PHYSICIAN ASSISTED SUICIDE AND MORAL REASONING

How Moral Reasoning Affects Stance in Agreement or Disagreement to Physician Assisted

Suicide and Euthanasia
Constance Brooks
University of Memphis

PHYSICIAN ASSISTED SUICIDE AND MORAL REASONING

Introduction
Physician assisted suicide or euthanasia has been a debate for some time now, and the
reasoning or justification for performing the act can be viewed by various perspectives (Turner,
1997). My purpose is to determine whether or not physicians, relatives or even patients make a
decision to enable physician assisted suicide based off moral reasoning. In order to do this, the
background of these procedures must be known and the moral reasoning of the persons who are
affected by the decision to enable or not enable the act of euthanizing is important to note as
well.
Discussion
Euthanasia and assisted suicide are terms used to describe the process in which a doctor or close
relative of an ill or disabled person which directly or indirectly leads to the demise of the
individual (2013, pg. 402). To begin discovering the origin of peoples decision to enable a
physician assisted suicide, one could look at the work of theorists. According to Winsor, Murrell
& Magun-Jackson (2015) moral reasoning is how people decide that a behavior or action is right
or wrong. Moral reasoning is separate from religion as Winsor et al., (2015) informs us that
moral reasoning is not how people participate in religious thought. The first theorist to mention is
Jean Piaget who felt that games were great models of society (Winsor et al., 2015). He believed
that there are two stages of one being heteronomous moral development which is moral
reasoning that focuses on how bad the consequences are (Winsor et al., 2015). On the other hand,
stage two is autonomous moral reasoning which focuses on your why he or she does something
(Winsor et al., 2015). If we were to put these two stages in the context of performing a physician
assisted suicide, a person who uses autonomous moral reasoning consider why the procedure was

PHYSICIAN ASSISTED SUICIDE AND MORAL REASONING

done. Maybe the patient requested or the family of the suffering patient has voted to proceed
with euthanasia, but either way the basis for deciding what is right or wrong is based off why the
procedure of physician assisted suicide is being done. As cited in Winsor et al. (2015), Lawrence
Kohlberg gave the analogy of a mans whose wife is terminally ill and has no means to retrieve
the medications. This scenario is relatable to the article written by Huddle (2015) who goes more
in depth and describes a man who is terminally ill and is suffocated by his wife while he is
unconscious, and on the other hand the wife stops the operation of the husbands mechanical
ventilation. Who is to blame in the latter scenario? According to Huddle, (2015) our moral
reasoning can be based on whether we allowed the behavior to occur or if we did the behavior.
This theory also ties with Piagets two stages (Winsor et al., 2015). Our moral compasses can
view the same outcome differently depending on how the outcome was achieved. This leads to
the debate in the aspect of public policy.
Public policy for physician assisted suicide and euthanasia varies all over the world.
According to Levy, Azar, Huberfeld, Siegel & Strous, (2013) most European have laws that view
euthanasia and physician assisted suicide as illegal acts. As mentioned by Levy et al., (2013)
Belgium and the Netherland allow euthanasia due to mental suffering. However, in the same
study it is mentioned that euthanasia and physician assisted suicide are forbidden by law (2013,
pg. 403). There are various guidelines the Dutch Medical Association lays out that the physicians
of the Netherlands must adhere to (Levy et al., 2013). Another issue with public policy is the
role of physicians in the process of physician assisted suicide and euthanasia. The study of Levy
et al, (2013) surveyed 103 subjects in Israel with a range of subspecialties in medicine. The study
found that when the practice was religion controlled the psychiatrist were more conservative in
how they viewed euthanasia than those of other practices (Levy et al., 2013). It was also noted

PHYSICIAN ASSISTED SUICIDE AND MORAL REASONING

that female physicians had more conservative views towards euthanasia than their male
counterparts (Levy et al., 2013). ). According to Leigh Turner (1997) if more than one person is
involved in the decision to proceed with euthanasia the amount of opposition is not as great as
when one person decides. This stems from the notions that both or all parties are in agreement
that no harm is being done to the patient who is terminally ill, and it also ensure that the
procedure is not being requested because of depression or other mental issues (Turner, 1997).
that It can be inferred from the study conducted by Levy et al. (2013) that religion does affect
the views towards physician assisted suicide and euthanasia. The various doctrines of religion
around the globe must also be considered in the stance of how an individual regards physician
assisted suicide and euthanasia.
One moral issue being addressed around the world is the degree to which individuals
should be enabled to determine the circumstances of their own deaths (1997, pg. 191Jewish and
Christian religions view human life as unqualified gift from God which originates reasons to
prohibit death through autonomous decisions (1997, pg. 192). With this being noted, a person
who is a part of such religion would possibly reason that physician assisted suicide and
euthanasia are not acceptable. Jewish and Christians religious communities view life as a gift
from God which leads to the more conservative regard towards physician assisted suicide and
euthanasia (Turner, 1997). Also, as cited in the study of Turner we see that it is written in the
Declaration of the Sacred Congregation for the Doctrine of Faith for the Roman Catholic
church no one is to dispose of their life at will (1997, pg. 196). However, we must realize that
what is acceptable as an explanation for moral reasoning in one community may not be
acceptable to an individual in another community (Turner, 1997). We must also analyze when it
is acceptable to adhere to the wishes of the patient.

PHYSICIAN ASSISTED SUICIDE AND MORAL REASONING

Leigh Turner (1997) informs the readers that a patient cannot request for their physician
or nurse to hasten the dying process. We must also realize that now medicine is more advanced;
therefore, physicians can give a diagnosis and even the symptoms of an illness to expect down
the road (Turner, 1997). This access to such information plays a role in patients requesting
physician assisted suicide or euthanasia (Turner, 1997). The patient has his or her own identity
and moral perspective which is why we must consider everyone and their personal judgement.
This goes against what was discussed earlier with the aspect f religion and the value of life. If
people who are in certain religious communities view their lives as a unimaginable gift which
hold sacred value, their regards towards physician assisted suicide would differ from someone
who bases morality off individualism alone (Turner, 1997).
Conclusion
Physician assisted suicide and euthanasia still have current debates. Even I, myself
experienced a loved and the turmoil caused to proceed with physician assisted suicide, and there
were individuals on both sides of the spectrum of whether to continue with the usage of a feeding
tube or remove the feeding tube and allow for the body enter into a state of utopia and lead to the
loved ones demise. There are so many factors to be considered that moral reasoning is only one
component in the decision to allow a physician assisted suicide or euthanasia. When Piaget is
considered and how it relates to Huddle (2013) you realize that agreements are being made in
how we perceive what is morally right or wrong. But to put in the context of being a patient, a
family member or even the physician and the discussion of performing a physician assisted
suicide or euthanasia we know that there is still much more for debate in generations to come.
There is much work still be done in order to come to common policy on physician assisted
suicide and euthanasia. The differences between individualistic morality and religious based

PHYSICIAN ASSISTED SUICIDE AND MORAL REASONING

morality are both complex in thought, but both aspect affect regards towards physician assisted
suicide and euthanasia.

PHYSICIAN ASSISTED SUICIDE AND MORAL REASONING

References
Huddle, T. S. (2013). Moral fiction or moral fact? The distinction between doing and allowing in medical
ethics. Bioethics, 27(5), 257-262 6p. doi:10.xxx/xxx.xxxx
Levy, T. B., Azar, S., Huberfeld, R., Siegel, A. M., & Strous, R. D. (2013). ATTITUDES TOWARDS
EUTHANASIA AND ASSISTED SUICIDE: A COMPARISON BETWEEN PSYCHIATRISTS
AND OTHER PHYSICIANS. Bioethics, 27(7), 402-408 7p. doi:10.xxx/xxx.xxxx
Turner, L. (1997). Euthanasia and distinctive horizons of moral reasoning. Mortality, 2(3), 191-205 15p.

Winsor, D., Murrell, V. & Magun-Jackson, S.. Lifespan development: An educational psychology
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