Physician assisted suicide: A new look at the arguments

Bioethics

Volumn 21, Issue 3, 2007, Pages 127-139

  Dieterle, J M ^a  

^a EASTERN MICHIGAN UNIVERSITY   (United States)

Author keywords

Assisted suicide; Death with dignity; Euthanasia; Physician assisted suicide

Indexed keywords

ARTICLE; EMPIRICISM; FEMALE; FEMINISM; GOVERNMENT REGULATION; HUMAN; MALE; NETHERLANDS; PATIENT DECISION MAKING; PHYSICIAN; PHYSICIAN ASSISTED SUICIDE; PREDICTION;

ADULT; AGED; AGED, 80 AND OVER; FEMALE; HUMANS; MALE; MENTAL COMPETENCY; MIDDLE AGED; NETHERLANDS; OREGON; PHYSICIAN'S ROLE; RIGHT TO DIE; SUICIDE, ASSISTED;

EID: 33846933344     PISSN: 02699702     EISSN: 14678519     Source Type: Journal    
DOI: 10.1111/j.1467-8519.2007.00536.x     Document Type: Article

References (114)

1. Bulleted points are quoted directly from the Seventh Annual Report on Oregon's Death with Dignity Act. Oregon Department of Human Services, Office of Disease Prevention and Epidemiology. March 10, 2005, p. 8.
2. Seventh Annual Report, op. cit. note 1, p. 8.
3. This consequence is cited by: D. Brock. 1992. Voluntary Active Euthanasia.
4. Reprinted in W.H. Shaw, ed. 2005. Social and Personal Ethics. Belmont, CA: Wadsworth: pp. 79-89.
5. J. Gay-Williams. 1992. The Wrongfulness of Euthanasia.
6. th Edition. Belmont, CA: Wadsworth: pp. 180-182.
7. Y. Kamisar. 1958. Against Legalizing Euthanasia.
8. nd Edition. Belmont, CA: Wadsworth: pp. 176-183.
9. J. Arras. 1997. Physician Assisted Suicide: A Tragic View.
10. th Edition. Boston: McGraw Hill: pp. 394-400.
11. D. Callahan. 1992. When Self-Determination Runs Amok.
12. Reprinted in R. Munson, ed. 1996. Intervention and Reflection: Basic Issues in Medical Ethics, 5th Edition. Belmont, CA: Wadsworth: pp. 175-180.
13. See also S. Potts. 1988. Objections to the Institutionalization of Euthanasia.
14. Reprinted in J.E. White, ed. 2003. Contemporary Moral Problems. Belmont, CA: Wadsworth: 218-221.
15. Arras, op. cit. note 4, p. 397.
16. Potts, op. cit. note 4, p. 220.
17. Gay-Williams, op. cit. note 3, p. 182.
18. Brock, op. cit. note 3, p. 86.
19. Potts, op. cit. note 4, p. 219.
20. Potts op. cit. note 4, p. 218.
21. Ibid.
22. Ibid.
23. Gay-Williams, op. cit. note 3, p. 182.
24. Text of the Oregon Death With Dignity Act, available at http://egov.oregon.gov/DHS/ph/pas/ors.shtml [Accessed 12 November 2006].
25. B. Onwuteaka-Philipsen et al. Euthanasia and Other End-of-Life Decisions in the Netherlands in 1990, 1995, and 2001. Lancet. 2003. Available at http://image.thelancet.com/extras/03art3297web.pdf [Accessed 12 November 2006].
26. See A. van der Heide et al. End-of-Life Decision Making in Six European Countries: Descriptive Study for data on Switzerland, Denmark, Sweden, Belgium, Italy and the Netherlands. Lancet. 2003. Available at http://image.thelancet.com/extras/03art3298web.pdf [Accessed 12 November 2006].
27. P. van der Maas et al. Euthanasia, Physician Assisted Suicide, and Other Medical Practices Involving the End of Life in the Netherlands, 1990-1995. N Engl J Med 1996; 335: 1699-1706.
28. van der Heide, op. cit. note 15.
29. H. Kuhse et al. End-of-Life Decisions in Australian Medical Practice. Med J Aust 1997; 166: 191-196.
30. Onwuteaka-Philipsen, op. cit. note 14.
31. From the Third 'Remmelink' Report - the English summary of the 2001 report on euthanasia in the Netherlands. See www.worldrtd.net/news/world/?id=587 [Accessed 12 November 2006].
32. Ibid.
33. Data from the Netherlands is not relevant here, since nursing home care is free and open to all. Neither insurance companies nor families are financially liable for the patient's care.
34. E. Barnett. A Family Struggle: Is Mom Capable of Choosing to Die? Oregonian, Oct. 17, 1999.
35. Ibid.
36. W.J. Smith. Oregon Assisted Suicide Abuses. Available at www. lifeissues.net/writers/smit/smit_18oregonassistedsui.html [Accessed 12 November 2006].
37. Barnett, op. cit. note 23.
38. Ibid.
39. Ibid.
40. Seventh Annual Report, op. cit. note 1, p. 24.
41. Seventh Annual Report, op. cit. note 1, p. 5.
42. L. Ganzini et al. Physicians Experiences with the Oregon Death with Dignity Act. N Engl J Med 2000; 342: 557-564.
43. Ibid.
44. D. Raymond makes a similar point in 'Fatal Practices': A Feminist Analysis of Physician Assisted Suicide and Euthanasia. Hypatia 1999; 14(2): 1-25.
45. M. Vitez. Oregon is the Laboratory in Asssisted-Suicide Debate. Philadelphia Inquirer, March 13, 2005.
46. Seventh Annual Report, op. cit. note 1, p. 13.
47. Ibid: 22.
48. Ibid. I reserve discussion of women until the next section.
49. Ibid.
50. Ganzini, op. cit. note 31.
51. Third 'Remmelink' Report, op. cit. note 20.
52. Ibid.
53. Data from the Netherlands is not relevant here, since they have a system of socialized medicine.
54. Seventh Annual Report, op. cit. note 1, p. 24. The numbers do not add up to 208 because there is no data available for three of the patients.
55. Ganzini, op. cit. note 31.
56. Gay-Williams, op. cit. note 3, p. 182.
57. Ganzin, op. cit. note 31.
58. Ibid: 2-3.
59. A.L. Francke. 2003. Palliative Care for Terminally Ill Patients. International Publication Series, Ministry of Health,Welfare and Sport, No. 16.
60. http://www.disastercenter.com/crime/orcrime.htm [Accessed 12 November 2006].
61. Ibid.
62. See http://www.disastercenter.com/crime/ [Accessed 12 November 2006] for crime rates for the United States and for each individual state.
63. www.angelfire.com/rnb/y/homicide.htm#murder [Accessed 12 November 2006].
64. Seventh Annual Report, op. cit. note 1, p. 16.
65. Ibid: 5.
66. Francke, op. cit. note 48.
67. J. Schwartz & J. Estrin. In Oregon, Choosing Death Over Suffering. The New York Times, June 1, 2004.
68. See http://www.deathwithdignity.org/fss/stories.asp [Accessed 20 June 2005]. For anecdotal evidence regarding the Netherlands law, see the PBS Frontline documentary An Appointment with Death (2002).
69. Potts, op. cit. note 4, p. 218.
70. Seventh Annual Report, op. cit. note 1, p. 5.
71. Ibid: 24.
72. See above, Section II. 3.
73. Seventh Annual Report, op. cit. note 1, p. 17.
74. Francke, op. cit. note 48, p. 14.
75. Ibid: 15.
76. I thank Georg Bosshard for this point.
77. D.E. Meier et al. A National Survey of Physcian-Assisted Suicide and Euthanasia in the United States. N Engl J Med 1998; 338: 1193-1202.
78. Ibid.
79. van der Heide, op. cit. note 15, p. 3.
80. Ibid: 2.
81. Ibid: 5.
82. Kuhse, op. cit. note 18.
83. S.M. Wolf. 1996. A Feminist Critique of Physician Assisted Suicide. Reprinted in J.E. White, ed. 2003. Contemporary Moral Problems. Belmont, CA: Wadsworth: 222-234. Wolf cites four possible consequences of PAS, of which I discuss three. The fourth has to do with society's conception of PAS, given that most of the media attention has been on female patients.
84. Ibid: 222.
85. Ibid: 223.
86. Seventh Annual Report, op. cit. note 1, p. 20.
87. Ganzini, op. cit. note 31.
88. R.L. Marquet et al. Twenty Five Years of Requests for Euthanasia and Physician Assisted Suicide in Dutch General Practice: Trend Analysis. Br Med J 2003; 327: 201.
89. Wolf cites P. Steinfels, Help for Helping Hands in Death, The New York Times, February 14, 1993, sect. 4, pp. 1, 6.
90. Women are twice as likely as men to suffer from depression. New Report on Women and Depression: Latest Research Findings and Recommendations. Available at http://www.apa.org/releases/depressionreport.html [Accessed 12 November 2006].
91. See http://www.census.gov/hhes/www/poverty.html [Accessed 12 November 2006].
92. See http://www.census.gov/hhes/www/poverty03.html [Accessed 30 June 2005].
93. See above, section II 2b.
94. Seventh Annual Report, op. cit. note 1, p. 15.
95. Ibid: 24.
96. Ibid.
97. Ganzini, op. cit. note 31.
98. Ibid.
99. See Raymond, op. cit. note 33, for a feminist response to Wolf 's argument. Raymond offers an account of female autonomy on which autonomous consent to PAS is possible.
100. Wolf, op. cit. note 72, p. 223.
101. Ibid: 228.
102. Ganzini, op. cit. note 31.
103. M. Pabst Battin. 1995. Physician-Assisted Suicide.
104. Reprinted in M.C. Brannigan & J. Boss, eds. 2001. Healthcare Ethics in a Diverse Society. Mountan View, CA: Mayfield: 524-532.
105. Pabst Battin is not, herself, endorsing this argument. Quote taken from p. 525. See also Potts, op. cit. note 4, p. 219.
106. If we took the original Hippocratic Oath to be constitutive of a physician's ethical duties, then surgery would be unethical, as Pabst Battin notes (op. cit. note 79). The Oath says, 'I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work'. For the full text, see http://www.pbs.org/wgbh/nova/ doctors/oath_classical.html [Accessed 12 November 2006].
107. J. Rachels. 1986. Active and Passive Euthanasia. In The Elements of Moral Philosophy. Boston: McGraw Hill: 90-103.
108. See Pabst Battin, op. cit. note 92, p. 524. She does not endorse this argument.
109. See P. Singer. 1993. Justifiying Voluntary Euthanasia. In Practical Ethics. Cambridge: Cambridge Univ. Press: 176-200.
110. The only occurrence of this argument that I could find in the philosophical literature occurs in Gay-Williams, op. cit. note 3, p. 181. It often appears in popular arguments against PAS. Examples: http://www.bfl.org/cbb/assisted_suicide.htm [Accessed 22 June 2005], http://www.epm.org/articles/physuici.html [Accessed 12 November 2006], http://www.leaderu.com/orgs/probe/docs/euthanas.html [Accessed 12 November 2006].
111. Gay-Williams, op. cit. note 3, p. 181.
112. Ibid.
113. For an excellent defense of PAS, see Dworkin et al. 1997. Assisted Suicide: The Philosophers' Brief. The New York Review of Books, Vol XLIV, No. 5, March 27, 1997.
114. I thank the students in my Spring 2005 Medical Ethics course, especially Randy Keller and Linda Verhun, for helpful discussions. I also thank Lori Watson for discussion on issues in this paper, especially Susan Wolf's argument. I thank Georg Bosshard andWillem Landman for helpful comments on an earlier draft. Finally, I thank Eric Buckhave for his support.