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Dying with Dignity

By Sabrina Ruiz

This paper was written for an English 121 as response to a prompt to write a paper using sources and using research to learn about a topic.

Millions of people around the United States suffer from chronic, life-altering, and terminal diseases. In many of these cases, these people are in constant untreatable pain. For some, death may be in their near future and their bodies are already dying. People that are placed in this position may decide that their life, though meaningful, is far too painful to bear; they decide to forgo the suffering and hasten their death through means of physician-assisted suicide. Unfortunately, those living in Michigan do not have the right to decide the time of which they die; they must let the natural process take its toll and leave their time of death up to whatever forces may be. This is, for some, a breech in their autonomy. Physician-assisted suicide should be a viable end to a person’s life if they choose, as well as a fundamental human right protected by law.

Part of the reason people are unable to legally die at the time of his or her choosing is due to the entwined Christian presence in US law. A person mustn’t choose when they die, they must leave it up to God. An article, published earlier this year by “Pew Research Center’s Religion & Public Life Project” states that the Catholic, Mormon, and Lutheran Churches agree “life should not be prematurely shortened because it is a gift from God.” (“Religious Groups’ Views on End-of-Life Issues”). Thus, the belief that suicide is morally wrong arose. Of course, someone could decide to end their life by their own means. Unfortunately, many of these methods are violent, tragic ends that must be conducted alone: in some cases, preemptively knowing and witnessing a death with no intent of intervention can be considered helping and will lead to criminal charges. One of the first major cases on the issue was in 1920. A man from Michigan was convicted of murder for helping his wife commit suicide. His wife had multiple sclerosis and requested a poisonous drink, of which he placed “within her reach.” (People v. Roberts) Multiple Sclerosis is chronic, incurable, and many people have symptoms that cannot be treated. At the stage of her disease’s progression, she decided she wanted to commit suicide. She was suffering, and her husband agreed to make a poisonous drink, knowing she would drink it and die. It was brought to the Michigan Supreme Court, and they determined it to be first degree, premeditated, murder.

Another case was also brought to the Michigan Supreme Court and gained national attention. A doctor named Jack Kevorkian created a machine that would allow someone to press a button, inject themselves with anesthesia and potassium chloride, and kill themselves. In 1990, he assisted a woman suffering from Alzheimer’s in the insertion of the IV needles and set up of the lines. People began to hear about this and sought him out to end their lives as well. He was tried on several occasions and nicknamed “Doctor Death.” People were made aware and became divided over the issue. Although initially he walked the tightrope of the law due to lack of evidence, he released a video on the television show “60 Minutes” showing footage of him actively injecting a patient with a lethal cocktail. This was because the patient was suffering from Lou Gehrig’s Disease and was unable to do so himself. He was charged with second-degree murder and sentenced to prison. The court stated afterward: “How history will view defendant is a matter this Court can neither predict nor decide. Perhaps in the brave new world of defendant’s `enlightened’ society, acts such as the one he committed in this case will be excused. Still, we find it difficult to hypothesize a rule of law under which this might be so.” (Bostrom) It took almost an entire decade to send him to prison, showing just how difficult it is for the law to interpret whether this man was a murderer—a debate that carries to this day. In fact, as of November 2019, there are no statutes or laws in place for cases such as Kevorkian or Roberts in Michigan, and any future cases must be conducted with the consideration of these preceding trials.

It can be surmised that this issue is a very slippery slope and should not be confronted. “Physicians have a duty to uphold the sacred healing space — not destroy it. Therefore, physicians must hear [the patient’s] request for death but never carry it out.” (Donald) It is believed that if physician-assisted suicide were made legal it would be an abused practice. The vulnerable would be taken advantage of, the mentally ill will seek it excessively, and the line between murder and assisted suicide will be blurred. However, physicians have a criterion for those choosing this route. According to “Assessing Competence to Consent to Treatment: a Guide for Physicians and Other Health Professionals,” physicians must determine “the ability to understand the relevant information, the ability to appreciate the disorder and the medical consequences of the situation, the ability to reason about treatment choices and the ability to communicate a choice.” (Grisso).  For example, in some European countries and in some states in the United States, physician-assisted suicide is legal and practiced. Oregon is one of the frontrunners in the cause, and legalized physician assisted suicide in the 90’s, during the wake of Dr. Kevorkian’s trials. Many people choosing this option are prescribed lethal medications that they can then choose to ingest at a place of their choosing. So far, “1,050 terminally ill patients have received prescriptions, and 673 of these patients have ingested the prescribed medications to hasten their deaths, while 377 chose not to. … The 1997 annual report revealed that 71 percent of the patients dying after ingesting medication under the Act were enrolled in hospice. The 2012 annual report places this number at 97 percent hospice enrollment. … the National Hospice and Palliative Care Organization estimates that 45 percent of deaths in the United States are under the care of hospice.” (Stutsman) Hospice enrollment usually happens when the patient expects to die within 6 months to a year. This means that almost every patient accepting this medication are choosing to go out on their own terms instead of letting the disease take them. It is clear this is a system that works, even in our own country. However, despite being the land of freedom and liberty, Americans in states criminalizing physician-assisted suicide are forced to live with a disease that will slowly destroy them. Considering the amount of suffering many people have seen loved ones go through, it is certain that people will always seek this option when confronted with a terminal illness.

I am a caregiver, often for those that are on hospice or palliative care. I have seen many people wither away. I have heard some people plead for death. I have administered multiple doses of morphine and fentanyl in succession to ease the pain of a dying patient. I look for visual cues in these patients, usually unconscious at this stage in the dying process, to determine whether they are comfortable or in pain. Dying is not always painless. Sometimes it takes years in a vegetative state before the body decides to stop breathing or the heart decides to stop pumping. With the increasing extension of the human life span comes some morbid consequences. Personally, I do not want to die from Alzheimer’s, Lewy Body Dementia, Parkinson’s, Lou Gehrig’s disease, Huntington’s Disease, and other terminal illnesses. I do not see these as dignified ways to die, and I would prefer to not burden my family with the hospital costs and care. I understand that other people may not want to choose the physician-assisted suicide route, but I believe the option should be available to those who may need it. Americans have a constitutional right to life and protections as to how we choose to live; it only makes sense to have a right to decide how to die.

Works Cited

Bostrom, Barry A. “In the Michigan Court of Appeals: People vs. Jack Kevorkian *.” Issues in Law & Medicine, Summer 2002, p. 57+. Gale Academic Onefile, https://link-gale-com.lcc.idm.oclc.org/apps/doc/A90440013/AONE?u=lom_lansingcc&sid=AONE&xid=5d8a11c8. Accessed 10 Nov. 2019.

Donald, Boudreau J., and Margaret A. Somerville. “Physician-Assisted Suicide.” The New England journal of medicine 368.15 (2013): 1450-2. ProQuest. Web. 10 Nov. 2019.

Grisso, Thomas, and Paul S. Appelbaum. Assessing Competence to Consent to Treatment: a Guide for Physicians and Other Health Professionals. Oxford University Press, 1998.

People v. Roberts, 211 Mich. 187, 178 N.W. 690 (1920)

“Religious Groups’ Views on End-of-Life Issues.” Pew Research Center’s Religion & Public Life Project, 16 Jan. 2019, https://www.pewforum.org/2013/11/21/religious-groups-views-on-end-of-life-issues/.

Stutsman, Eli. “Twenty years of living with the Oregon Death with Dignity Act.” GP Solo, July-Aug. 2013, p. 48+. Gale Academic Onefile, https://link-galecom.lcc.idm.oclc.org/apps/doc/A344286377/AONE?u=lom_lansingcc&sid=AONE&xid=6ddb4258. Accessed 11 Nov. 2019.

 

Professor Sally Pierce had this to say about Sabrina Ruiz’s writing. I appreciated the overview Sabrina gave on this topic and particularly that she localized the piece by talking about Michigan connections to this topic and her own connections to the topic as well. I also appreciated how she integrated a range of sources into this essay. I wished there had been some discussion and consideration about how people make this decision well, but time and space constraints probably influenced Sabrina’s choices as they do for all writers.

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