The Terminally Ill Have a Right to Die
Kassandra Trinkley
April 11, 2015
In 2014, John Rehm found himself severely crippled by Parkinson’s Disease and wanting
to die. Over the course of 10 days, he starved himself to death because the state in which he lived
in, like most states, barred physicians from helping terminally ill patients commit suicide.
Patients like John Rehm who are terminally ill often desire to end their lives on their own terms
but, without the aid of a doctor, find themselves unable to do so as easily. This is not only painful
for the person who is dying, but also their families. John Rehm’s wife, Diane Rehm, was only
able to watch as her husband starved himself to death because there was no other way for him to
take his own life. When questioned about it, however, Rehm did not feel like what her husband
did was bad. Instead, she supported his actions and wished that he could have ended his life
quicker, without the suffering, saying, “I would like to, in every state across the country, in every
city, in every county, I would very much like to see a justification, an allowance, for aid in
dying.”i Deaths like these are unnecessary and unfortunate and could easily be prevented if states
legalized assisted death, also known as physician assisted suicide.
Many people, when arguing against physician-assisted suicide, invoke claims about
doctors giving people lethal ejections against their will. Hurricane Katrina is often referenced as,
when the hurricane swept through New Orleans, Memorial Medical Center was unable to be
reached. When the power was knocked out and the temperature began to rise in the hospital, the
staff, still working there, eventually broke down. The evacuation process was difficult and tiring.
Doctor Anna Pou, who cared for patients with chronic medical conditions on the seventh floor of
Memorial, decided to continue caring for patients in her own way. She asked for and received
narcotics that could cause death in patients and was seen entering and leaving patients rooms
with two other nurses. One year later, she and the nurses involved were arrested for seconddegree murder for causing the death of four of the patients that had remained on the seventh
floor. However, Doctor Pou and the nurses were not indicted on any of these accounts and the
charges were dropped. When asked about the patients in an interview, Pou's choice of words
reflected the kind of action she had taken: "No, I did not murder those patients. Mr. Safer, I've
spent my entire life taking care of patients."ii
The actions taken at Memorial hospital are not even remotely similar to those taken
during physician assisted suicide, even though they are usually compared to euthanasia. In order
to understand what physician assisted suicide is, it is important to define exactly what each and
every term is. Despite this, physician-assisted suicide is not the same thing as euthanasia, a term
that is often used interchangeably with it..iii
Euthanaisa is Greek, coming from the words "eu" meaning goodly or well and
"Thanatos”, which is said to be the personification of Death in Greek mythology. Combined,
these two words mean good death. iv,v This is because Euthanasia is described as a mercy killing.
It is meant to describe the situation in which a patient is suffering beyond the control of a doctor
and little relief can be provided. In order to relieve the patient of that pain, the doctor
intentionally gives the patient a lethal injection to help them quickly into passing. These lethal
injections are often pain killers so that the passing is not as painful as it could be otherwise.
However, this is only active euthanasia. There exists another type of euthanasia that occurs in the
background which not many people consider or equate to mercy killings. Passive euthanasia,
nonetheless, exists and is a very common practice in medicine despite the fact that so many
people advocate against active euthanasia. Passive euthanasia requires the same level of intent as
active euthanasia, however, care is revoked instead of invoked. In place of a lethal injection, a
doctor will take a person off of a life-supporting system or decline to give them surgery. In both
situations, the act of euthanasia is carried out by a person other than the patient who is suffering.
Both of these types of euthanasia are further divided based on the consent of the patient. When
the person requests to die and euthanasia is performed, the act is classified as voluntary. When
no request is made and no consent is given, the euthanasia is considered non voluntary. But when
the patient does not request to dye and it is preformed anyway, euthanasia is considered to be
involuntary. From these definitions, it is clear to see why some people are against the idea of
doctors taking the life of patients. Even in the case of emergencies and suffering, the idea of a
doctor acting against the will of the patient, or not asking and delivering a death, is a shocking
and horrifying thing. If something falls against the will of the person it is being done to, it should
not be preformed in the first place. Fears of twisted words, and the lines between voluntary and
involuntary would be skewed, is what causes many people to shake their heads when they hear
about mercy killings.
However, we fall back on the topic of what is physician-assisted suicide? It is exactly as
it states, actually. Physician-assisted suicide is when a doctor assists a patient with killing
themselves. More specifically, it occurs when a doctor provides a patient with information,
guidance and means to end their own life knowing and intending that what they have said will be
used for the purpose of taking the patient’s life. While it sounds similar to euthanasia, the
physician’s role is much more removed. Medication is perscribed to the patient and the doctor
informs the patient exactly how much they need to take in order to end their life. It is then up to
the patient to take this medication themselves in their own time, if they even choose to do so.
The difference between euthanasia and physician-assisted suicide is, therefor, how much of a
role the doctor plays.vi
Requests from patients wanting to end their lives are actually very common. Several
studies found that more than half of oncologists received requests from patients wanting to end
their lives. However, physician-assisted suicide is not legal everywhere, despite the fact it is
entirely within the hands of the patient to decide when and if they make use of what has been
provided. The only places which legalize physican-assisted suicide are the Netherlands,
Luxembourg and Switzerland. In the United States, patients who are terminally ill and mentally
sound adults have some access to physician assisted suicide in Oregon, Montana, Washington
and Vermont. As Orgeon was the first state to legalize physician-assisted suicide, it will be used
as an example. There are four components of the Orgeon Death with Dignitiy act that act as
criteria for those seeking assisted death. The patient must be 18 or older, a resident or Oregon,
sound in the mind and diagnosed with a terminal illness that will lead to death within 6 months.
If these criteria have been met, the patient must orrally request the medication at least twice and
write to their physician at least once. The physician is legally obligated to notify the patient of
alternative care and must request but not require the patient to notify their next of kin. If all of
these criteria are met, the physician will perscribe the medication.vii
Figure 1:Morality of
Suicide
This figure shows
the number of
patients that have
died from
perscribed
prescriptions under
the DWD Act vs the
total number of
prescription
recipeints.
Since the time of its enacting, the Death with Dignity Act has given out 1,173
perscriptions. Since the bill was passed in 1997, this is works out to a rather small number.
However, not all of the perscriptions have been used. Of these, only 752 people died from
ingesting medications perscribed under the bill.viii Propoenents against physician-assisted suicide
will often declare that bills encourage an attitude among those disabled or ill that is deteramental.
They might start to feel like the right to die is a responsibility to die because physician-assisted
suicide becomes forced among those who are vunerable. However, many adults feel like the
morality of suicide is only present when there is suffering. Even in situations where people are
ready to die or a burden is on their families, people do not feel like they have a right to suicide.
While avoiding the term physician-assisted suicide, the Pew Research Center was able to poll a
group of adults on their feelings on the right to suicide. While the results did not seem clearly to
support the right to suicide even in the case of suffering, there was a clear and obvious decline
when it was suggested that people should have a right to suicide when they become a burden. It
is unlikely, therefor, that people would view physician-assisted suicide as a requirment,
especially when the requirments to obtain perscriptions are very strict in the places where they
are allowed. Additionally, of the people who choose to injest their medication in 2013, they cited
losing autonomy as their primary end of life concern. Becoming a burden was only cited in 35%
of the people who chose to end their lives, below loss of dignity, lost autonomy and less able to
engage in activites that made their lives enjoyable.ix
Figure 2:Morality of Suicide
This figure shows the percentage
of polled U.S Adults who agreed a
patient morally had the right to
end their own life based upon
what their situation was.
Another common argument against physician-assisted suicide concerns vunerable people.
People feel as though those who are disabled often suffer from a feeling of “burn out”x in which
they feel depressed due to prejudice against their condition or intolerance. However, disabilities
do not equate to those who are diagnosed with terminal illnesses. Protecting one group of people
does not mean that another group has to suffer for it. The same arugment could be applied for
people suffering from depression. These people might try to make use of physician-assisted
suicide, especially if their depression persists for long periods of time. As someone who has
suffered from depression and seen others never recover from it, I can see how people could fear
these vunerable groups being allowed access to physician-assisted suicide and making decisions
based on what they are currently feeling. That is why it is important to define terminal illness and
exactly who can make use of physician-assisted suicide. This also deals with another common
argument of the accuracy regarding the diagnosis of terminal illnesses. In actuality, doctors are
inaccurate in their prognoses for terminally ill. But instead of underestimating as most people
would thing, doctors have been found to be inaccurate in the diagnosis for terminally ill in a
systematically optimistic manner.xi This means that doctors will predict a patient has a longer
survival time than what is actually observed, as evident from the chart provided below from a
study preformed by the University of Chicago’s Medical Center’s Nicholas A. Christais and
Elizabeth B. Lamont.
Figure 3: Predicted Survival of Terminally Ill Patients by Doctors
Compared to Actual Survival Time
This graph shows the comparisons of estimations that doctors make
over the life expectancy of terminally ill patients vers their actual
servival rate. It is clear that doctors tend to overestimate the time
patients still have to live on average.
A terminal illness in itself is a disease that cannot be cured or adequately treated and is
expected to result in the death of the patient within a short period of time. In Oregon, the
prognosis for terminal illness must be less than six months and confirmed by two doctors. This
helps prevent issues of a false diagnosis and further confirm the fact that the patient will die
quickly. People with disabilites or depression, therefor, are not included within this group and
would not be eligible for assisted-suicide. In Oregon, care has been taken to ensure the law is
treated carefully and respectfully so that other people do not suffer while they can still help those
that are terminally ill die on their own terms. As long as this care is applied in other places, it is
possible to ensure that these people do not have to starve themselves to death just so they can
have peace in passing.
However, when dealing with the right to live or the right to die, one of the primary
arguments against it comes from people who feel like physician-assisted suicide is against the
teachings of religions. This is a very common feeling among many religions because the idea of
ending someone’s life prematurely often goes against what many people view to be God’s plan.
This is because many religious groups feel like it is “considered as a rejection of God’s
sovereignty and loving plan”xii because if God is the one who gives life, he should be the only
one able to take it away.xiii Because many Americans are religious, they feel like physician-
assisted suicide should be illegal in order to prevent defying the will of God. That being stated,
there is no one unifying belief amongst all people that physician-assisted suicide should be
illegalxiv. Several religious groups such as Methodists, United Church of Christ and Mainline and
Liberal Christian denominations maintain that the right to choose is an important freedom and
regional denominations of Churches may show different opinions on the moral rights of people
to end their own lives. The primary problem with laws created based on faith stems from the
issue that not all faiths are the same and our government is not to make any laws based upon the
faith of others. Personal belief is a wonderful thing but since it is not a universally shared truth, it
is not right to force the religious opinions of some onto all. The United States is not a theocracy
and within the Constiution, it outlines the freedom to follow whatever religion people believe in.
This also prohibites Congress from “promoting one religion over the other and also restricting an
individual’s religious practices”xv. While the ending of a life is a controversial topic, religion
should not be used to restrict the rights a person has to peacefully ending their life on their own
terms because that religious opinion may not be theirs. Likewise, respecting the freedom of
doctors is equally as important as respecting the freedoms of those who want to die. If a doctor
feels morally opposed to helping a patient commit suicide, they should have the right to
recommend another doctor who is not opposed. This ensures that people are free to practice
their religions freely while not being forced to conform to a belief that is not their own. If
someone’s religion says that they are opposed to ending their own life or another’s life, their
faith should be respected. However, in the same way, we must respect those whose beliefs say
that those who are suffering at the end of their lives should be allowed to die peacefully if they
choose to do so.
Ultimately, people who are terminally ill have a right to die on their own terms. If the rest
of the United States enacted laws similar to those found in Oregon and the few other places it is
actually legal, many people would no longer have to suffer at the end of their lives. Denying
people who are terminally ill who want to die the right to die is a cruel thing and can end in
tragic situations like those experienced by John Rehm. Legalizing physician assisted suicide can
help aleviate the suffering of those who are already dying and with careful monitoring like that
already found in Oregon, it is possible to ensure that other people are not at risk for abusing this
law. The rest of the United States needs to follow Oregon in suit and enact similar, if not the
same laws.
i
"Diane Rehm Advocates for Aid in Dying After Husband's Painful Death From Parkinson'sby
Chris." Diane Rehm Advocates for Aid in Dying After Husband's Painful Death From Parkinson's.
N.p., n.d. Web. 11 Apr. 2015.
ii
"Opinion 2.211 - Physician-Assisted Suicide." Opinion 2.211 - Physician-Assisted Suicide.
N.p., n.d. Web. 07 Apr. 2015.
iii
Shea, Fredericka K. "Hurricane Katrina and the Legal and Bioethical Implications of
Involuntary Euthanasia as a Component of Disaster Management in Extreme Emergency
Situations." Annals of Health Law. N.p., n.d. Web. 7 Apr. 2015.
iv
Daniel Schorn; Morley Safer (August 15, 2007)."Katrina Doc Denies Mercy Killings". 60
Minutes.
v
"Euthanasia." MedicineNet. N.p., n.d. Web. 07 Apr. 2015.
vi
"Euthanasia Definitions." Euthanasia Definitions. N.p., n.d. Web. 07 Apr. 2015.
vii
"Death with Dignity Act." Death with Dignity Act. N.p., n.d. Web. 07 Apr. 2015.
viii
013, 140, and 130. Oregon’s Death with Dignity Act--2013 (n.d.): n. pag. Web.
ix
"Euthanasia." MedicineNet. N.p., n.d. Web. 07 Apr. 2015.
x
Vitalism Revitalized...page 16.
xi
013, 140, and 130. Oregon’s Death with Dignity Act--2013 (n.d.): n. pag. Web.
xii
"Religion and Spirituality." Religion and Spirituality. N.p., n.d. Web. 11 Apr. 2015.
xiii
"Death With Dignity: Combatting Religious Opposition to Physician-Assisted Suicide." Religion
Dispatches. N.p., 22 June 2009. Web. 11 Apr. 2015.
xiv
"Religion and Spirituality." Religion and Spirituality. N.p., n.d. Web. 11 Apr. 2015.
xv
"First Amendment." First Amendment. N.p., n.d. Web. 11 Apr. 2015.