Running Head: DEATH BY ASSISTANCE 1

Death by Assistance: Euthanasia and Physician Assisted Suicide

Kumiko Sasa

Colorado Mesa University

Death By Assistance: Euthanasia and Physician Assisted Suicide 2

For some the dying process comes natural, but for others an earlier death may feel more

suitable. This argument has become one of the more pronounced challenges in today’s society. Is

it ethically and/or morally right to assist in someone’s death? Social workers, politicians and the

general public are working to address this particular question; this is primarily due to the fact that

more individuals, with debilitating illnesses or limitations, are starting to feel that death, at a

certain point, is more appropriate for them under such circumstances, than living any longer.

This perspective creates various arguments for and against procedures like euthanasia and

Physician Assisted Suicide (PAS) that allow individuals to choose their time of death.

First, looking at euthanasia, there are two types: active and passive. This distinction is

also argued over regarding the actual difference between the two actions. For active euthanasia,

BBC News explains that this “occurs when the medical professionals, or another person,

deliberately do something that causes the patient to die” (2014). This is similar to their definition

of passive euthanasia, which states that “the patient dies because the medical professionals either

don’t do something necessary to keep the patient alive, or when they stop doing something that is

keeping the patient alive” (2014). This includes things such as taking an individual off their life-

support machine or feeding tube, and not carrying out a specific life-extending procedure or

giving them life-extending drugs. Given these two definitions, it’s important to clarify what

euthanasia actually means. Boudreau and Somerville (2014) examine this particular word

through historical context. Originally, euthanasia had the meaning of “a good, gentle, and easy

death” (Boudreau & Somerville, 2014, p.2). Today, this word has taken on the meaning “to

euthanize,” which the Oxford Dictionary indicates as the action of “putting (a living being,

especially a dog or cat) to death humanely” (2015). Overall, Boudreau and Somerville (2014)

believe that the appropriate definition physicians should use comes from the Canadian Senate’s

Death By Assistance: Euthanasia and Physician Assisted Suicide 3

report in 1995; which states that euthanasia refers to “the deliberate act undertaken by one person

with the intention of ending the life of another person in order to relieve that person’s suffering”

(Parliament of Canada, 2000). This definition can often be confused with that of physician

assisted suicide.

Physician Assisted Suicide (PAS), also known as Physician Aid-in-Dying, has the same

objective as euthanasia: causing the death of a person. By definition, it “refers to the practice in

which a physician provides a competent, terminally ill patient with a prescription for a lethal

dose of medication, upon the patient’s request, which the patient intends to use to end his or her

own life” (Starks, Dudzinski & White, 2014). “Upon the patient’s request” is an important part

of this definition as it gets at “the dying person’s bill of rights.” According to a variety of

resources, this bill developed from a workshop hosted by Amelia Barbus in 1978 (as cited in

Home Health, and Hospice Care, Inc., 2014). Under this bill, it includes the right to:

be treated as a living human until I die.

maintain a sense of hopefulness, however changing its focus may be.

be cared for by those who can maintain a sense of hopefulness, however changing this

may be.

express my feelings and emotions about my approaching death in my own way.

participate in decisions concerning my care.

expect continuing medical and nursing attention even though “cure” goals must be

changed to “comfort” goals.

not die alone.

be free of pain.

have my questions answered honestly.

retain my individuality and not be judged for my decisions, which may be contrary to the

belief of others.

expect that the sanctity of the human body will be respected after death.

Death By Assistance: Euthanasia and Physician Assisted Suicide 4

be cared for by caring, sensitive, knowledgeable people who will attempt to understand

my needs and will be able to gain some satisfaction in helping me face my death.

From a social work perspective, the definitions of both Euthanasia and PAS, present a variety

of bioethical issues, in regards to an individual’s decision to end their own life. According to “the

dying person’s bill of rights,” individuals have the right be free of pain, whether that’s a mental

illness, or life altering disease; they have the right to “express their feelings and emotions about

their approaching death in their own way,” as well as “participate in decisions concerning their

own care.” Under this bill, it appears that the autonomy and respect of an individual’s decision

for death, is highly regarded. In addition, it represents the role of social workers to a certain

degree, as they are to respect an individual’s autonomy and self-determination. However, the

conflicting question to answer is what about beneficence? When the individual’s action is to

harm themselves, is it legal for a social worker to limit the individual’s self-determination? With

physician assistance, the life of an individual can be taken away either through the lack of or halt

of care, or the prescription of a lethal dose of medication upon patient’s request. According to

section one in the Code of Ethics of the National Association of Social Workers, “social workers

may limit clients’ right to self-determination when, in the social workers’ professional judgment,

clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves

or others” (National Association of Social Workers, 2008). This presents one of the many

challenges social workers may face, as well as physicians who are a part of a client’s decision for

Euthanasia or PAS.

However, this challenge doesn’t end with social workers or physicians, it presents itself to

the general public as well. Numerous arguments are made against PAS as are arguments for it.

First, one of the primary arguments against PAS, is because it includes the word suicide which

Death By Assistance: Euthanasia and Physician Assisted Suicide 5

insists the action of taking one’s life. Boudreau and Somerville (2014) highlight how suicide

carries a heavy stigma. Society tends to associate it with the concept of failure, either in

community support, mistreatment of mental health issues, or individual shortcomings. Further,

the action presents itself as a scapegoat from reality and life. Marilyn Golden, a policy analyst,

discusses that the free choice of physician assisted suicide is illusory. That many other things can

push people, especially elderly to choose assisted suicide. This includes feelings of being a

burden on the family and elder abuse. She states that “such abuse could easily lead to pressures

on elders to ‘choose’ assisted suicide” (Golden, 2014). This pressure to choose, as she

continually mentions in her article, is due to the problems in managed care. It’s cheaper to

provide assisted suicide than better preventative care. Advocates of Life (2011), a non-sectarian

organization, makes a similar argument, in that physician assisted suicide and Euthanasia are

completed on a variety of individuals who hadn’t made those decisions themselves. In short, the

health care system can unethically have the power to end someone’s life who may not have

wanted that decision for themselves.

In contrast, a variety of organizations, families and individuals are pro-PAS. Primary

arguments, in favor of PAS, are based on the principles of respecting autonomy, justice,

compassion, honesty and transparency (Starks, Dudzinski, & White, 2014). First, some

individuals feel it should be a competent individual’s right to choose when and how they die.

Second, under such circumstances of mental illness and prolonged pain, PAS allows individuals

to relieve such anguish. As one website states, PAS allows patients the opportunity to “die with

dignity rather than have the illness reduce them to a shell of their former selves”

(Balancedpolitics.org, 2014). Third, PAS is also argued to lessen the anguish of the patient’s

family and friends, along with preparing them for saying goodbyes. Rather than a sudden death,

Death By Assistance: Euthanasia and Physician Assisted Suicide 6

PAS allows family members the opportunity to be prepared emotionally, mentally, and

physically for a loved one’s death. Fourth, others state that by making PAS legal, more open

discussions may occur regarding end-of-life care, including an individual’s options and concerns

for a particular care. Then finally, some argue for PAS because it can reduce health care costs,

“which would save estates and lower insurance premiums,” along with freeing up nurses and

doctors “to work on savable patients” (Balancedpolitics.org, 2014).

In all, Euthanasia and Physician Assisted Suicide present a variety of challenges both

ethically and physically. Each deal with ending a person’s life, whether that means withholding

care from them or providing them the means necessary to end their life. As a result of such

actions, people are both for the idea of Physician Assisted Suicide and against it for various

reasons. For some, they feel that the autonomy and right of an individual to end their life should

be respected. Others see it as an increased opportunity for abuse and harm to individuals with

disabilities.

Death By Assistance: Euthanasia and Physician Assisted Suicide 7

References

Advocates of Life. (2011). Euthanasia. Retrieved February 16, 2015 from

http://www.advocatesoflife.com/euthanasia.htm

Balancedpolitics.org. (2014). Should an incurably-ill patient be able to commit physician

assisted suicide? Retrieved February 17, 2015, from

http://www.balancedpolitics.org/assisted_suicide.htm

BBC News. (2014).Active and passive euthanasia. Retrieved February 11, 2015, from

http://www.bbc.co.uk/ethics/euthanasia/overview/activepassive_1.shtml

Boudreau, J. and Somerville, M. A. (2014). Euthanasia and assisted suicide: A physician’s and

ethicist’s perspectives. Medicolegal and Bioethics, 4(4), 1-12. Retrieved from Academic

Search Complete.

Home Health and Hospice Care, Inc. (2014). The Dying Person's Bill of Rights. Retrieved

February 16, 2015, from http://www.3hc.org/services/hospice/dying-persons-bill-of rights

Golden, M. (2014, January 1). Why Assisted Suicide Must Not Be Legalized. Retrieved

February 16, 2015, from http://dredf.org/assisted_suicide/assistedsuicide.html

National Association of Social Workers,(2008). Code of Ethics of the National Association of

Social Workers. Retrieved February 16, 2015, from

http://socialworkers.org/pubs/code/default.asp

Oxford Dictionary. (2015), Definition of euthanize in English. Retrieved February 11, 2015,

from http://www.oxforddictionaries.com/us/definition/american_english/euthanize?q=toeutha ize .

Death By Assistance: Euthanasia and Physician Assisted Suicide 8

Parliament of Canada. (2000).Quality end-of-life care: the right of every Canadian. Retrieved

February 10, 2015, from

http://www.parl.gc.ca/Content/SEN/Committee/362/upda/rep/repfinjun00-e.htm

Starks, H., Dudzinski, D., & White, N. (2014). Physician Aid-in-Dying. Retrieved February 16,

2015, from http://depts.washington.edu/bioethx/topics/pad.html