Physician-assisted suicide (PAS) and euthanasia is a widely debated and controversial topic in our society. It is believed that the principle of PAS and euthanasia portrays, “merciful acts that deliver terminally ill patients from painful and protracted death” (page 477, column 2). In the paper, “Physician-Assisted Suicide: A Tragic View,” John D. Arras discusses the subject and states that while he agrees with patients making decisions, implementing laws supporting PAS and euthanasia is a huge threat to our social order.
However, John D. Arras also concludes that he does not disapprove with the possibility of having a legislative policy in favor of PAS/euthanasia, only if there is “sufficient evidence of reliability of various safeguards” (page 477, column 2). To begin, it is important to look at the possibility of PAS and euthanasia being a positive practice in our medical profession. John D. Arras looks at a situation which poses a patient suffering from uncontrolled pain by having the physician ignore their decisions amongst life and death.
He mentions that physicians may contribute to “suicide and suicidal ideation” (page 478, column 1) which is statistically shown in over fifty percent of cancer patients who suffer from uncontrolled pain that is often brought on by untreated depression. In this situation however, if patient is given control of their own lives and obtain adequate psychiatric and palliative care to treat depression, it is assumed that most would lose interest in PAS/euthanasia. Using a similar example, there will always be a small amount of patients who may have pain that cannot be treated, for these patients J.
Arras believes that present law on PAS/euthanasia can represent an impossible barrier to a distinguished and decent death. In comparison to the argument above, there are more objections towards the legalization of PAS and euthanasia because it is widely seen as “inherently immoral, as violations of the moral rule against killing the innocent” (page 477, column 2). With this being said, J. Arras argues that objections cumulate through having a patient decide if they should live or die and having liberalization occur.
His first argument concludes that, the practice of PAS would be almost impossible to keep within reasonable boundaries and that there must be a line drawn between active euthanasia. Instead, legalization of PAS entails a “wholesomely modest policy agenda,” (page 478, column 1) that limits reforms to only a certain group of individuals therefore excluding those who are actually terminally ill and are suffering. In fact, legalization poses a threat towards how society looks at patient autonomy and mercy, because fatal illnesses would be hard to confirm. An example of this situation is mentioned by J.
Arras as he evaluates the fact that if one individual does not find value to living his life how does that differ from a patient who is ill with cancer. Proving that situation, it is seen that legalization of PAS has many flaws, one of which includes discrimination against patients if active euthanasia is banned. It would also cause more harm than good if the physician does not take into consideration the patient’s state of mind. By allocating patients with suitable palliative care, physicians would be able to “distinguish fact from fiction in the ethics and law of pain relief” (page 482, column 2).
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