By utilizing a framework evaluating the manner, whereby the course of bodily weakening and decay is felt by lethally ill patients, this study focuses on the following issue. The significance of viewing the idea of dignity in an effort to recognize the influence that the loss of physical autonomy has on the self-identity of the patient should be analyzed (Oliver, 2002). Although several types of research have emphasized the palliative care principle of dying with dignity, less focus has been put on the aspects that possibly impact the feeling of dignity with passing away (MacGregor, 2007). In fact, several studies have overlooked the bodily susceptibility of those persons who experience chronic illness. What has evidently been ignored in this researches is the manner, in which the failure to act autonomously brings forth a sense of losing dignity in patients suffering from chronic illnesses. Therefore, there is a necessity to discover the degree to which it is impacted when they lose their capacity to act as independent agents.
The extremely polarized argument over the course of physician-assisted suicide is somewhat new to the sphere of ethical matters. It was initially overtly authorized in the United States in the year 1994, in the period when Oregon had approved its Death with Dignity Act (Tuma, 2003). Despite the fact that this document specifies that a doctor may recommend a fatal dose of medication to lethally ill individuals under some circumstances, the term also includes the following issues. It involves providing a patient with the knowledge on the manner in which to commit suicide, or how to do so in a way distinct from prescription (Gostin, 2006). This idea is different from euthanasia because of the fact that the patient, instead of the doctor, undertakes the final step thereby causing the own death. Precisely some situations that Oregon’s law involves are extremely challenged. The force behind it was to offer a rational opportunity to chronically ill patients to terminate their lives under their own wishes, at the same time, safeguarding their dignity and evading their remarkable suffering that would have no relief, except their ultimate death.
As the logistics and morality of physician-assisted suicide encompass a rather late discussion, the notions concerning suicide in broad terms have been in existence from the old times. Some people consider related grounds for and against suicide open to incorporate a physician-assisted suicide. Others assume that there are several debates to be reached for every circumstance (MacGregor, 2007). One widespread argument that supports this idea is that the current technology significantly extends individuals’ lives. It puts them in a state they perhaps would not have been in if they existed in another period.
In antiquity, patients with chronic diagnoses had less time to exist (Tuma, 2003). However, it has transformed, but not every chronically ill patient is living a life that is being noble and without pain. Some individuals argue that physician-assisted suicide offers to those suffering persons an opportunity to eliminate enduring and prolonged suffering. It is debatable that although we possess the strength to care for the individual in a constant vegetative situation for several years through feeding equipment. It may not be what each one of us would like. Some people think that it is unjust to compel the technology upon a patient and basically punish the one for existing at present rather than in the early 19th century (Oliver, 2002). One more argument that favors the idea utilizes the concept of personal autonomy to assert that individuals entail the right to live and die, basing on their own terms of a better life. Finally, someones point out that if the practice is illegitimate, it excludes our freedom to decide our own options concerning lives.
With several arguments, it is simple to believe why we are nowhere close to reaching an agreement. The contentious features of physician-assisted suicide entail our various beliefs on how much autonomy we really possess, and whether possible misuses of the course of actions are harmful enough to prohibit it in general (Tuma, 2003). With respect to this theoretical consideration surrounding this practice, it is, in some instances, simple to overlook that we are addressing the lives of the particular people living within our society. Their skewed experiences are significant to the arguments as our speculative way of thinking is. One organization that is responsive and struggles to convey an understanding of the matter is the Death with Dignity in Oregon (Oliver, 2002).
Kant’s Ethical Theory
The philosophical consideration of human dignity habitually starts with an argument of the opinions of Immanuel Kant. According to the philosopher, dignity is a supreme and unreserved fundamental principle. Objects possessing dignity are not just mechanical means to the fulfillment of several individuals’ ends. However, they are, instead, in his popular expression, the ends in themselves. Therefore, they should be appreciated and taken care of with the greatest respect. All human beings, according to him, encompass dignity in a standard of their humanity, i.e. their ability for independent action (Gunderson, 2004).
One may argue that if an individual is experiencing some prospect of existing in a morphine-stimulated state or in a constant vegetative condition, a person feels the sense of losing the foundation for the Kantian dignity that one encompasses. It means one’s ability for independent actions (Tuma, 2003). Nevertheless, in Kant’s opinion, the independent environment that acts as the foundation for our dignity is not practically apparent. We can recognize at first that it is a thing that every individual entails once we exist. Given that this ability remains regardless of whether it is exercised or not, Kantian human dignity cannot be acquired. It also cannot be robbed. Therefore, since all human beings hold the same capacity for self-directed action, they all possess the same dignity (MacGregor, 2007).
As several advocates of the legalization of assisted suicide plead to human dignity to second their case, Kant upholds the following position. The dignity of human beings leaves suicide ethically unacceptable. Therefore, if an individual destroys himself or herself in an effort to flee from a hard state, then he or she is utilizing the person simply as a means in order to sustain an endurable situation until the end of life. Nonetheless, the one is not an object, thus, it is not a thing that can be employed as a method. The one should in all his or her actions constantly be considered as an ending in itself. To destroy the one is to treat oneself not as a thing entailing supreme worth, but as just a means to a conclusion of restricted worth. That means any wish the person is satisfying in terminating the individual’s life (Gunderson, 2004).
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In Kant’s opinion, since it is ethically unacceptable to treat a person devoid of due respect, suicide is in all situations ethically unacceptable. For this reason, human dignity, as Kant appreciates it, does not support the justification of assisted suicide. The philosopher asserted that coherent beings possess inherent value. They are worth for their own sake. It is what provides them their dignity (Gunderson, 2004). In addition, this inherent significance is supreme and obstinate. Ethics, humanity, and independence in people are what provide them their dignity, including their total and objective worth. Therefore, he assumed that there had existed no condition whereby a coherent being would perhaps stop to possess the objective worth.
The Utilitarian Theory
The utilitarian theory of John Stuart Mill could perhaps be employed to get to an answer to the ethical dilemma surrounding physician-assisted suicide practice. As put by this view, it is morally suitable for any individual to undertake the right thing in an effort to create the utmost good (Feldman, 2006). From the perspective of this practice, the right actions are those that are believed to cause a greater extent of happiness instead of unhappiness. Another way to pose this is happiness in the course of the suffering relief. In a situation whereby the doctor with the patient agrees to end the life of the first one by recommending a fatal drug, the target is to eliminate or put an end to the ache and pain of the ill person. It means that the doctor tries to reduce suffering and increase happiness. This practice is only allowed in Oregon, in the United States. Through the act Death with Dignity, it is lawful for medical personnel to recommend medication to end life for chronically ill patients (Tuma, 2003).
Settling on the procedure of physician-assisted suicide can somewhat turn out to be a greasy slope. The outcome of destroying patients is declining the trust and relationship that exists between the ill person and the physician (Truog, 2007). Another rationale for objecting to the practice is that it leads to humiliating human life that should have been perceived as valuable. Ending the existence with the reasons being problematic and costly ignores the worth of life. It is significant to realize that human existence is greater than just cells and tissues. Therefore, it is immoral to support this practice with claims of monetary or any other reasons. It is definite that a moral dilemma regarding this treating comes about whenever chronically ill patients appeal for their lives to be ended (Tuma, 2003). One intense instance of this step could perhaps be enlarging the principles of physician-assisted suicide. If Utilitarianism is reliant on happiness, then it does not imply that this practice could perhaps be broadened to encompass the needy or mentally starved. If not firmly examined, the outcome could be disastrous.
Furthermore, according to utilitarianism, happiness is explained as a deficiency of pain and deliberate pleasure. On the other hand, unhappiness is the lack of satisfaction and existence of pain. Chronically ill patients are in most instances not happy and always feel the ache. Thus, under the Utilitarianism rule, it is morally suitable for such patients to terminate their lives with the goal of minimizing the pain and suffering they undergo (Feldman, 2006). It would also perhaps increase societal happiness as it would reduce monetary expenses to the family of the suffering patient as well as the society. Under this rule, a morally acceptable act would perhaps be employing the best appropriate measure to reducing pain and suffering at the same time reiterating the significance of the ill person.
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Physician-assisted suicide is a vital means of minimizing pain and suffering, including recovering the dignity of an individual. On the other hand, according to the viewpoint of utilitarian theory, a chronically ill patient may perhaps opt to remain alive for the benefit of his or her relatives and friends. It is the case for the family of this individual, who may go through suffering due to death. Moreover, due to the fact that society emphasizes too much worth on life, a patient may perhaps decide to live for the benefit of societal happiness. Moreover, under the utilitarian viewpoint, the family members may thus settle on the option to keep a chronically ill individual alive. It may be reached at after considering that ignoring the worth of life would, therefore, cause destruction to the society. There is an incredible opportunity for saving a life (Truog, 2007).
It is evident that physician-assisted suicide is one of the most contentious legal and moral issues. The benefits and limitations of this moral dilemma may thus be validated under Mill’s Utilitarian theory and on the foundation of moral egoism. Advocates of this practice believe that it is the only way to eliminate too much suffering and ache that chronically ill individuals feel (MacGregor, 2007). On the other hand, opponents claim that it is immoral due to the fact that it ignores the significance of life and infringes on the non-malfeasance standards of not destroying others (Oliver, 2002).
Case Study: Emilio Gonzales
Emilio was an 18-month old baby who was diagnosed with Leigh’s disorder, i.e. an advancing and severe neuro-metabolic condition. The boy had been surviving on life support in the ICU for about 5 months. The hospital had raised the Texas Advance Directives Act that permitted it to take out life support if an ethics committee ruled that continuous life support being medically unfit. The hospital offered the family a notice of 10 days and tried to transfer Emilio to an optional provider. His mother had managed to acquire additional time with the support of advocacy groups and some lawyers, but Emilio passed away prior to the judge’s final verdict on the case (Truog, 2007).
From this case study, the committee agreed with Texas law that stipulated that as soon as the physician determined that nothing else could be done for the patient, the family might be provided with a 10-days’ notice to find another institution. Otherwise, the relatives have to pass the ill person under the care of another physician that is ready to offer the treatment needed by the one. If it is not possible, then life support is withdrawn.
In this case, the ethics committee agreed upon the following recommendations:
i. A 10-days’ notice should be given in order to make the family make quick decisions.
ii. The family is free to transfer the sick person to another facility or under the care of another physician in a bid to provide some room for the hospital to assist other patients with better chances for survival.
iii. The 10-days’ notice should be extended a little bit to allow the relatives to find another facility or another physician who can assist the patient.
Many of the cases such as the one discussed of Emilio originates from a harsh breakdown of trust in a relationship between physicians and patients. Even though in the finest situations, clinicians habitually communicate poorly, and this deficit is aggravated at the time when communication should take place across the gaps established by culture, language, and class. The enhancement of doctor’s communication and dispute-resolution skills would, therefore, move a long way in the direction of stopping such matters from happening. We can improve this by utilizing the established ethics committees that characterize the diversity of society, without any financial connections to the hospitals they operate in. Even though there may exist the cases whereby the law must be utilized to trump the requests of the families and their patients, it is without a doubt that Emilio’s case is one of them. Therefore, instead of putting at risk the respect we embrace for minority and diversity standpoints, I suppose that in such situations like this one with the baby, we must strive to improve our ability to endure the choices of others, even though we deem they are erroneous.