The Permit and Legalization of Euthanasia for the Terminally Ill Patients

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In today’s society one of the most controversial issues is legalizing the practice of physician assisted suicide and euthanasia. Doctors believe that these particular medical practices violate the Hippocratic Oath, while the general public deems them unethical. Euthanasia is killing on request and is defined as a doctor intentionally killing a person by the administration of drugs, at that person’s voluntary and competent request. Physician-assisted suicide is defined as a doctor intentionally helping a person to commit suicide by providing drugs for self-administration, at that person’s voluntary and competent request. The Hippocratic Oath which is a document that most medical student swear to abide by after completing medical school, prohibits the practice of physician assisted suicide and euthanasia stating: “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.”( North, 2002.) “In ancient Greece and Rome, attitudes toward infanticide, active euthanasia, and suicide had tended to be tolerant.. Although the Hippocratic Oath prohibited doctors from giving ‘a deadly drug to anybody, not even if asked for,’ or from suggesting such a course of action, few ancient Greek or Roman physicians followed the oath faithfully. Throughout classical antiquity, there was widespread support for voluntary death as opposed to prolonged agony, and physicians complied by often giving their patients the poisons they requested.” ( Dowbiggin, 2003).

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Legalizing the practice of Physician Assisted Suicide and/or Euthanasia will allow the government to give terminally ill patients the right to die with dignity, provide a sense of closure for family members and friends who are watching a terminally person slowly die, reduce the cost of medical bills after the person is deceased, while also protecting those who may become victim to this practice.

Every year thousands of individuals here alone in the United States are diagnosed with a terminal illness. Many of these patients will endure physical pain from this illness. As a result patients are requesting assistance in ending their lives and deciding not to live the last months in excruciating pain. What is a terminal illness? A terminal illness is defined as progressive disease where death as a consequence of that disease can reasonably be expected within 6 months. There are many fatal illnesses such as heart disease and cancer. These diseases cause a huge amount of physically debilitating effects on patients. To qualify for Euthanasia or Physician Assisted Suicide in the state of California for example a patients has to meet several qualifications. The patient has to be 18 years of age or older, resident of California, Capable of making and communicating health care decisions for him/herself diagnosed with a terminal illness that will lead to death within six months, Physically and mentally capable of self-administering the aid-in-dying drug. Physician protocol include the attending physician must be licensed in the same state as the patient and have a current United States Drug Enforcement Administration (USDEA) certificate, the physician’s diagnosis must include a terminal illness, with six months or less to live, The diagnosis must be certified by a consulting physician, who must also certify that the patient is mentally competent to make and communicate health care decisions, If either physician determines that the patient’s judgment is impaired, the patient must be referred for a psychological examination, The attending physician must inform the patient of alternatives, including palliative care, hospice and pain management options. Patient request timeline includes first oral request to physician, 15 day waiting period, Second oral request to physician, written request to physician. Other qualifications include use of the law cannot affect the status of a patient’s health, life, or annuity insurance policies, Physicians and health care systems are not obligated to participate, Translators should be made available for non-English speakers and Pharmacists are also protected from prosecution for filling aid-in-dying prescriptions. ( 5 Oct. 2015). To date there is no one particular medication prescribed for physician assisted suicide or euthanasia. Currently in Oregon, secobarbital is the medication most commonly prescribed for physician-assisted suicide, followed by pentobarbital. (Oregon Department of Human Services. 2009). The lethal dose prescribed is typically 9 g of secobarbital in capsules or 10 g of pentobarbital liquid, to be consumed at one time. (New England Journal Med. 2005). The contents of the secobarbital capsules or the pentobarbital liquid should be mixed with a sweet substance such as juice to mask the bitter taste. Until the time of use, the medication must be stored out of reach of children and kept away from others to prevent unintentional overdose or abuse. (Oregon Department of Human Services. 2009). The pharmacist or physician should instruct patients to take the lethal dose on an empty stomach to increase the rate of absorption. ( McEvoy GK, Snow EK, 2011). The typical dose of pentobarbital as an oral hypnotic for adults is 100–200 mg at bedtime, and that of secobarbital is 100 mg orally at bedtime. Patients receiving the lethal dose of secobarbital or pentobarbital should be instructed to take an antiemetic (e.g., metoclopramide) about one hour before ingesting the barbiturate to prevent nausea and vomiting. (Arch Intern Med. 2000). Cases of vomiting after taking an antiemetic have been reported; in the event of vomiting after medication ingestion, patients should be instructed to have a family member contact the attending physician to determine the course of action. Also, patients should be instructed that if they decide not to end their life after ingesting the medication, they must contact emergency medical services to begin lifesaving measures. (Task Force to Improve the Care of Terminally-Ill Oregonians, 2010). Patients need to be informed of appropriate disposal methods in case the medication is not taken; the Food and Drug Administration provides guidance on that issue. Patients need to be informed of appropriate disposal methods in case the medication is not taken; the Food and Drug Administration provides guidance on that issue (U.S. Food and Drug Administration). Secobarbital and pentobarbital are not among the medications recommended for disposal by flushing, and they should be placed in the household trash after mixing with an unpalatable substance such as coffee grounds. Unused medications also can be brought to a drug “take-back” program involving law enforcement personnel. Patients are not permitted to return controlled-substance medications to a pharmacy. Proper reporting by pharmacists to the Oregon Department of Human Services is mandated by the DWDA so the agency can collect information and publish an annual statistical report. (Oregon Department of Human Services. Pharmacy dispensing record, 2010) .Pharmacists are required to complete and submit, within 10 calendar days of dispensing a lethal medication dose, a pharmacy dispensing record form with the following information: the patient’s name and date of birth; the prescribing physician’s name and phone number; the pharmacist’s name, address, and phone number; the medication and quantity dispensed; and the dates the prescription was written and dispensed. (U.S. Food and Drug Administration, 2010)

Coming to terms with having a fatal illness can take a psychological toll on patients. Individuals who request Physician Assisted Suicide and Euthanasia are required a psychological evaluation before being approve for such a practice. An article in the journal of American Medical Associated reported in a posted survey of patient’s desire for a hastened death due to a terminal illness. The survey focused on the psychological affects a terminal illness has on patients. (JAMA, 2009). Relieving physical pain and suffering from terminally ill patients is the main priority of physician assisted suicide and euthanasia. Legalizing this practice will allow patients to be treated for depression so that they are able to determine if the option is something they really want to pursue. Many people who are depressed tend to make irrational decisions to elevate their pain and suffering.

Medical professionals and the general public oppose the legalizing of Physician Suicide and Euthanasia. They believe doctors will target the disabled, homeless and elderly. Some physicians are opposed to this practice because it violates the Hippocratic, while others approve. Many fear the abuse of physicians assisting in death, because of the controversial American Pathologists Dr. Jack Kevorkian. Between 1990 and 1996 he performed a series of assisted deaths by lethal injection and carbon monoxide, with what he called a death machine. During this time 25 patients died. Autopsy reports indicated that many of the patients did not suffer from what is classified as a terminal illness and could have lived for several months or even years. (Patient Rights Council, 2013). Marjorie Wantz, age 58, who died of a lethal dosage of drugs administered by Dr. Kevorkian had no life-threatening condition. An autopsy found that she had no illness or disease. She has been taking a medication called Halcion, which can impair your judgement (Kales, 1991). When it comes to the debate of physicians assisting in ending lives this particular story is one that many tend to think about. Will patients who have other options be persuaded into physician assisted or euthanasia death?

Abusing this practice is one among many other reasons why it should be legalized. This will provide safe guards for those who may become victims and also allow the government to implement strict regulations for patients requesting assisting in dying. Physician would have to get the medication through insurance, which in turn would require the insurance company to report such request to the government.

In conclusion Physician Assisted Suicide and Euthanasia should be legalized so that this will allow the government to give terminally ill patients the right to die with dignity, provide a sense of closure for family members and friends who are watching a terminally person slowly die, reduce the cost of medical bills after the person is deceased, while also protecting those who may become victim to this practice.

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