Physician Assisted Suicide is one of the many ethical issues that our society is facing today.  It is a question of whether or not a physician should legally be allowed to provide a terminally ill patient with the means to commit suicide.  According to what I have learned, there are several ways in which this can be done.  In some cases, the physician only supplies the patient with information on what can be done and in other cases, the physician supplies the patient with the actual means such as a prescription for a lethal dose of pills or a supply of carbon monoxide gas.  Another, more commonly used term for this would be voluntary euthanasia, voluntary because it is a completely voluntary event and no one is being forced to commit suicide.  Euthanasia which literally stands for “good death,” therefore meaning each person chooses to die their own way.

Some may wonder why anyone would want to legalize Physician Assisted Suicide, but just as there are many reasons against it, there are just as many reasons for it.  Foremost is the case of extreme physical suffering of a terminally ill patient.  Should a terminally ill patient have to suffer for months at a time or should one be allowed to make a decision to end the pain and should it be legal?  Some people say that rather than assisting a terminally ill patient in death, we should be more concerned with taking additional steps to comfort them.  Who is right in these cases? This debate over whether or not to make Physician Assisted Suicide legal has been around for long time, “the right-to-die movement has been under way since the 1970’s but has gained steam in the 1990’s (Fact.com). 

The subject of Physician Assisted Suicide and the moral issues surrounding it are similar to the abortion issue of its time. The argument has a lot to do with morality, medical ethics, and religion.  There are many arguments both for and against Physician Assisted Suicide and I can understand certain points on both sides.  Those for Physician Assisted Suicide feel that the most important point is that it should be a personal decision and that we should all be allowed to decide when and how we die.  They feel that no human should have to suffer to the very end and feel that we should have enough compassion to make it legal for them to do what they feel is right.  Also, those supporting Physician Assisted Suicide believe that this is something that has actually been occurring for many years between doctors and patients.  It just hasn’t actually been openly discussed.

Those against Physician Assisted Suicide feel that pain and suffering are treatable and usually strongly support the hospice approach, which is all about patient care and comforting a patient in their last days.  They also believe that if it were to become legal that some patients would choose to die for all the wrong reasons.  They feel that legalizing assisted suicide in any form will lead to more suicides and also lead to society accepting suicide as normal.  That is why very strict rules and guidelines would need to come into play.  For example, depression would not be a valid reason for Physician Assisted Suicide.  Only in the event of a terminal illness where death is imminent should it be allowed. 

Another concern of some opponents to Physician Assisted Suicide is that with the cost of treatments some insurance companies may try to encourage patients to participate.  That is why a full psychiatric examination would be necessary and it would be up to a doctor to determine if the patient is doing this of his or her own free will.  Another argument that has merit is the fact that some elderly patients have no one to speak for them and with enough pressure they may give in and agree even if it is not what they truly desire. 

            Then there is the medical ethics issue.  Doctors take the Hippocratic Oath and have sworn to always try to save and heal a patient.  Most people believe that Physician Assisted Suicide goes against that oath and that a physician should never actively hasten death.  They feel that if the best a doctor can do is to keep a patient sedated and comfortable to the very end, then that is what needs to be done, but is that really considered living or just existing?

            Religion is another key aspect when it comes to Physician Assisted Suicide.  Most religions believe that life is a gift from God and only God should be able to take it away.  They also believe that taking a life in any form is morally wrong, even if it is in the best interest of a patient.  Therefore, suicide in any form is not acceptable.   But should the laws of the states be decided on religion and if so, which religion?  Today’s society is made up of so many different religions that it would be hard to base any law on religious beliefs.

          Recently I read the book Jean’s Way by Derek Humphry in order to get a better understanding of Physician Assisted Suicide.  In this book is the detailed account of how Derek Humphry helped his first wife Jean, who was terminally ill with cancer, commit suicide.  Upon reading this book I discovered that Derek and Jean were Atheists.  I feel that this allows for some of the decision’s they made in their lives, because they acted in their own best interests and not in God’s.

   When I first picked up the book, Jean’s Way, I wasn’t sure what to expect.  I knew it was going to be a story about death, but I never stopped to realize that it would be a story about living also.  The first paragraph that caught my eye was actually in the Preface:

            “The underlying message of Jean’s Way remains the same as when it was written 25 years ago: it would be far more preferable to legalize medically-assisted suicide for terminally and hopelessly ill adults, for it is a tremendous strain and risk put on families.  Oregon, Netherlands, Belgium, and Switzerland have it – in varying ways – but for the rest of the world it’s a long time coming.  Too long!” (Humphry x).

Although this book was originally written in 1978, it was copyrighted in 2003 and a new Preface and Epilogue were added.  I think Derek Humphry makes a good point in stating that although it’s been 25 years since his wife’s death, the world really hasn’t changed much in it’s view on Physician Assisted Suicide. 

            As I began reading Jean’s Way my first thought was that it was actually a love story (which in some ways it was).  It starts off talking about how they met and shortly thereafter they wed.  It talks about them starting a family and about his career.  It sounds just like most love stories we read.  That is until you get to the part where they find out the first time that she has cancer.  This was something that Jean was always afraid of because cancer was in her family history, her own mom died of lung cancer.  From this point forward, the story became more about how they decided to “live” with her cancer. 

            Jean’s first sign of cancer was a lump that she had noticed in her breast.  As she had thought, it turned out to be cancer and her breast was removed.  A short time later it was determined that the cancer had also spread to her lymph nodes and she returned to the hospital to have those removed also.  Roughly a year later, Jean began having pains in her back.  At first the doctors diagnosed it as “a strain triggered off by influenza” (Humphry 41-42).  However, when her back didn’t get any better further tests revealed that the cancer was back.  It was at this time that Derek was told “the situation is very serious and you should prepare yourself to expect the worst” (Humphry 45).  As Jean’s pain began to worsen and she was pretty much in pain all the time, and basically confined to bed, the doctors informed Derek, “the cancer has spread to the bone and you must expect your wife to be dead by the end of the year” (Humphry 56). 

            This is where the book began to be an emotional roller coaster.  There were brief periods where Jean was doing well and they hoped for a future together and there were times they thought that the end was near.  Through it all, Jean had the courage and the will to live.  She was a strong woman putting forward the fight of her life.  Eventually it began to get to a point where Jean was having a hard time dealing with the pain.  It was during one of these times that Jean asked Derek to promise her something:

            “I want you to do something for me so that if I decide I want to die I can do it on my own terms and exactly when I choose.  The one thing that worries me is that I won’t be in any position to make the right decision, what with my being knocked senseless by all the drugs.  I might be too daft to know whether I’m doing the right thing or not but I shall have a good idea when I’ve had enough of the pain.  So I want you to promise me that when I ask you if this is the right time to kill myself, you will give me an honest answer one way or another and we must understand, both you and I, that I’ll do it right at that very moment.  You won’t question my right and you will give me the means to do it” (Humphry 74).

Shortly after this Jean began a temporary recovery, the new medications were beginning to work and Jean wanted to go home.

            The next year was filled with ups and downs.  Each time they thought that the end was near, Jean recovered and was able to cope and continue living with the help of her family and friends.  With each new hope came another downfall.  Many different combinations of medications, chemotherapy and radiation were tried in the hopes of restraining the cancer.  Yet in truth, Jean was still declining.  Eventually it came to the point where even the drugs were barely enough to make the pain bearable. 

            Then one morning as Jean was trying to sit up in bed, she reeled back in great pain.  She had actually broken a rib just by trying to sit up.  The cancer in her bones was now in its last stages and other broken bones were possible.  It was then that Derek knew he had to fulfill the promise he had made to Jean and find the means necessary to assist her when the time came.  He was lucky enough to have a doctor friend that he turned to, who gave him a lethal combination of sleeping pills and painkillers which could easily be dissolved in water (Humphry 113).

            Derek went home and prepared the mixture and placed it on a shelf for when the time came that Jean needed him.  It wasn’t long after that they received word that the cancer had spread to Jean’s neck.  They knew then that the brain would be next.  After returning home from the hospital after this last bout of bad news, they spent much time together just holding each other. 

Then one day Jean awoke and said “Is this the day?” (Humphry 121) and Derek knew that the time had come.  Just as Jean had asked over a year ago, Derek was willing to give her the death that she wanted.  She wanted to die at home with just Derek at her side.  She knew well ahead of time that this day would come and they prepared for it together.  It was then that Jean stated, “I shall die at one o’clock.  You must give me the overdose and then go into the garden and not return for an hour.  We’ll say our last good-bye here but I don’t want you to actually see me die.” (Humphry 122).  She then told him that “I’ve got this bloody cancer and I simply can’t fight it any longer.  But you must make a new life for yourself or else all that you and I have done will be waste” (Humphry 123). 

            Jean’s one last request was that after she was gone she wanted Derek to go to her father and let him know exactly how she died.  She didn’t want her father to think that she had suffered and died the way that her mother had.  Then she stated that it was close to one.  After retrieving the mixture and placing it in a cup of coffee, he brought it to Jean and she stated, “Good-bye my love” (Humphry 127).  After Jean drank the coffee, Derek remained by her side, he did not go to the garden as she requested.  He was afraid that she would awake and be disoriented.  However, at 1:50 p.m. as Derek sat watching, Jean died peacefully.

            In this story, Jean was lucky to have a husband such as Derek who loved her enough to let her die on her own terms and not those of the disease which ravaged her body.  It’s not everyone who can accept death this way.  However, Derek and Jean both knew that the end was near and that the pain and suffering would only get worse.  No one should have to suffer that way.  Although it may not be the opinion of the majority, I believe that what Derek did took great courage and strength, and I’m moved by what he did for Jean.

            About a year after Jean died, Derek married a woman named Ann who convinced him to write Jean’s Way.  However, getting the book published proved to be extremely difficult because the book dealt with death and assisted suicide.  Publishers were not immediately interested in the book.  After many rejections, a publisher was finally found in Soho.  Today the book is published in 7 different languages. 

            After the book was published, Derek was contacted by the police who wanted to question him regarding the assisted suicide.  He knew what he had done was illegal and that writing about it could bring about repercussions.  However, in the end, the Director of Public Prosecutions decided not to prosecute the case due to insufficient evidence. 

            In 1980 a conference was held to announce the formation of the Hemlock Society, “dedicated to the understanding and legal acceptance of active voluntary euthanasia for the terminally ill”.  By early 1986 “there were 13,000 members and a staff of seven” (Humphry 146).  This was the first such group of its kind in North America and was funded from the proceeds of the book Jean’s Way. 

            As part of my research I decided to interview a few people at work and ask them where they stood on the subject of Physician Assisted Suicide.  The first woman I spoke with, Sandy, is in her early 50’s and is currently being treated for liver cancer.  Sandy stated that she believes that Physician Assisted Suicide should be allowed in severe cases where all other options have failed.  Next I spoke to a woman in her early 40’s, Lori, who also believes that it should be legalized although it should have very strict regulations and rules.  Lastly, I spoke with another woman, Mary, who has been in the nursing field for 30 years.  She stated that throughout her career she has seen it happen many times and she feels that it is more of a matter between the physician and the patient and patient’s family and that it should be allowed.

            Although many people that you speak to are for Physician Assisted Suicide, I’m sure there are many that are against it.  In the United States today, the only state that has legalized Physician Assisted Suicide is Oregon, which passed the Death with Dignity Act in 1994.  Several other states have tried and failed such as California and Washington.    “At present, 32 states specifically prohibit mercy death (or assisted suicide), and almost all of the remainder, and most countries of the world, make it illegal under general homicide statues” (Thiroux 212).

            For me, growing up a very strict Catholic I always thought that suicide was a sin, that was before I was truly able to form my own opinions.  Over the last several years I watched my grandparents slowly deteriorate until their quality of life was one that we all knew they didn’t want to be living (bedridden, confused, in pain, etc.).  I had never really given Physician Assisted Suicide a thought until I had to sit back and watch my grandparents suffer.  Luckily they didn’t have to suffer for very long, but I’m sure the suffering was more than they wanted to endure.  I then thought that it was pretty sad that when animals get extremely sick or old we are given the ability to “put them to sleep”,  yet humans must tough it out and suffer to the very end.  Although it was too late to be of any help to my grandparents, I knew then that I wanted to find out more information about Physician Assisted Suicide and what it meant, which is why I wrote this paper.

Works Cited

“Assisted Suicide.” FACTS.com Issues & Controversies. 1 Apr. 2005. <http://www.2facts.com/ICOF/Search/i0202510.asp>.

Humphry, Derek, and Ann Wickett.  Jean’s Way.  1978.  Junction City: Norris Lane Press, 2003.

Marto, Mary, et al. Personal Interview. 5 Apr 2005. 

Physician-Assisted Suicide: Ethical Topic in Medicine.  27 Mar. 2005. <http://eduserver.hscer.washington.edu/bioethics/topics/pas.html>.

Right to Die: Overview.  1 Apr. 2005. <http://publicagenda.org/issues/overview.cfm?issue_type=right2die>.

Thiroux, Jacques P. Ethics Theory and Practice.  Eigth Edition.  Upper Saddle River: Pearson Education, Inc. 2004.