Physician Assisted Suicide Essays (2173 words) - Medical Ethics

Physician Assisted Suicide The mission of this hospital is rooted in our emphasis on the individual, and directed toward providing the highest level of autonomy, beneficance, comfort, healing, privacy and respect for the dignity of the patient. With these as our guiding principles, we evaluated Physician Assisted Suicide (PAS) as a possible treatment option at this institution. We have concluded that PAS can be a viable treatment option after making the following considerations: 1. Defing the elements of justified PAS, 2. Consideration of moral justifications, 3. Why personal autonomy is important, 4. Informed consent, and 5. The benefits of the approach of causitry to issues of biomedical ethics. The elements of PAS are an agreement between a physician and the patient on the treatment option after consideration of all other options, (informed consent) conditions consistant with the Oregon state law and the asurance of the agent choosing this course of action in an autonymous nature. Moral arguements question the validity of PAS as an option. We make the determination that PAS can indeed be considered equivelent to other medical decisions regarding whether or not continue treatment in cases where the prognosis is immenent death, or prolonged intense suffering followed by death. If for example, a patient with a terminal illness such as lung cancer has a choice between hospice care, and being made comfortable, or PAS, we can not say that the two approaches are inconsistant with eachother. A patient who refuses treatment and accepts death as a consequence has the right self determination by law. If this action is acceptable under law, it is not unfair to consider PAS as an equivelent means to the same end. Therefore, there will be cases where PAS is most certainly a valid option for the patient. To reach our decision, it is important to understand our view of personal autonomy. We will elaborate on it's relevance and worth in addressing PAS. Finally, criteria for PAS candidates is intricate, and established. Though we justify PAS as a viable treatment option, we do not take issue with the legal criertia established by the state of Oregon. Personal Autonomy Personal autonomy can be characterized as self-determination or the the extent to which an individual actively participates in in how his or her life is lived. Autonomy, therefore, requires some elements of control and choice. Defining autonomy in a being that is both rational and passionate can prove complex and problematic. A differentiation of first and second order volitions will help us conclude the what the exact nature of what defines autonomy. First-order desires are those passions to which the agent is subject to as a living being. The desire to live, procreate, feel secure and content are some examples of these desires. While they are certainly expressions of human passions, they do not account for man's rational capacity, a fundemental facet of human nature. Second-order desires are wants about wants, or the desire to have certain desires. We will focus, however, on second order volitions, which differ from second order desires. Second order volitions involve the wish of an individual that certain first-order desires will motivate him to action. It is the rational choice of the agent which characterizes this, and therefore we will conclude that second-order volitions represent contemplation of a choice by the agent, which leads to a choice that by virtue of this process, is an indication of his true-self. Therefore, it is through these second-order volitions that we exercise autonymous action.1 The expression of rational choice in relation to a first-order desire is what we will define as the main component of an autonymous action. There are those who would oppose this view in lieu of other moral considerations. If the agent has a lack information, or choices, the action in relation to the first-order desire is then no longer autonymous. Therefore, we will require that another dimension to autonomy is the range of options availible to the agent. In order to promote autonomy, it is absolutely essential that informed consent is a focal point of treatment. It is the concept of autonomy which is our guiding force in our formulation of a policy on PAS. PAS as a treatment option has no universal application. In Oregon, where it is legal, two patients with the same doctor, the same illness and the same prognosis can make opposite decisions regarding treatment. If one patient simply chooses to wait for death to occur after stopping treatment, and the other chooses PAS, both of these autonymous actions are therefore equal. They have the same end, and