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Topic: Physician Assisted Suicide
February 17, 2014 | Posted By Bruce White, DO, JD

Last month, a New Mexico trial court judge ruled that a terminally ill patient had a constitutionally protected right to aid in dying from a physician without risking criminal prosecution for assisted suicide. Judge Nan G. Nash of the Second District Court in Albuquerque based her opinion in the New Mexico Constitution: “This court cannot envision a right more fundamental, more private or more integral to the liberty, safety and happiness of a New Mexican than the right of a competent, terminally ill patient to choose aid in dying.” Thus, the state became the fifth to permit physician-assisted suicide, following Oregon (1997, approved by voter referendum), Washington (2006, approved by voter referendum), Montana (2009, allowed by state supreme court opinion), and Vermont (2013, enacted by the state legislature).

The case was brought by two oncologists (Drs. Katherine Morris and Aroop Mangalik) who asked the court to clarify the state’s assisted suicide law and allow them write a lethal dose of a drug for a 49-year-old patient (Aja Riggs) with advanced uterine cancer. Critical to the case may have been the December trial testimony from the patient: “I don’t want to suffer needlessly at the end.”

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

May 30, 2013 | Posted By Marleen Eijkholt, PhD

One week ago, the state of Vermont passed legislation allowing Physician Assisted Suicide (PAS) in its ‘Patient Choice at End of Life’ Bill. This Bill will protect physicians from criminal liability for prescribing a medication that will hasten a patient’s death, under certain conditions and given certain safeguards. The legislative regime is relatively clear, and its comprehensible provisions can be applauded. Still some ambiguity exists overall about the distinction between PAS and euthanasia, as evidenced by the following headline: ‘Vermont Assisted Suicide Bill: Vermont Gives Euthanasia the Green Light’. The legislation itself does not necessarily do a service to clarify these terms, in its reference to active euthanasia. In this blog post, I seek to clarify some of the legislative regime in Vermont and clarify some terminology around PAS and euthanasia. 

Vermont is the third State that has legally permitted PAS, and is the first one to do so by law directly. Oregon and Washington legalized PAS respectively in 1994 (confirmed in 2006) and 2008 after referenda. Montana allowed PAS by a court judgment in 2009, but no Bill has been enacted yet. Vermont’s Bill was crafted with the Oregon legislation in mind. Its current safeguards revolve around record keeping by the physician, its requirements that a patient needs to suffer a terminal illness and have less than six months to live, as well its requirements for a the written statement of a patient (next to two oral ones), and a concurring opinion from a second physician. These safeguards were a compromise to facilitate and speed up the process of the Bill. In 2016 these safeguards will be replaced, and PAS will be governed by professional practice standards, like in other areas of medicine (Provision 5292).    

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

November 12, 2012 | Posted By Wayne Shelton, PhD

The issue of physician suicide has been on the public agenda in the United States for the past 25 years or more. Legitimate worries about medical overtreatment, unnecessary suffering and loss of dignity have motivated a growing number of Americans to consider this issue more favorably. People are rightly concerned about loosing control over what happens to them once they enter the hospital when the are very sick and risk dying. Instead of being at the mercy of technological forces beyond their control, free individuals want to have a say over how they make the final exit from life. The key factor, in my opinion, is more about self-control than it is about actually the strong desire to take a lethal dose of medications at the time of the patient’s choosing. But let’s be clear what we are talking about. 

Oregon was the first state to legalize physician-assisted suicide, which occurred in 1994 in the Death With Dignity Act. This law gives patients with capacity facing a clearly diagnosable terminal illness within 6 months or less to live the right to receive (and the right of the physician to prescribe) a prescription for a lethal dose of medication for the expressed purpose of ending their lives at the time of their choosing. Because we have had many years to collect empirical data about the effects of this law, we can use Oregon as a case study. As of 2011, 935 people have had prescriptions and 596 have died from ingesting medications they received based on this law. For about 90% of these patients, the primary concern about end of life care was “loss of autonomy”, but “inability to make life enjoyable” and “loss of dignity” were also major concerns. Moreover, based on the data, there is no evidence of any kind of abuse to any particular segment of the population, as some feared might happen. In fact the utilization rate of hospice care is up.  Following Oregon, Washington and Montana also have legalized physician-assisted suicide and we will have to wait and see the data of these laws continue to yield generally positive results. But overall the data gathered so far supports physician-assisted suicide a beneficial service. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

June 19, 2012 | Posted By Michael Brannigan, PhD

Does the case for terminal sedation actually weaken the case against physician-assisted suicide?

Terminal sedation, more clinically referred to as "palliative sedation," is a legally sanctioned alternative to physician-assisted suicide, a last resort in palliative treatment. It involves inducing and maintaining unconsciousness in a terminally ill patient until the patient dies, and is often accompanied by withholding or withdrawing medical feeding and hydration.

For example, if, in my advanced cancer, I experience intolerable pain, delirium, dyspnea or distress, to alleviate these unmanageable symptoms I let my physician sedate me into unconsciousness until I die. Sort of like undergoing anesthesia before surgery, without waking up.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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