of "How to Die in Oregon." It gives you a closer point of view of the patient who is choosing to die on their own terms.
35 comments:
In patient assisted suicide I believe that it is the patients right to receive this act if it is what they want. In each topic we have had we have always pushed for the patient’s rights to be respected. Why not now?
To start off, I want to give a breakdown of what the process of PAS is like in Oregon because it seems as though many classmates are worried about patients demanding this service because they're simply depressed..so here is the process that patients must go through in Oregon in order to receive a prescription to assist with dying:
1- must have a dignosed terminal illness (6 months to live)
2- patient must initiate written request to doctor
3- Patients request must be confirmed by 2 witnesses (at least one of whom is not related to the patient, is not entitled to any portion of the patient's estate, is not the patient's physician, and is not employed by a health care facility caring for the patient)
5- Physician must examine the patient's medical records and confirm the diagnosis (patient must be free of a mental condition impairing judgment)
6- If the request is authorized, the patient must wait at least fifteen days
7- Following the 15 days, a second oral request must be made by the patient
8- The patient has a right to rescind the request at any time.
So, basically it would be very unlikely that a patient would be granted permission for Physician Assisted Suicide (PAS) unless the entire process is successfully completely. By the process, a depressed person wouldn't be able to participate.
We always talk about the oath, "above all else, do no harm" and this was also brought up today in class. However, I've always believed that there are worse things than death. I think it should be legalized because of this, but I also think there should be tight regulations on it. Like Coleman said, it's all about patients' rights and it's hard to put boundaries on that. If I were a physician I don't know that I would be able to do it, but that patient should have the right to receive care from someone that would.
To me, physician assisted suicide is taking someone's life, and I do not believe a health professional has the right to do that. Personally, I know I would not be able to participate in the facilitation of suicide. It's perfectly fine for the patient to have a choice, but I see no reason to get a physician, pharmacist, or any other health professional involved. If the patient wants to take their own life, let them fill out a DNR and do it themselves, and if they are unable, they can have someone other than a health professional do it for them. I just think that there is too much liability and immorality involved. Plus there is always a chance that the "terminally ill" patient survives. I would have trouble taking someone's life, no matter how old or the condition they are in. Fortunately I can say that I have never had an experience with someone close to me wanting PAS, and until I do I guess my opinion remains one without certainty or any personal emotional attachment. I do know that there is a huge difference between putting down an animal and a human, the main reason being the difference in species therefore I see that as an irrelevant comparison.
Kyle Crisco, P1
Class of 2015
I think physician assisted suicide is a hard subject to come to a complete yes or no answer for. I believe it has to be decided from the details of the specific situation. Some people are always going to have a problem with it and maybe even classify it as murder, but if that is truly what someone wants to do, is it really your right to tell them no because you do not agree? I do not believe so.
In terminal illnesses I can see why physician assisted suicide would be a desired thing. The person ends up suffering so much. I have witnessed it first hand of a terminally ill patient who was on a respirator and had feeding tubes have to starve to death. Not only did that cause him to suffer it also caused his family to suffer. However, I think it goes back to conscientious objection. I know I would not feel right dispensing the medication for a physician assisted suicide.
I believe PAS is something that can help patients die gracefully. Oregon has some great things in their laws that would prevent rash suicide attempts but this should be something you can choose to have in place in the event something happens, ie, debilitating accident/sudden illness. I have a grandparent who had a debilitating stroke 2 years ago who I know whould sign up PAS given the chance. He is unable to speak clearly, has had many stints since then in hospitals because he intracted MRSA inpatient, and has had amputations which are causing phantom pain. He was a very strong, proud, and independent man. Since, all of which is gone and feels as if his soul was gone a few months after the stroke. He is incapable of doing anything on his own and is constantly crying and yelling in pain. It has been horrendous for our family to watch him suffer physically and
emotionally.
This is a decision that the patient and their family should be making. Medical staff should not be the ones suggesting PAS but simply a realistic reasoning voice should questions be asked.
I believe Physician Assisted Suicide it is the patient's right. This act should only be used for patients who are terminally ill or who have a very progressive and debilitating disease for which there is no cure. The mindset of a patient with these ailments may seek Physician Assited Suicide as the best choice for not only themselves bur for their family as well. The patient may seek to alleviate further financial burden that would be taken on if the patient were to live out their days under hospital care. The patient's quality of life may also be so negatively effected by their ailment that they can save themselves from agony by choosing physician Assited Suicide. I believe for this act the patient would have to be evaluated for mental defect. If the patient was deemed fit it would be their choice and their decision. Having a physician help them along in the process would also be helpful as opposed to the patient trying to take their own life where they have a higher chance of making a mistake and hurting others in the process.
I believe the patient should have the right to PAS but there should be strict guidelines that are implemented to make sure PAS is used correctly. I thought the breakdown of the Oregon guideline that Ashley posted was very interesting and is definitely a good start to something that could be implemented throughout the country.
If the patient can communicate on their own I think that those cases could be much easier than the ones where the patient can't communicate their wishes and then it depends on their family members. If a law is ever passes for the whole country there needs to be a lot of details about the cases that a family member is making the decision because they may want to end someone's life for the wrong reasons.
Nathan Batchelder, P1
I believe that physician assisted suicide is not immoral whatsoever. From personal experience, I feel that this is a good thing. For weeks I watched my grandfather suffer in pain in which he could never overcome. It was tormenting to my family because we knew that the doctors were just delaying the inevitable. The doctors prescribed him so much pain medication to where he barely knew who I was. I cannot justify delaying a person’s death who is not aware of their surroundings or capable of making decisions due to the pain they are experiencing. When my grandfather passed, my family had mixed feelings. We all dearly missed him, but we also knew that he was not suffering anymore. From what I have learned, I believe that physicians should honor valid requests from patients, or the patient’s family members, during times such as these.
When talking about patient assisted suicide, I believe the patient should have the right to determine if this is what they want. I think there should be measures in place however to prevent spur of the moment decisions from occurring. You don't want someone who is depressed coming in right after something tragic and just wanting to die; something similar to Ashley's post would be appropriate. I have actually heard of "assisted suicide hotels" that they have in Europe. This is pretty much a medical bed and breakfast that the patient goes and spends the night. Their friends and family can come spend some last moments together, they eat a last meal and then the physician administers the suicide medication. This is a more peaceful way to go out in my opinion. The only thing that is controversial in my opinion is deciding for people who are not able to speak their wishes and have not signed a DNR or talked about the situation with a spouse or family member previously. I am not sure how this would be handled because you are not sure what the patient wants.
I believe that the only way physician assisted suicide is ethically right is if the patient is terminally ill and gives written consent to the physician. This should not be allowed for patients who are severely depressed, have other mental/emotional issues or have a disease or condition that may improve over time. I believe it is more unethical and immoral to allow the patient to live in such significant pain any longer than he/she wishes. If there is no chance that the patient will recover, then I support the decision to allow the patient to die with dignity. However, there should be very strict regulations to make sure this is the right decision for the patient.
I like the process that Ashley says that Oregon goes through if a patient would like to receive a prescription aiding in their request to die. I feel those who don't agree with subject, sometimes can't understand what a patient is going through. There are some disease/terminal illness that changes a person life permanently. We may or may not be able to understand, but we definitely can't feel what they are going through.
Some patients maybe able to live with this same disease, but others may not. It varies per individual and we can't just say get over it to the patient who cannot deal. We must take in consideration how this has affected the patient quality of life and help their family members understand that they should do of what is best for their love one, not what's best for themselves. And first and foremost, these patients who would like to go through this should not feel as if they are being selfish and leave this world without guilt.
I also like the process Ashley described for Oregon. I think patients should have the right to this service, but there would obviously need to be many procedures, rules, and sign offs to prevent it from getting abused. I like the idea of it only being available to a terminally ill patient with severe documented pain. Physician assisted suicide would allow these types of patients to choose to die with dignity and side step an unnecessary amount of pain before their inevitable death.
I understand what people are saying about PAS, and I agree that each individual has a right to make decisions concerning their lives. Still, a part of me just doesn't feel it's right to take another's life. The patient may be suffering to a degree no one could even understand and if they want to die, they'll find a way. The physicians don't need the responsibility of allowing suicide under their watch. I believe it totally changes the relationship between patient and physician, and that's not good! Besides, who is to say the patient's state won't improve? All the stuff about the patient's rights aside, I hate to see anyone give up hope.
I believe that patients have the right to choose if they want physician assisted suicide. If this were to be implemented everywhere I think strict regulations need to be established, such as the restrictions used in the state of Oregon. We have seen that physician assisted suicide works in some countries, there is no reason it cannot work here if implemented correctly.
I think that this is an extremely difficult topic to have a set in stone answer to. There are always circumstances in which a person might feel fully justified in saying yes to something they would normally say no way to. I don't know that I could personally every assist in a suicide, but there are instances in which I wouldn't blame or judge someone who did. The oaths and laws and beliefs that we govern our profession by are not set up to help us deal with situations such as assisted suicide.
I was unable to find the specific article I mentioned in class, but I did find this really good summary of the Death with Dignity Act: http://www.doh.wa.gov/dwda/faq.htm#what
From what I have read, Oregon's law is very similar to Washington's described on this website. There are some key differences from what we discussed last week. The patient can self-administer the medication where they choose, and a physician does not need to be present, for example.
I also found this article pretty interesting:
"Forced Abandonment and Euthanasia: A Question from Katrina" by Kenneth Kipnis
http://findarticles.com/p/articles/mi_m2267/is_1_74/ai_n19094727/?tag=content;col1
Sorry for leaving these on here so late! I hope you get a chance to read these if you're interested.
I personally don't agree with the physician assisted suicide. I completely understand that it's patients' choice to decide whatever about their life but at the same time, but I don't think it should be legalized. One of the problems with making it legal is that PAS will be an easier way out of treating a terminal disease. The other problem is that it will raise a moral issue among physicians. There will be a lot of physicians who don't want to do this because they consider it as killing someone.
I agree with what a number of people have already stated - in the end, it should be the patient's right to choose whether or not PAS is something they want. I feel that the process in Oregon as illustrated by Ashley above is very reasonable - that makes it a process that takes a certain amount of time and thought, and therefore not something that a patient can just decide to go through with on the spur of the moment. Beyond all else, I feel that a patient should have the right to do with their life whatever they want to do with it (outside of endangering others or other things that don't fall into the realm of reason, of course). If a patient does not want to spend what they have been told is their last few months of life suffering, who are we to make that choice for them? I also think the question needs to be asked - if we refuse to help them die, are they going to try and do it themselves by other means?
I also agree with Bess's comment about some things being worse than death. I feel that the fear of what you know is coming could fall into this - let's say you know exactly what your next six months are going to entail. Might include unbearable agony (worse than the pain said patient might already have), increasing symptoms of whatever illness you have, slow loss of functions that once came easily to you, losing the ability to do things on your own or even take care of yourself in the most basic of ways. Pride is always going to be a big part of who we are as people and I can see how having all of that slowly and painfully stripped away, as well as the fear of leaving behind a large medical debt to their family could make dying on their own terms seem a preferable alternative.
Physician Assisted Suicide is something that I believe should be a patients right. However, for me personally it would be very hard to come to grips in taking someone's life. After all, isn't part of our oath doing no harm? In my opinion, if I were take a patient life even with there consent I would feel as if I went against the oath.
I believe that if the patient wants this service, they should be able to receive it. If a patient wants to end their life, they can do it with or without the assistance of a physician. Why not then help them make it an easier process. When I say easier, I am not solely thinking just for the patients needs, but also for the families needs. PAS let's the patient die on their own time, in a clean manner. Why not let them do this, as opposed to having to take their own life with a gun, or overdose and having to have a family member discover their dead body. This is one extreme example, but for me I believe it is relevant.
I hate to seem short-sighted and realize that all medical professions are intertwined, but I do not see how this topic will directly affect my professional career. As a citizen and an active voting member of our society I might have views on the issue, but I do not see the point of taking a professional stance on something that I will not have to directly deal with. It is highly unlikely that I would be called upon to fill a euthanasia prescription or IV specifically. If I was I doubt that I would be informed that that is what I was doing, though I might have reason to suspect it. If anyone can think of a reason I am misguided on my understanding please help me see that. It seems like this is between a patient and their doctor, and therefore their moral conundrum or lack thereof.
Jonathan Graham P1
I think this is a subject that will people will never be able to completely agree on. It is very controversial and will continue to cause arguments for years to come. I find myself midway between the two extreme views on the subject. I feel that physician assisted suicide is appropriate in certain situation however when there is any doubt it should be avoided. If the patient requests for physician assisted suicide and they have been assessed and deemed terminal then it should be permitted. However, if no approval can be received from the patient or family of the patient then physician assisted suicide should not be performed. Ultimately, physician assisted suicide kills the patient and therefore cannot be reversed so it is important that it is carried out in situations where there is no doubt in either the physician or the patient.
I feel like being for or against PAS is a hard choice because you never know what kind of situation you are going to be placed in during your career as a pharmacist. I think that its hard to say what choice you will take until a patient is actually there in front of you begging for you to help them.
I think that patients should have the choice of physician assisted suicide, but so should the physician. Even knowing that it is what the patient wants, ending someone's life is a hard action to deal with so physicians should be allowed to conscientiously object. I think the process Ashley Harris laid out is a good way to ensure that PAS is a patient's well thought out decision and not a fleeting whim brought on by a sudden bout of pain or frustration.
When we talk about how a physician should never harm a patient, but harming a patient could mean other things than death. Forcing a patient to go through months of severe pain in my opinion is more harmful to them and their quality of life than to let them go peacefully. Being able to schedule their time to go allows them to make reconciliations and say goodbye to loved ones. In many cases, people who are terminally ill are too sick by the time they actually pass on naturally to be able to say the goodbyes that they may want to say to those that are special to them. A patient has the right to be able to decide what they feel is the best decision for them.
At what point do we draw that line that it's immoral for a physician to assist someone with their last wishes? How can we say that it's legal to have an abortion, but that it's illegal for someone to ask a doctor to terminate their life? I don't think that we should be able to dictate what decisions can or cannot be made between a patient and their physician.
This should soley be based on the decisions of the patient no matter how experienced the practioner may think he or she is. however, we will have to watch out for the situation where if we consider this as a right there could be the potential of individuals who may not even have terminal illness but would want to end their lives by such suicide assistance. this is a very delicate issue that has so many things tied to it especially in the ethical point of view.
At what point do we get to draw the line whether it is immoral or not for a physician to assist a patient with the termination of their life? Like some have said, it can save a patient's dignity, save them pain, and spare them unnecessary suffering. How can we say that it's legal for a woman to have an abortion and end a life that has no choice, but say that ending the life of a person that CAN choose is illegal? I don't think that we have the right to dictate what decisions a patient and their physician reach between themselves. That's part of the physician responsibility - to determine what is the best for each patient in each specific situation. Until you are in the situation yourself, I don't think you can truly say that you wouldn't help someone.
Physician assisted suicide is a very serious issue and should not be taken lightly. I don't think this should be available for everyone. However, if someone is diagnosed will a terminal illness I think this should be an option. Someone should not have to suffer if they chose not to. I think if we don't allow this, people may take it into their own hands.
Physician assisted suicide can be a controversial issue, but it is better than individuals killing themselves using homemade methods and possibly botching the job. Physicians should be responsible enough to perform a clean and preferably painless assisted suicide. As a drug addict comes into a pharmacy looking for needles and receiving them based on the fact that it is better to use clean needles than dirty ones, the same applies to those who want to commit suicide. They should get the best possible help available. They will probably commit suicide no matter what the circumstances, so why not assist them for a clean and painless suicide.
Physician assisted suicide to me is a way out for patients that goes against our ethical code. We are required to help patients live the best life possible, not the help them end it. Now if a sound-minded patient (not their spouse) requested a DNR, then we should honor that request, but asking us to help them to that point crosses the line. I believe that we personally should do everything within our power to keep a patient alive until all options have been exhausted, and if their time has come then it has come, but I'm not going to be the one to do it to them.
People make many decisions a day. Many of which are small, and sometimes made subconsciously, however, some decisions that are made are life changing. Deciding to commit suicide takes more thought than what is required when deciding whether to eat food from Subway or McDonalds. The truth of the matter is, no matter how much thought goes into a decision, there is a potential for future regret. People who decide they want their life to end are influenced by an underlying reason. The way to handle this, in my opinion, is to assist the patient in resolving any issues that may be affecting their stress levels enough to decide suicide is the only way to go. I understand some people who would consider suicide may be terminally ill, and the thought of 'leaving it all behind' may seem ideal to them. We need to reiterate that suicide is not necessarily the best option available for these patients. Somebody with the fire and willpower to fight and get through any adversity they are experiencing will never give up. Instead of blowing out the candle, we as healthcare professionals must use every resource to keep that flame burning. It's amazing what love and support can do to somebody who is considering ending their life.
Moe Sobh
WUSOP Class of 2015
I thought this was a really interesting article about the director of "How to Die in Oregon." It gives you a closer point of view of the patient who is choosing to die on their own terms.
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