Should every person have the right to die with dignity?

Yes

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by Chrystal Mahan

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The Right To Die: Shouldn't It Be My Choice?

In this day and age, with modern medicine being as advanced as it is, one would think everyone could have a good quality of life after any major medical trauma. But the truth is this is not always the case. I know I personally would not want to be kept alive if I could not have a good quality of life. I would not want to be kept alive by machines to only extend the process of a slow death. I would not want to be in a vegetative state, kept alive only by a machine because my family has a hard time saying good-bye. That is not the quality of life I expect to have for myself. I feel one should have the right to choose to have the machines turned off. I may or may not go through with it, but the choice should be mine.

A common term for the "Right to Die" is "Physician Assisted Suicide." This is probably the most common. Another term is "Passive Euthanasia" and this is a case where the patient is unable to make decisions about treatment and it is left to the person listed in a will, or the doctors.

A survey of 2000 doctors showed us that only 6% said they have assisted in patient suicides, only 18% said they have even received such a request, and 1/3 of these have given the requested help. Most who admitted in assisting said they only did it once or twice, 1/3 said they would write prescription in lethal dose if legal, and said they would give a lethal injection if legal.(Finsterbush) So what does this tell us? To me it can say a few different things. It could say not enough doctors where questioned to really give us a good picture of the situation. What about the area the doctors lived? It could also be many doctors are not being honest, or it could just be that this is such a new topic that one can conclude nothing from that.

I don't think this is a new subject. I just think it is just now getting talked about out in the open, out in the mainstream. But, what about the great wars this country has seen over the last 60 or so years. What about those soldiers that were wounded with no chance of survival? We have all seen the movies, despite the fact it is a movie, we know, deep down, many of those "put me out of my misery" stories are true.

What exactly is the "Right to Die?" This can refer to a person which has a terminal illness and/or a very serious condition should be allowed to die (i.e. commit suicide) before the reality of death occurs. This is usually thought of when a person is living by the means of life support. The right to die is the patient's last wish that his or her caregivers allow death. The patient does not want life support or medication where any recovery is impossible or not likely. The argument is that one who is kept alive by machines or medicines is not experiencing a good quality of life.

What is Quality of Life? Can it be defined? Quality of Life measurement is to measure the extent of which people's "happiness requirements" are met - i.e. those requirements which are necessary (although not sufficient) condition of anyone's happiness - those without which no member of the human race can be happy (McCall). Does that mean the quality of life can be measured by happiness alone? So, if you are not happy, then you are sad. And sadness would be a bad quality of life.

The measures often used in the study of health care are 'quality-adjusted life years' (QALYs) and the related 'disability-adjusted life years' (DALYs); both equal 1 for each year of full-health life, and less than 1 for various degrees of illness or disability. Thus the cost-effectiveness of a treatment can be assessed by the cost per QALY or DALY it produces; for example, a cancer treatment which costs $10,000 and on average gives the patient 2 extra years of full health costs $5000 per QALY. Assessing treatments in this way avoids the much greater problems associated with putting a monetary value on life, as required in other areas of economics; saying that a treatment costs $5000 per QALY (i.e. per year of life) does not say or assume anything about the monetary value of a year of life (Wikipedia).

There is a fine line on the determining factors for quality of life when thinking on the terms of the right to die. If there is no brain activity, that is not good quality of life. If you are being kept alive by machines, never to enjoy life the way you knew it that is not a good quality of life. Living artificially is not good quality of life (Williams). But who determines the quality of life, you, your family or your doctor?

If you are someone who wishes to have the right to die if your quality of life is not what it should be after a major illness or accident, there are actions you must take before this happens. Tell everyone you know. Make a will. Get every last detail down on paper. Give it to a lawyer. Keep one on file to every Dr. office you visit. Hold a family meeting; let them know of your wishes. Listen to what they have to say, even if they do not agree. Living Wills and Do Not Resuscitate orders are legal and binding documents that will make the patients treatment orders known ahead of time. Another biding document is called the Five Wished Document. This document allows a person to state in advance the priorities and values they wish to have honored at the end of their life. The most powerful document is the Medical Durable Power of Attorney (MDPOA) and it designates an agent to make decisions for the patient and can be used to give written guidance regarding end of life decision making. The attorney will work very closely with the patient's family (Williams).

There are many websites to visit and articles to read for those that agree with the right to die. Equally there are just as many who do not (www.theonion.com). We will now take a look at the argument of the two sides. At present time there is very little forward movement of any laws regarding the right to die.

Measure 16 of 1994 established Oregon's Death with Dignity Act. This act makes physician assisted suicide legal, but with certain restrictions. This makes Oregon the first state to allow this. Under the law a capable adult must be an Oregon resident that has been diagnosed with a terminally ill disease by a physician. This person may request in writing from his/her physician a prescription for a lethal dose of medication for the purpose of ending their life. This request must be witnessed by at least two people. One of the persons can not be related, can not be entitled to a portion of the patients estate, or be an employee of the caring facility. Another doctor must sign with a second opinion. After this there is a 15 day wait. At anytime the patient can change their mind (Coleman & Kerbo). This law protects the doctor from any liability for participating in a suicide.

In 1999 Texas passed the Texas Advance Directives Act which allows a healthcare facility to discontinue a treatment that is being used to keep the patient alive. The difference with this law is that it can be against the wishes of the patient and guardian. As with the other law, this one has a process it must follow as well.

Richard T Hull's theory "The Case for Physician -Assisted Suicide." is a look at one side of the argument. Hull is a professor of philosophy that is for assisted suicides, but only for the terminally ill. One should also note that he feels this should be a regulated procedure and not just something any doctor can do whenever he feels in necessary.

Hull feels that the reason patients choose to want the right to die is due to the inadequate care patients spend their last days with. Many doctors are unable to give them the adequate narcotics necessary for pain management, so the patents end up suffering. He does bring up one important discussion. How would one know if it was really the patient talking, or the illness? How then would you draw the line and let one live and another die? Who's to say that the one you must let live because they don't fall into a certain criteria don't try to take matters into their own hands?

Next we look at the opposing side. Margaret Somerville law and medical professor said the euthanasia is a no. She stakes the claim that this procedure has no regard for human life. The principle behind the theory is that it is wrong for one individual to take the life of another, except in justified self-defense. (Somerville) She has two major arguments against the process of euthanasia.

Impact on Society is the first one. Somerville states that legalizing such a procedure would damage many social values. She defines euthanasia as "an act that requires two people to make it possible." Her second argument states allowing this procedure would have a huge impact on medicine. She believes the society as a whole, they way we know it would be in a upheaval that we could never come back from. It would change the focus of the entire world and is that something we are ever going to be ready for? Something we ever want to face? Somerville states that the entire process is just a simplistic, wrong and a dangerous response to the reality of human death. She concludes that those who are asking for assistance in dying are at their most vulnerable, their weakest, and fear loss of control or abandonment. She believes this is placing them in a category where their only alternative is to be killed or killed themselves.

We have looked at some opinions that are for and against the right to die. Now I would like to look at another perspective as well as look at the for and the against ideas related to that perspective.

There is a perspective that we must recognize, and that is the right to die with dignity. We all know life must be protected, but we must also allow one to have a humane death. Individuals have the right to determine their own death. When people are in a great deal of pain and agony, with no relief in site, they should be allowed to seek out medical assistance in ending their own lives. We know that patients can refuse the right to life-support technology, so they should be allowed the right to seek assistance in dying if they choose to. In order to do this, we must pass the law in all 50 states, make it socially acceptable and enact rules to determine that the patient seeking the intent on ending their own life. Arguments for this perspective state that administering a lethal drug is more humane then the current practice of withdrawing life sustaining treatments. Many physicians already secretly help patients - this would make it legal for them without and repercussions. As long as regulations about their circumstances under which individuals may seek a physicians help in dying are clear and strictly enforced, the danger of abuse can be kept to a minimum. Arguments against this perspective include ideas like the severe pain that leads to suicide is really treatable. Just because one is seriously ill does not mean they are close to death. This could cause conflict of interest between doctor and patient. Another big argument is that many patients who are considering suicides when they are terminally ill are actually really depressed, not suicidal (www.publicagenda.org ).

In conclusion, looking at some different opinions regarding the right to die, one can correctly state that both sides have a pretty good structured argument. I for one do not see a day that everyone will agree. Many factors like morals and religion also play a part in how people look at assisted death. But for those that do not have a problem with it, it should be left to each his own, and that right to choose should be theirs.

Reference:

Hull, Richard T. (2003, spring). The case for physician assisted suicide.

Free Inquiry Taking Sides, 258-261.

Lykes, Fred. (2003). "A defense of physician assisted suicide (pas)."

http://www.euthanasi a7.com/?src=overture

Public Agenda

http://www.publicage nda.org/issues/front door.cfm?issue_type= right2die

Somerville, Margaret. (2003, spring) The case against euthanasia and physician

assisted suicide. Free Inquiry. Taking Sides, 262-265.

Williams, Frank.(2005). The right to die.

Gibbs Magazine.

http://www.gibbsmaga zine.com/Right%20to% 20Die.htm

Wikipedia, the free encyclopedia

http://en.wikipedia. org/wiki/Quality_of_ life

(1997). Right to die controversy. The Onion.

http://www.theonion. com/content/node/381 41

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