PHYSICIAN-ASSISTED SUICIDE THE MORAL ISSUES

PROHIBITIONS STANDARD ARGUMENTS –THEOLOGICAL (SOCRATIC) --- GOD GIVES LIFE –SOCIETAL (ARISTOTELIAN) --- DENY A RESOURCE –ECONOMIC (FEUDAL) --- DENY KING A TAXPAYER ORTHODOX JEWISH –ONLY “GOSSES” (ACTIVELY DYING) REMOVE LIFE SUPPORTS EASTERN ORTHODOX –HUMILITY AND THE EXAMPLE OF THE CROSS ROMAN CATHOLIC –RESPONSIBILITY TO GOD (MASTER OF LIFE) –STEWARDS OF OUR LIVES PROTESTANT –FORBIDDEN BY COMMANDMENTS –OUTSIDE DIVINE PROVIDENCE

SECULAR ARGUMENTS FAVORING PHYSICIAN-ASSISTED SUICIDE AUTONOMY –EXERCISE CONTROL OVER MATTERS DIRECTLY AFFECTING INDIVIDUAL –PROCEDURAL SAFEGUARDS PROTECTING AUTONOMY PLURALISTIC SOCIETY –RIGHT TO DETERMINE LIFESTYLES, DEATHSTYLES, AND TIME AND MANNER OF DYING CAUSAL ARGUMENT –NO MORALLY RELEVANT DIFFERENCE BETWEEN “KILLING” AND “LETTING DIE” –“INTENTION” NOT RELEVANT –PHYSICIAN’S ROLE AS “HEALER” INCLUDES ULTIMATE PAIN RELIEF

REASONS AGAINST: “FROM THE BEDSIDE” E.D. PELLEGRINO PAIN RELIEF IS POSSIBLE –MALPRACTICE IF NOT PROVIDED RESPECT FOR AUTONOMY REQUIRES NOT TALKING ADVATAGE OF THE VULNERABLE AND SUGGESTIBLE ADVANCE DIRECTIVES TO CONTROL DYING MORAL ABANDONMENT NOT TO SUFFER WITH PATIENT LAST GIFT TO FAMILY UNDERMINES TRUST IN PHYSICIAN DESENSITIZE THE PROFESSIONAL DEVALUES GROUPS IN SOCIETY MANAGED CARE = MANAGED DEATH? UNDERMINES DISTINCTION BETWEEN “KILLING” AND “LETTING DIE” SLIPPERY SLOPE: LOGICAL, PSYCHOLOGICAL, EMPIRICAL

OREGON’S COMPLIANCE CHECKLIST PHYSICIAN MAY CHOOSE WHETHER TO PARTICIPATE IN PAS PHYSICIAN WHO ELECTS NOT TO PARTICIPATE MAY NOT ABANDON PATIENT PATIENT QUALIFICATIONS FOR PAS –AGE --- AT LEAST 18 –RESIDENCY --- ONLY RESIDENTS OF OREGON –CAPABILITY --- ABLE TO COMMUNICATE AND FREE OF MENTAL ILLNESS OR DEPRESSION –VOLITION --- FREE OF COERCION –TERMINAL ILLNESS MONTHS TO DEATH INFORMED DECISION --- DIAGNOSIS, PROGNOSIS, RISKS, ALTERNATIVES TWO ORAL AND ONE WRITTEN REQUESTS –1ST ORAL 15 DAYS BEFORE PRESCRIPTION; 2ND ORAL 15 DAYS AFTER FIRST; WRITTEN 48 HOURS BEFORE PRESCRIPTION –PHYSICIAN INQUIRIES INTO REASON FOR REQUEST TWO WITNESS TO REQUEST; NOT PHYSICIAN PATIENT MAY RESCIND AT ANY TIME IN ANY WAY REGARDLESS OF MENTAL STATE ATTENDING PHYSICIAN --- OVER ALL RESPONSIBILITY FOR PATIENT REFERRAL TO CONSULTING PHYSICIAN REQUIRED TWO FORMS TO OREGON HEALTH DIVISION PRESCRIPTION MUST BE SELF-ADMINISTERED