Monday, March 9, 2020

The Bio-Legal Issues Surrounding Physician Assisted Suicide Essays

The Bio-Legal Issues Surrounding Physician Assisted Suicide Essays The Bio-Legal Issues Surrounding Physician Assisted Suicide Paper The Bio-Legal Issues Surrounding Physician Assisted Suicide Paper A most troubling issue in the bio-legal discourse is that of the so-called ‘right-to-die,’ which continues to receive debate in current medical and legal consideration. The concept of euthanasia implies that the dignity of human life may be compromised by the affliction of terminal illness, intractable pain or an incapacity to function without artificial life-support systems. Under this pretense, we are suggested to have an entitlement to choose a dignified passing rather than a prolonged suffering. This is an incredibly complex issue though, subject to variation based upon one’s ethical, biological and philosophical understanding of any given medical case. Ultimately, the exploration here will suggest that there is, among other defenses, a legal basis for the defense of physician assisted suicide which denotes that a failure to allow such is tantamount to a failure to relieve suffering where such is the only means that might accomplish such and a failure to apply the proper regulatory oversight to standards precipitating physician assisted suicide. In contrast, the sanctity of human life has for centuries been considered an objective fact of universal rationality, with great intellectuals such as Plato decrying suicide and any enabling of the practice as both existing in contrast with our rights of self-determination. This thinker is joined by most established religions, broad swathes of society and most of the highest offices of American governance due to a sociologically crucial interest in the sanctity of human life. In the last two years or more of executive-led religious indoctrination, it is important that one’s moral background not become the driving force behind the formation of legislative backing though. There is a clear duality in the debate, where beneath an explicit layer of semantic and legislative wrangling, there is an enormous religious subtext which calls into question the effectiveness of the separation of Church and State, as defined in the Constitution. With conservative lawmakers such as Samuel Alito and John Roberts ascending to the Supreme Court bench in the last two years, there is a certain thrust away from bioethical progressivism. However, such a reality is in clear contrast to the well-established virtues of a pragmatic protection for the right to such a decision as euthanasia. At the very base of the philosophical impulses in providing medical care, as set forth in the Hippocratic oath, is the function of relieving illness, injury, suffering and pain. This is the perspective which provided foundation to a perspective which found legal support in the last decade and a half. In 1994, the Oregon legislature passed Measure 16 of the state’s pre-existent Death With Dignity Act. Thus, now, â€Å"in Oregon, US, only physician-assisted suicide is legal, and this began in 1997. † (Pasterfield, 450) Designed to protect and ensure the medical rights of the terminally ill, the measure was approved by a very slim majority through public referendum, establishing a standard by which physicians may assist in the termination of life for patients who desire an immediate cessation of pain due to intractable and fatal conditions without fear of legal reprisal. One of the bill’s key segments, section 127. 885, indicates that â€Å"no person shall be subject to civil or criminal liability or professional disciplinary action for participating in good faith compliance,† with the conditions set forth in the measure. (Oregon, 7) This is to indicate that for physicians adhering to the parameters allowing for the administering of life-suspending procedures as set forth in the legislation, the State of Oregon may take no retaliatory action. Such legislation would be the first of its kind in the United States, though it has yet to achieve any genuine penetration to precedent on the federal level. Still, the ‘right to death’ movement, which has gained greater notoriety in recent decades than ever before, is informed by the premise that it is within the Constitutional body of rights for an individual to decide to terminate one’s own life. The purpose of this initiative has been to proliferate entitlement and access, to those suffering from intractable pain or illness, to those that might help them achieve death with comfort and dignity. Its supporters are typically those aligned with civil liberties organizations such as the ACLU. Likewise, many in the medical community view this is as a natural right which should be accorded to all patients, fundamentally reflecting one of the most basic freedoms regarding one’s own life. This speaks to one perspective on the capacity of this legislation to alleviate personal pain and suffering for those contained within Oregon’s public healthcare system. The terms of the 1994 legislation are quite specific in their delineation of preconditions required for the administering of a lethal injection using a legally controlled substance. These include multiple levels of physician and witness approval concerning the patient’s physical and emotional state as well as a mandatory waiting period during which the patient is enabled to reflect on the decision before reaching a final resolution. The helps to shape its effect as one which is beneficial only to those patients desiring its parameters, thus expanding the medical options available to those suffering from terminal illness. The legal implication of this legislation would be highlighted during the mid-90’s with the high-profile focus on ethical considerations entering the courts. The issue of physician assisted suicide attained its highest degree of public acknowledgement with the media-embraced case of Michigan physician Dr. Jack Kevorkian. Developing his practice around the provision of assisted suicide for those suffering irreversibly from untreatable medical conditions, Kevorkian ignited public controversy, with many viewing him as a champion of a theretofore untested Constitutional right and others still labeling him a murderer. It was his very publicly visible philosophy of entitlement which caused the state of Michigan to pass legislation denying his right to the practice, as well as retracting his license to practice medicine. This would help authorities, in nothing less than Kevorkian’s fourth trial, to place him behind bars for manslaughter. This would be consistent with the prevailing legal appropriation of his practice. Following the prohibition of physician assisted suicide in Michigan, other states adapted a similar strategy, with important distinctions and regulations being framed around the debate. For instance, a 1998 Supreme Court decision held a Washington State decision making illegal physician assisted suicide, likewise helping to clarify additional euthanasia related issues, concluding that it was lawful to end life-support systems even separate from the subject of physician assisted suicide. (Meisel, 1) For those in the ‘right to die’ camp, this would demonstrate a fear that prohibition against such practices as Kevorkian’s would undo the right for those on life-support, in a persistent vegetative state, to cease artificial life-functions. Indeed, this fear would prove somewhat justified by the celebrated recent case of Terri Schiavo. Florida Governor Jeb Bush intervened on behalf of the comatose patient’s parents to prevent the vegetative woman’s husband from having her feeding tube removed, which would have terminated her life. The governor offered a brief statement that indicated what he perceived as the legal crux of the matter, assessing that the â€Å"potential for irrevocable harm to Terri Shiavo is real and imminent. Even an erroneous decision not to terminate the withdrawal of sustenance results merely in the maintenance of the status quo. †(2). For precedent, the governor cited a court decision that captures current legal perspective in Florida on the debate: . . . the possibility of subsequent developments such as advancements in medical science, the discovery of new evidence regarding the patient’s intent, changes in the law, or simply the unexpected death of the patient despite the administration of life sustaining treatment at least create the potential that a wrong decision will be mitigated. An erroneous decision to withdraw life-sustaining treatment, however is not subject to correction. Cruzan v. Director, Missouri Dept. of Public Health, 497 U. S. 261, 283 (1990). † (Bush, 2). This legal intervention does not exist in the vacuum of constitutional law, as evidenced above. Instead, it casts a broad net of views on the matter, drawing the serious medical dissensions to such a terminal commitment into the debate. One of the primary impetuses for allowing the practice is the claim that a patient who is suffering from intractable and ongoing pain is in a state of such reduced quality of life that death is the only humane option. However, according to the state of Florida as represented by its governor’s actions, there are relatively few conditions of this nature which cannot be treated by current standards in pain medication. Still, it is particularly visible when one considers states such as Colorado and Oregon, that the governor’s behavior would be contradicted by legal standard. â€Å"According to the United Network for Organ Sharing, many states. . . follow the Uniform Determination of Death Act, drafted and endorsed by the American Medical Association in 1980. That act sets the ‘irreversible loss of cardiorespiratory or whole-brain functions according to medical standards of practice’ as the standard for declaring death. † (Auge, 1) The Bush administration’s conservative agenda has helped to return this issue to the legal spotlight. Though the current presidential administration has attempted on several occasions to undermine the Oregon legislation through its courts, the euthanasia of these individuals remains legal under state law. As recently as January of 2006, the Supreme Court upheld the still pertinent Oregon State law permitting the practice. In a 6-3 decision, senior justice Antonin Scalia offered the dissenting opinion, arguing that â€Å"the federal government has long used its powers ‘for the purpose of protecting public morality,’ and that Congress granted the executive branch authority to prevent assisted suicide. † (Christie, 1) It should therefore be evident that the intention of legal and constitutional efforts to provide protection for euthanasia is not to increase its implementation but to find appropriate parameters within which to protect the freedom of choice. The movement which favors an institutionalization of clearly defined euthanasia laws is guided by the need for a safer, better regulated and more readily available accessibility to the option. Bibliography: Auge, Karen. (2004). Deaths border now less defined. Denver: Denver Post. Bush, Jeb. (2004). Appellant, Case. : SC04-925. Schiavo v. the State of Florida. Supreme Court of the State of Florida. Christie, Tim. (Jan. 2006). Assisted Suicide Upheld. Eugene, OR: The Register Guardian. Keown, John. (2002). Euthanasia, Ethics and Public Policy: An Argument Against Legislation. University of Cambridge Press. Meisel, Alan. (2004). The Right to Die: The Law-of-life Decisionmaking. Aspen Publishers. Pasterfield, Diana Wilkinson, Clare. (2006). GPs’ views on changing the law on physician-assisted suicide and euthanasia, and willingness to prescribe or inject lethal drugs. British Journal of General Practice, Vol. 56, No. 527. Olevitch, Barbara A. (2002). Protecting Psychiatric Patients and Others From the Assisted-Suicide Movement. Praeger. Oregon. (2008). Death With Dignity Act 1994. The Oregon State Website. Online at oregon. gov/DHS/ph/pas/docs/statute. pdf. Young, Robert (2002) Voluntary Euthanasia. Palo Alto: Stanford Encyclopedia of Philosophy. Online at http://plato. stanford. edu/entries/euthanasia-voluntary