Physician Assisted Essay

Physician Assisted Essay-89
"If I ever have an accident or a terminal disease that would affect my mind or body, I will end it." Twelve years later, he did so.Similar sentiments are shared by a significant proportion of Americans.Like other individuals suffering with chronic medical illnesses, he chose suicide as a means of controlling the course of his disease and the circumstances of his death.

Proponents perceive PAS as an act of humanity toward the terminally ill patient.Methods: Psychiatric and psychosocial perspectives are used to understand the factors contributing to the interest in PAS, as well as to guide interventions in the clinical care of patients with advanced disease.Results: Research and clinical experience suggest that attending to issues of depression, social support, and other psychosocial issues in addition to pain and physical symptom control are critical elements in interventions that are useful in reducing the distress of patients who desire hastened death.Distinctions between withdrawal of life support and euthanasia/PAS are, in many ways, considerably clearer.Long-standing civil case law has supported the rights of patients to refuse any unwanted treatment, even though such treatment refusals may cause death.8 On the other hand, patients have not had the converse right to demand treatments or interventions that they desire.Since patients are allowed to refuse life-sustaining medical interventions (eg, life support, artificial nutrition, and hydration), they are effectively permitted to commit suicide by treatment refusal.Despite the refutation of this argument by the US Supreme Court, advocates of legalization argue that no ethical difference exists between terminating life-sustaining care and administering lethal medication for the terminally ill patient.Both euthanasia and PAS have been distinguished, legally and ethically, from the administration of high-dose pain medication meant to relieve a patient’s pain that may hasten death (often referred to as the rule of double effect) or even the withdrawal of life support.6,7 The distinction between euthanasia/PAS and the administration of high-dose pain medications that may hasten death is premised on the intent behind the act.In euthanasia/PAS, the intent is to end the patient’s life, while in the administration of pain medications that may also hasten death, the intent is to relieve suffering.This distinction has had the effect of allowing a patient on life support the ability to end his or her life on request, yet a patient who is not dependent on life support does not have such a right.In fact, this difference in perceived "rights" formed the basis of the arguments made to the Supreme Court in Washington v Glucksberg9 and Quill v Vacco,10 in which it was argued that this distinction violated the due process clause of the 14th Amendment (the Supreme Court unanimously rejected this argument).


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