Healthcare Ethics

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1. Is it reasonable or wise to ask those committed to preserving and extending life to act as thanatologists?

Thanatology is defined as the study of death and dying, especially in their psychological and social aspects. (http://www.thefreedictionary.com/thanatologists).

In terms of making decisions about death and dying, there are opposing views when it comes to physicians who are committed to preserving life. People might not trust a physician who acts as a thanalogist. Physicians take the Hippocratic Oath and commit to do no harm to patients, so to ask them to participate in assisted suicide is contrary to the Oath. The Hippocratic Oath, to which physicians swear allegiance, postulates that physicians must be responsible for their patient's well-being. Based on this logic, opponents of assisted suicide argue that it is wrong. However, there are also the proponents that argue for self determinism of the patient, who has the right to make her or his own decision in terms of health (http://seattletimes.nwsource.com/html/localnews/2008814607_death05m0.html).

Indeed there are some physicians and American that agree with physician assisted suicide and some have been persecuted.
However, the law allow assisted suicide in some states, as long as the physician does not participate in the actual act. For example, the physician-assisted suicide law that goes into effect on March 5, 2009, but the Washington State allows hospitals and doctors to refuse to participate, creating a difficult decision for those who deal with end-of-life care. Voters passed the measure last fall for people who meet the legal requirements, such as ?a patient must be diagnosed as having less than six months to live, be of sound mind, make a request orally and in writing, have it approved by two different doctors, then wait 15 days and make the request again. A doctor can prescribe a lethal dose, but cannot administer it. In Washington, about a third of hospitals have said they will participate in the program, a third have said they will not participate, and a third are somewhere in between, the Seattle Times reports (see http://seattletimes.nwsource.com/html/localnews/2008814607_death05m0.html).

Examples of the in-between hospitals: One system will not dispense lethal prescriptions for hospital inpatients, but will allow doctors in its outpatient cancer clinic to prescribe lethal doses to patients who request them and meet the legal criteria. Another hospital will not participate, but will refer patients to providers who are participating. The Washington law is modeled on an Oregon law. The Oregon experience suggests Washington is unlikely to see vast numbers of dying people asking for lethal prescriptions right away: As of last fall, in the 11 years the Oregon law had been in effect, roughly 340 people had received prescriptions to hasten their death (http://seattletimes.nwsource.com/html/localnews/2008814607_death05m0.).

2. Must physicians meet their patient's demands for aid in dying through active mean?

As mentioned above, physicians and hospitals are given a choice. Physicians are not expended to provide services that they find unconsciousable, meaning that it is something that they could not live with; they could not sleep at night; it is wrong.
However, as mentioned above, the physician is not to administer the drugs, just prescribe a lethal dose. Is this really different? And, even in states where the law allows voluntary active Euthanasia, as mentioned above, physicians cannot administer a legal dose, or will be charged for murder.

Also see http://www.associatedcontent.com/article/1410721/for_voluntary_active_euthanasia.html?cat=5.

3. Have patients who cannot assist in suicide a right to voluntary active Euthanasia?

This depends on why the patient cannot assist. Is she or he considered competent is one question. If the patient is not competent, a surrogate can make the decision to forgo treatment, however, the surrogate cannot make the decision for voluntary active euthanasia because the act then becomes involuntary. (http://www.associatedcontent.com/article/1410721/for_voluntary_active_euthanasia.html?cat=5).

If the patient is mentally competent, but is paralyzed, for instance, and cannot take a legal dose of medication, the physician is still not able to legally assist the patient or she or he could be charged with murder. However, proponents for voluntary active euthanasia would probably argue that in this case, the physician should help the patient, but legally, it is still prevented.

In the book review below, the main arguments for ...