Although the physician does not directly end the patient’s life, physician-assisted suicide (PAS) occurs when the physician provides the means (i.e. information or drugs) to commit suicide. Patients who request PAS from their doctors usually suffer from terminal illnesses, such as AIDS, cancer, or neurological disorders, in which death is inevitable, and it is estimated that 12% of physicians receive at least one request for PAS per year (Beck, Wallace, Starks & Pearlman, 1996). While some people believe that the ability to end life in those cases is critical for preserving human dignity, PAS is still a controversial topic because others do not consider assisted suicide moral.
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Most of the controversy surrounding PAS exists because there are two conflicting viewpoints that depend on the ethics used to interpret the act of assisted suicide. On one hand, it is possible to prohibit PAS, and that approach to solving the issue would adhere to deontological ethics. Even though the concept of autonomy exists in that ethical framework, deontology does not consider freedom absolute because actions are considered moral when they adhere to universal moral rules (NYSTF, 1994).
On the other hand, relativism and utilitarianism would consider PAS a viable option for some people. Relativism considers that truth is subjective, so it is important to consider outcomes and define morality based on evaluating actions in specific contexts. Therefore, because suicide is the only way to prevent suffering and end life while maintaining dignity in terminal illness, relativist ethics would agree that PAS is a moral action in those circumstances. Utilitarianism also believes that moral actions are those that reduce suffering and maximize suffering, so PAS would be considered the best option for terminally ill people who will inevitably experience a decrease in quality of life and prolonged suffering.
However, it is also important to consider the mental state of terminally ill patients and their families when requesting PAS. It would certainly be unethical to simply accept their request for assisted suicide because current medical technology allows them to manage terminal illnesses to a certain extent. Therefore, a truly ethical approach for medical personnel would be to communicate with their patients and provide psychosocial support to improve their quality of life. PAS should be considered only when it is completely clear that patients are in advanced stages of terminal illness and the pain becomes unmanageable.
Avoiding PAS in end-of-life care would be unethical according to some people, but more importantly, it violates the code of ethics relevant to medical workers. Although illegal actions are prohibited by the code of ethics in healthcare, healthcare workers must respect the self-determination and right to dignity, which is not possible if they are not allowed to engage in PAS to help them preserve dignity and respect their choices. Finally, it is important to consider that the World Health Organization’s (WHO, 2014) definition of palliative care states that healthcare workers are not allowed to prolong the suffering in dying patients. Making PAS illegal is contradictory to the code of ethics and the requirements of healthcare workers in palliative care, and its morality needs to be reconsidered.
In addition to the ethical issues surrounding the topic of PAS, various legal issues have been created to prevent physicians from assisting their patients to commit suicide. Public awareness of PAS increased after...