Physician Assisted Suicide Term paper
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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 individual considerations of quality of life, and an array of
potential first-order desires explain the difference in choices. Therefore, it
is the execution of the choice by the informed agent which constitutes the
autonymous decision. With personal autonomy as the primary consideration, the
patient then has the right to PAS as a treatment option, and denial is
deprivation of self-determination. (Indeed this constitutes deprivation of
freedom, which is intrinsically wrong, and contrary to the patients natural
right to self determination. PAS in a Clinical Setting In relation to PAS, the
agent must act "1) intentionally, 2) with understanding, and 3) without
controlling influences that determine their action."2 As an institution
concerned with autonomy as a central right of the patient, we are supporters of
requested withdraw of treatment (as well as PAS,) as there is no difference in
the matter of allowing to die and killing. Killing is any form of
"deprivation or destruction of life", and allowing to die is
"intentional avoidance of causal intervention so that a natural death is
caused by a disease of injury,"3 which in itself is deprivation. Therefore,
there is no distinction between allowing to die and directly intervening to
bring about a patient's death. Moral Jusifications Compassion is a focal virtue
in our practice. Compassion is defined as a feeling of profound sympathy and
sorrow for another who is affected by misfortune, accompanied by a strong desire
to ease the suffering. Sometimes in healing the terminally ill suffering from
profound pain, assisting the patient in suicide is the only means of alleviating
his/her suffering. Those who oppose PAS are not subject to judgement or
coercion. PAS is a matter of choice and is not an alternative to be suggested by
the physician. It is a procedure which is only regarded among request and acute
investigation thereafter. Patients are protected from non-voluntary euthanasia
because, again, physicians will only address the option of PAS upon the request
of the patient and the physician cannot physically be the cause of the death
(euthanasia). No actions will act out of accordance with such, especially in
situations of life and death. It is clear that opposition to PAS is rooted in
the execution of normative judgements, which object to the action unequivically
and universally. This view neglects the secular and universal standard of
self-determination and autonomy in patient care. This is not a criticism of Philosophy Role essay Philosophy Of Religion essay Philosophy Of Mind essay
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