Valerie Ho

Period 1
Murder in the Medical World
Physician-assisted suicide must end in order to allow everyone to live their life to the
fullest. This form of suicide is when a doctor knowingly prescribes a lethal drug, which can kill
them within hours, to their patient to allow them to commit suicide. Currently, assisted suicide is
only legal in five states, Oregon, Washington, Vermont, Montana, and New Mexico ("State-byState Guide to Physician Assisted"). A doctors role is to help heal the patient, and by helping
them die it goes against the Hippocratic Oath, an oath that doctors must follow. The guidelines to
allow the drug to be administered are vague and not strictly regulated, which result in a higher
amount of deaths. In European countries such as the Netherlands and Belgium, physicianassisted suicide is legal, which shows the slippery slope in that there are many deaths from not
life threatening illnesses. Everyone should be given a chance to live, and with the constant
medical advances, there is no guarantee that a patient will die within the time frame predicted.
Physician-assisted suicide is an inhumane death that should not be administered by doctors
because of the Hippocratic Oath that doctors swear to, the subjective measures of by which the
lethal drug is administered, and the constant advances in medicine that can result in a cure for the
patient.
Physician-assisted death is considered a felony in all states except five, and the
punishments range from a large fine to charges of manslaughter (State-by-State Guide to
Physician-Assisted). The Hippocratic Oath is a historic oath taken by physicians that ensure that
they try their best to help patients and uphold ethical standards. In the original oath is Greek, but
the translation says, I will neither give a deadly drug to anybody who asked for it, nor will I
make a suggestion to this effect (Hippocratic Oath). Physician-assisted suicide is giving a
deadly drug to patients, which is deemed unethical by the oath. Doctors no longer swear to the

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original Hippocratic oath, but rather swear to a modern version of it. Although in some modern
versions, it allows doctors to take a life, the text often warns, This awesome responsibility must
be faced with great humbleness and awareness of my own frailty. Above all, I must not play at
God (Hippocratic Oath, Modern Version). There is a distinguishable difference between
withdrawing the life-sustaining treatment of the patient, with the familys consent, and giving a
killing prescription to a conscious human being.
Life support is the artificial replacement of vital organs, such as lungs, heart, or brain,
which is used when one of these organs fail to function. It is within a patients right to decline the
use of life support. A doctor typically advises a patient and their family to stop life support when
there is no hope for recovery for their organs (What is Life Support?). When patients are in a
coma, many become brain dead, which are when the brain no longer functions, so the machine
takes the responsibility of the brain to keep the heart beating. Doctors consider brain dead the
same as being dead because once off the machine the brain cannot function to keep the person
alive, and this is usually the stage where families decide to pull the plug (Who Decides When to
'Pull). The American Medical Association opposes physician-assisted suicide, but finds it
ethically acceptable to withdraw life support. Taking one off life support is legal and requires the
consent of the patient and their family, as they are unconscious. In Vacco v. Quill, the United
States Supreme Court ruled that New York was allowed to have a ban on physician-assisted
suicide. The case furthermore distinguished between physician-assisted suicide and the
withdrawal of life-sustaining treatment, stating it is a distinction widely recognized and
endorsed in the medical profession and in our legal traditions (Harned). Physician assistedsuicide is taking the life of a breathing, able human. Pulling the plug is distinctly different
because without the machine, the patient would not be able to live.

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The measures by which to administer the lethal drug to kill the patient are unclear and
subjective. This can result in many unnecessary deaths if physician-assisted suicide was legal in
more states. In order to receive physician-assisted suicide, the patient must be 18 years or older
and living in a state where the practice is legal. The additional requirements for the drug is to be
mentally competent, i.e. capable of making and communicating your health care decisions;
diagnosed with a terminal illness that will, within reasonable medical judgment, lead to death
within six months ("How to Access Death). The term mentally competent is very vague.
Patients with depression or other mental illnesses are not allowed to be prescribed the drugs
because it may impair their decision, but often times the patients are not diagnosed. A study
conducted by the New York State Department of Health shows that as the cancer or other
terminal illness progresses, up to 77% of patients can be affected by depression, although the
percentage is highly under diagnosed (Suicide and Special Patient). Furthermore, there are no
requirements in Oregon or Washington that patients must receive psychological evaluation or
treatment prior to receiving lethal drugs (Harned). In these cases, there is a high chance that a
mental illness go undetected resulting in a death that could have been prevented.
There have been times where the lethal drug has been administered to people with
depression. The mere availability of having physician-assisted suicide as an option can pressure a
patient into wanting to end their life with the drug. In a study done by the BMJ, a global
medicine journal, in 2008, out of 58 patients from Oregon who requested doctor aid in dying,
48% had a form of depression or anxiety. Of those who successfully received the drug, 16% had
criteria for depression (Ganzini, Roy, and Dobscha). This statistic is far too high to ensure safety
for terminally ill patients and their families. H. Rex Greene, MD, a certified hematologistoncologist, palliative care/hospice physician, and a member of the CMA Council on Ethical

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Affairs for the past 18 years, explains that physician-assisted suicide is not a solution for
depression:
Demoralization Syndrome, which is very common in chronic, ultimately life threatening
illness, the features of which (hopelessness, helplessness, and despair) fit the profile of
the victims of Oregon's law, who are consistently reported NOT to be in pain or disabled
by their allegedly terminal illness but request [physician-assisted suicide] because of
fears of what might come in the future: helplessness, dependency, becoming a burden.
Oregon in fact has proven that the only symptom driving requests for [physician assisted
suicide] is psychological distress. Clearly the standard of care for depression and
demoralization is not a lethal overdose of barbiturates. (Zoanni)
Furthermore, another flaw of physician-assisted death in the U.S. is that the patient is not
required to notify their family members prior to their decision of obtaining the deadly
prescription (Harned). The patient can be recommended to consult with their family, but without
any requirements, the family can be oblivious to the killing of their own kin.
A good doctor-patient relationship is vital for the quality of life for the patient. A solid
relationship involves trust between the patient and their doctor. By having the connection, the
patient can communicate how he or she feels and they can work together to figure out the best
way to deal with their illness. In Oregon, there have been cases where physicians who have
known the patient for one week or less prescribed them the deadly drugs (Harned). According to
reports by the Washington State Department of Health, in 2015, over half of the patients who
received the drug knew the doctor for less than 25 weeks (Death with Dignity Act). This
undermines the relationship between the patient and doctor. An oncologist from California said
that physician-assisted suicide, strikes at the heart of what we do as physicians and adds

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ambiguity to the physician- patient relationship (Harned). Doctors are supposed to do
everything in their ability to heal and treat a patient. Allowing and aiding a patients death gives
the doctor too much power. They are supposed to present all the possible options for treatment to
a patient, and adding death on the list is not a solution.
Physician-assisted suicide is sometimes deemed necessary because terminally ill patients
suffer uncontrollable pain. However, according to studies by the American Medical
Association (AMA), the American Pain Society (APS), and the New York State Task Force, the
pain can be relieved 95-98% of the time ("Suicide and Special Patient"). This makes physicianassisted suicide an unviable option for relieving pain and suffering. There are alternative options
to the pain, such as taking analgesic medications and pain relief techniques. The American
Medical Association believes that, Physician-assisted suicide is fundamentally incompatible
with the physicians role as healer, would be difficult or impossible to control, and would pose
serious societal risks. Without a trusting relationship with the doctor, the patient will be ignorant
to the many options to treat their illness and instead go for the seemingly easiest onedeath. In
Oregon, the most common reasons for wanting physician-assisted suicide are loss of autonomy,
loss of ability to participate in daily enjoyable activities, and loss of dignity (Gonzales v.
Oregon). Lives cannot just be cut short due to ones unhappiness in their life. It is unreasonable
and uncontrollable to allow conscious, living people to die with the help of their doctor. Also,
many times the patient is not acting on their own behalf but rather on their families or
caregivers. According to the Washington State Department of Health, out of everyone who have
received the drug in Washington, 16% wanted to die because they believed they were too much
of a burden for their family, caregiver, and friends or had economic concerns. Compassion &
Choices, a main advocate group of physician assisted suicide, believe in death with dignity,

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which is invalid here because the patient is not even making a decision based on their own
condition, but rather other peoples.
Another requirement is that a patient must have a prognosis to die within six months, but
there is no guarantee of that. From 1998-2008, Oregon reports show that out of the 627 patients
who received the lethal drug, 16% of them were still alive by the following year (Zoanni). This
shows that there is human error and unexpected surprises that can lengthen the life of an
individual. Also, with advancing medical technology, the life of a patient can never be taken for
granted. There are always advances in medicine and new experiments being tested. Patients
should be able to live out their lives and not have them be cut short. Medical advances are
helping the survival of patients as well as extending their life. The more time they have, the more
time with family and loved ones. The medical advance of the year by ASCO is cancer
immunotherapy, which halts cancer growth (Advances in Treatment). So with continuous
advances like this, the patient will be able to be saved from the brink of death, but with the
option of doctor-assisted death, they will not be able to live again. Ana Gospodinoff was told that
she had breast cancer and a 3% chance of making it through the next month (Facing Breast
Cancer: Couple). With continuous treatment and hope, she persevered and is now a living
miracle. Had she given up hope and vied for physician-assisted death, she would not be with her
family and continuing her life. Gospodinoff participates in relays and events to help find cures
for cancer and inspire others. She hopes everyone has a chance to live and said, You cant make
somebody want to fight. I can tell them my story and tell them I was dead; yet Im standing here
(Facing Breast Cancer: Couple).
Physician-assisted suicide can present a slippery slope situation in many European
countries where it is legal. In Europe, the practice is legal in Netherlands, Belgium, Luxembourg,

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and Switzerland (Lewis). In these countries, the rates of assisted dying are much higher than in
the United States, and are drifting away from people with fatal terminal illnesses. In Holland,
where assisted suicide is legal, a 47-year-old woman who had incurable tinnitus, like train
brakes constantly shrieking in her head, was able to die by euthanasia, which is the killing of
someone with the assistance of another. Her reason was because, there was no treatment and no
foreseeable end to it she convinced us her suffering was unbearable (Reid). The woman was
not close to death, but was still allowed to die. A requirement for assisted death in the
Netherlands is unbearable pain, yet this woman got away with her death (Lewis). According to
reports by the Dutch government, half of Dutch physicians suggest euthanasia as a solution to
their patients (Harned). In Holland in 2013, doctors euthanized 650 babies because their parents
claimed the babys suffering in life would be too much to handle (Zagorski). The slippery slope
of assisted suicide has led to babies being killed without being given a chance to have a life. The
regulations and requirements of physician-assisted suicide have been stretched greatly in
European countries. The same fate can happen in the United States if physician-assisted death is
extended to more states.
In Belgium, assisted suicide has taken another step towards murder. A study published in
the Canadian Medical Association Journal in 2010 shows that out of 1265 nurses, 120 nurses
reported that a patient of theirs had received euthanasia without explicitly asking. This is
essentially involuntary euthanasia, which is the killing of someone without his or her consent.
The nurses were under doctors orders 98% of the time, which shows that there is an abuse of the
lethal drug by doctors (The Role of Nurses). With similar guidelines in Belgium as the
Netherlands, the euthanasia rate has increased to 4.6% of all deaths in a 2013 report. The rate has
steadily risen since the legislation passed in 2002, which was a mere 0.3% (Lewis). The number

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of deaths will continue to increase and the line between euthanasia and murder will be blurry.
Advocates of physician-assisted suicide believe in aid in dying and dying with dignity.
Compassion & Choices, gives these terms a seemingly happy name, when in reality, it is
physician-assisted suicide and the killing of a human being. Supporters want the choice to die,
which seems like a fair cause, but the effects of such legislation can be fatal. It will become
difficult to determine who is able to receive the drug and the mental condition of the patient.
Physician-assisted suicide is an undignified death that should be banned in the United
States. The Hippocratic Oath is a traditional oath of ethics that makes doctors promise to do
everything in their power to treat a patient. Taking a patient off life support is completely
different than physician-assisted suicide. On one hand, the person is unable to survive on his or
her own without the machine, and a terminally ill patient has the ability to make decisions for
themselves. Yet, the guidelines for receiving the lethal killing drug are vague and allow
supposedly ineligible patients to die. Depression is highly under diagnosed among terminally ill
patients, and with no requirements to have each patient individually checked, it is much easier
for the mentally incompetent to get approved. Also, the patients are making decisions on behalf
of their family because they feel as if they are a burden, which is unacceptable and not dying
with dignity. Time with family and loved ones is priceless so economic concerns should not be
a valid reason to obtain the drug. Finally, the slippery slope situation is evident in European
countries where even babies are being euthanized because of their future suffering. The death of
a terminally ill should not be in the hands of their doctor, the one who they are supposed to trust
with their life. Miracles and medical advances are evident in life, and every human being should
be given the chance to fulfill their life.

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