Opinions on physician-assisted suicide sharply divided - Tucson News Now

Opinions on physician-assisted suicide sharply divided, poll shows

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(RNN) - Physician-assisted suicide has been debated for decades, and is not legal in most of the U.S. Though the controversy over helping terminally ill patients die continues, some states have passed laws allowing that practice as public opinion slowly shifts.

Many feel that it is wrong for people, regardless of their health condition, to ask their healthcare provider to end their life; others feel it is their right to choose how and when they die.

Physician-assisted suicide, also called death-with-dignity, aid in dying, or right-to-die laws allow doctors to legally prescribe lethal prescription drugs to people who are near death.

When a physician is asked to help a patient die, the doctor must provide valid information as to the terminal illness afflicting the patient and educate the patient of their final options. The doctor must then make the decision of whether or not to help the patient into death by providing the lethal dose of medication.

Aid in dying is currently legal in Oregon, Washington, Montana and Vermont.

Eligibility for right-to-die

Compassion and Choices is an organization for the right-to-die legislation and says their mission is to improve care and expand choice at the end of life.

"Aid in dying refers to the practice of allowing mentally competent, terminally ill adults to request a prescription for life-ending medication from their physician to control the time and manner of their own death. Compassion and Choices ensures that mentally competent, terminally ill adults have access to this option for a peaceful death," Ashley Carson Cottingham with the organization said.

A bill entitled, "The Patient Choice and Control at End of Life Act," went into effect with Vermont Gov. Peter Shumlin's signature, making Vermont the first state to approve such a law through the legislative process in 2013, instead of via a public referendum or a court decision.

Oregon passed the Death with Dignity Act in 1997. Washington followed suit, passing the Death with Dignity Act in 2008, and Montana passed the Rights of Terminally Ill Act in 2009.

Yet organizations against right-to-die say instead of the decision being in the patient's hands, it's more up to the doctor.

"The decision for assisted suicide is really in the hands of the doctor who determines whether the person is sufficiently "terminal," has decisional capacity, is acting voluntarily, has judgment not impaired by depression, etc.," Diane Coleman with Not Dead Yet said. "Anyone could ask for assisted suicide, but the doctor decides who gets suicide assistance and who gets suicide prevention."

There are certain criteria that must be met first. For example, to participate in Oregon, an individual must be:

  • 18 years of age or older
  • A resident of Oregon
  • Capable of making and communicating healthcare decisions for him/herself
  • Diagnosed with a terminal illness with only 6 months to live

The attending physician decides if the criteria have been met, but further requirements are then necessary. Some of those include:

  • Two oral requests by the patient, at least 15 days apart
  • A written request by the patient signed by two witnesses
  • Confirmation of diagnosis and prognosis by the attending doctor and a consulting physician
  • The attending and consulting physician must determine whether the patient is capable of making health care decisions for him/herself
  • Patient must be informed of feasible alternatives
  • Attending physician must ask the patient to notify their next-of-kin about the request for prescription
  • Physicians must report all prescriptions for lethal medications to the Oregon Health Authority, Vital Records

Suicide vs. Painless Means

A poll from Gallup shows that Americans' support for physician-assisted suicide changes radically depending on whether or not "suicide" is used in the question's wording.

When asked if the doctor of a patient with an incurable disease should be allowed "to assist the patient to commit suicide" at the patient's request, 51 percent of Americans said it should be permitted.

However, when the question was rephrased to ask if the doctor should be allowed "to end the patient's life by some painless means" at the patient and their family's request, support shot up to 70 percent.

"There's definitely been much more support for our organization and the laws we promote," Melissa Barber, communications specialist with the Death with Dignity National Center said. "The conversation about end-of-life options continues to grow."

Yet another Gallup poll shows a divide in perception of the morality of aid in dying.

Forty-five percent of Americans find it morally acceptable, while 48 percent say it is morally wrong.

Following the law

While aid in dying laws set procedures of how the process should work, Compassion and Choices believes the biggest fear is the practice being abused.

"In most cases opponents don't fully understand the aid in dying practice, fear the practice will be abused or have moral objections," Coleman said.

Coleman said the legalization of assisted suicide provides a blanket legal immunity to doctors and other participants.

"If someone does it, they should be subject to investigation and prosecution just like other homicides," she said.

The Hippocratic Oath essentially is a vow that states that the goal of a doctor should be to preserve lives and that the doctor will make every effort to do so.

You do solemnly swear, each by whatever he or she holds most sacred

That you will exercise your art solely for the cure of your patients, and will give no drug, perform no operation, for a criminal purpose, even if solicited, far less suggest it

"Old, ill and disabled people deserve the same suicide prevention as everybody else, and society should never agree with someone's suicide or help them to do it," said Diane Coleman with Not Dead Yet, an organization that opposes the legalization of assisted suicide.

Groups like Compassion and Choices say opposing organizations believe aid in dying is "assisted suicide," but say people who already are dying are not "suicidal" for wanting their life to end peacefully, not agony and despair.

Coleman adds that suicide is not illegal, and anyone can commit suicide without assistance, even in cases where the only available means is refusing food and water.

Dr. Kevorkian

Dubbed Dr. Death, Dr. Jack Kevorkian was the former Michigan pathologist who was supportive of physician-assisted suicide and the "right to die" legislation.

He was charged with murder several times through the 1990s for helping terminally ill patients take their own lives. After being convicted of second-degree murder in 1999, he was imprisoned until 2007.

Kevorkian admitted to CNN he had performed his medical procedure on at least 130 people using injections, carbon monoxide and his infamous suicide machine.

After his release, he told CNN he had no regrets about what he had done.

"No, no. It's your purpose (as a) physician. How can you regret helping a suffering patient?" he said.

During the interview, he discussed how it felt to take a patient's life.

"I didn't do it to end a life. I did it to end the suffering the patient's going through. The patient's obviously suffering - what's a doctor supposed to do, turn his back?"

Kevorkian died in June 2011 after suffering from kidney problems for years. He was 83.

Hospice and end of life care

Groups and individuals both for and against aid in dying seem to have similar feelings about hospice and end-of-life care.

Barber said the services offered are excellent and offer great support for patients and their families, but in some cases, some patients still want more control.

"For many, the care provided through hospice is able to keep them comfortable and free of suffering," she said. "But there are some people who'd prefer to have more control over their final days."

"According to the Oregon annual report of usage, 97 percent of the people who took the medication in 2012 were also enrolled in the hospice."

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