In the contemporary society due to the success of medicine, it is now possible to live a long life despite suffering from a disease, even though the quality of life may be compromised. Therefore, today it is possible to keep the biographical life of a person alive, while his biological life is finished. In these circumstances some people who value the quality of life more than a long life, demand to die with dignity. In this context, the role of a doctor is not only to cure or heal but also to assist such a person in terminating his suffering and agony. During 1990’s, Dr. Jack Kevorkian (also known as “Dr. Death”) helped around 130 terminally ill people to end their lives. This incident in scientific terms is called ‘Physician Assisted Suicide’ (PAS), wherein the physician provides a prescription for a dose of lethal medication at the patient’s request and which the patient uses to end his life. PAS is legal in the US, Netherlands, Belgium, and also a few other countries where there is no specific law banning assisted suicide including Switzerland, Luxembourg, Italy etc.
It is the norm that right to life should be protected by law, invariably and equally, and life is not to be taken away on reasons based on opinion (Human rights and Euthanasia, Dr. Brian Pollard, 1998). But what if a physician finds himself in such a situation where a patient begs him to prescribe such medication that would lead to the patient’s death? A retired Norwegian physician Christian Sandsdalen admitted to giving an overdose of morphine to a woman who was chronically ill for 20 years after she begged him for help. This act led to the cancellation of his medical license but he was not sent to prison. In another case, as tried in the European court of Human rights, a woman fell in front of her home because of which she became paralyzed and never recovered from it. She needed artificial ventilation and constant care for the rest of her life. She asked for a lethal dose of medication so that she could end what she thought was an undignified life (Koch v. Germany). There are numerous such examples where physicians find themselves in a dilemma as to whether they should cater to the requests of these terminally ill, helpless patients or if they should follow the rule book and let them live.
In Physician assisted suicide, the foremost thing required is the competence of the patient. There may be situations when a person asks for lethal medication as a result of depression or inability to bear pain of the treatment. Therefore, there is a greater emphasis on the role of a physician as an able judge of human competence and he should not be easily swayed by emotions. Moreover, a physician also has to be completely sure as to whether there is any alternate available treatment for the disease and in case there is none, whether death, is a viable option to get rid of the undignified life (which the patient feels he is living). The guideline for the physicians provided by the Oregon State (Oregon Death with dignity Act, 1994) suggests: (a) Family members should be involved in decision making process, (b) Physicians should not suggest physician assisted suicide, and (c) care should be exercised in prescribing appropriate doses of lethal medication.
The opponents of Physician assisted suicide claim that it is a disgrace to the medical profession as physicians are taught to treat illness and extend life and therefore, physician assisted suicide goes against their training and the very essence of their profession. Imagine a doctor who kills his patients! The opponents articulate that Physician assisted suicide reflects a poor state in ending of life care. They suggest that better pain control and palliative care should be the priority for the dying patients and not the legalization of physician assisted suicide.
To conclude, it might be said that the starting point of medical ethics is proper respect for humans and thus, this implies that there is a moral obligation to push death farther off and prolong life. But there might be situations where a doctor has tried every possible thing and still has not been able to alleviate the suffering, or the disease is incurable and the patient as a result, desires not to live any longer. This gives birth to a dilemma where the physician finds himself at the crossroads, whether to respect the autonomy of the patient and fulfill his desire or whether to follow the prescribed nature of his profession and deny his wish.