Written By: Damien Knight
In November 1994, voters in Oregon approved by a margin of 52 to 48 percent a ballot initiative known as the “Death with Dignity Act”. This law, after surviving constitutional challenges and second referendum in which Oregon voters opposed repeal by a margin of 60 to 40 percent, ultimately went into effect in November 1997. The law permits physicians in Oregon to prescribe lethal drugs for terminally ill adult patients who want to end their own lives. In order for a patient to be eligible for such assistance, the attending physician must determine that the patient has a terminal illness and is expected to die within six months, and a consulting physician must confirm the diagnosis and prognosis. The following requirements are also stipulated:
(1) The patient must make an initial, oral request; reiterate the oral request after 15 days have passed; and also submit a written request, supported by two witnesses.
(2) Before writing the prescription, the attending physician must wait at least 15 days after the patient’s initial request and at least 48 hours after the written request.
(3) The attending physician must fully inform the patient with regard to diagnosis and prognosis, as well as feasible alternatives – including comfort care, hospice care, and pain control.
(4) Both the attending physician and the consulting physician must certify that the patient is “capable” (i.e. has decision making capacity), is acting voluntarily, and has made an informed choice.
* (5) If either physician believes that the patient’s judgment might be impaired.
(e.g. by depression) the patient must be referred for counseling.*
The Oregon law allows the attending physician and others to be present when the patient takes the lethal dose.
The Oregon law “Death with Dignity Act” allows for assisted suicide in fatal cases. First the basis of this law is that it has to be an adult patient who has only six months to live, and this patient is aware fully of their condition. For many this law might be seen as legalized murder but I think it is justified and support it. Many would question the morality of such a law but if we ask ourselves does this in the long run provide for the greater good we would have to recognize it as our duty to give this option to those who are dying of illness.
Those who often oppose things such as assisted suicide give various reasons why they do. Often these reasons involve religious and moral values. These reasons being that ‘murder is wrong’ and ‘suicide is wrong.’ Also taken into these arguments is how the loss of a loved one as the immediate result being too painful to bear. Often people will say that if they were kept alive just a little longer that the person could have been saved. The Oregon law states that for the assisted suicide to be permissible the patient has to be fully aware of his alternatives. So if the person fully knows they can be saved it would be in their best interest not to commit the assisted suicide.
So when would ‘murder’ and ‘suicide’ be societies moral obligation? If we look at this from a benefiting everyone perspective such as utilitarianism we would find we are obligated to commit to this law when the person’s death is more beneficial than the person’s life. When we ask what circumstances would make this probable, we then have to look at the facts. In the beginning of the book we are given a story of a man who murders his brother at his brother’s request while he is very sick. We can examine this murder and see if like the Oregon law it holds up to being beneficial in the long term.
The story mentions that Mathew Donnelly (CH7 p 460 pg 4 Philosophy: a text with readings) contracted cancer he was in constant pain and had little left of his body due to surgery to remove the tumors. Now they don’t say if he was in a fatal condition but let’s assume he was and his brother comes and relieves him of his misery. Is his brother wrong for the murder? In the long term not only does Mathew no longer suffer, but he is no longer incurring hospital bills that his family may or may not be able to pay. This is good for his family. He also could no longer be a working part of society he would have to had drawn disability draining government money. These points mean that in the long run in spite of immediate loss of life and a funeral bill his murder is justified.
Assisted suicide would have to be assessed in the same way. The doctor after receiving an oral request and after 15 days have ascertained that the patient is both not depressed and is acting of his own will, and then the doctor can write the prescription for the lethal dose. These requirements make it harder for people to choose this method. This way we do not accidentally allow the suicide of a person who might heal and become an able bodied citizen of society.
So what makes assisted suicide moral? It is moral when it does not just benefit the patient, and the family but the entire society. These burdens include: financial, physical, and emotional tolls. If he is spending more money to try and stay alive, then his family can afford. If watching his suffering is more painful than bearing death and he would need an aid if he were to be dismissed. If he could never work again once dismissed meaning others would pay for him. These things he might determine would make him a burden.
If the patient determines he would be a burden upon himself, his family, and his neighbors and the government with his illness then it is best he utilize this law and take his life, he would be morally obligated too. This way not only is he or she no longer in pain they can die knowing they will burden no one else. They can die as the law says with dignity instead of living as a burden and for these reasons I support the law.