Kaitlyn Thomas

Professor Kretzer

ENG 1201

11 November 2021

Literature Review

Physician-Assisted Suicide is described as the act of a patient voluntarily terminating

their own life by administration of a deadly substance with either the direct or indirect assistance

of a physician (Angela Morrow, RN,2021). The key difference between PAS, Physician-Assisted

Suicide, and euthanasia is euthanasia performed solely by the physician, whereas the Physician

provides the “means” and the patient then acts out life-ending measures. PAS, (Physician-

Assisted Suicide) has been a hot topic of controversy for decades, and the first bill to legalize

PAS was actually created and tried from 1905-1906 in Ohio but was ultimately turned down. The

debates of whether or not this should be legalized will range from ethical to legal, to religious

and one’s own civil right to decide to live life on their own terms. In this paper, I will discuss the

ethical, moral, and legal aspects of PAS and why this is a highly charged subject for a

controversial debate.

As of 2015, Physician-Assisted Suicide is currently legal in 10 states in the United States

as well as 5 countries in the world. The states that are currently legal in the US include

California, Colorado, Hawaii, Maine, Montana, New Jersey, Oregon, Vermont, Washington, and

Washington D.C. Across the world, it is currently legal in the Netherlands, Belgium, United

Kingdom, Columbia, and Japan (Angela Morrow, RN,2021). For every argument in favor of

legalizing physician-assisted suicide, there will always be a counter-argument against the

legalization.
 While it is legal in some states, there is much debate on whether or not it is considered

ethical for a Physician to agree to perform assisted suicide for a patient in their care. When a

person becomes a Physician, they agree to a pledge known as the Hippocratic oath and the key

duty of a doctor as stated in the oath “I will not administer poison to anyone where asked,” and

“Be of benefit, or at least do no harm.” (Saint Joseph’s University 2011). So how does the

Hippocratic oath contradict the Physicians’ legal responsibility of performing assisted suicide?

The misconception among people is that anyone can get a PAS performed and that is not the

case.

There are many hoops and requirements for one to get the complete sign-off on this act.

The requirements will vary depending on the state but one source stated the following for the

Oregon Death with Dignity Act requirements: The patient must be a legal adult 18 years or older,

a current valid resident of Oregon, able to make and communicate health care decisions and

diagnosed with a terminal illness that will lead to death within six months(Saint Joseph’s

University 2011).

The process of obtaining a prescription for the lethal medication needed will also require

many boxes to be checked. “According to the Oregon Death with Dignity Act, the following

steps must be fulfilled: Two oral requests to the physician, separated by at least 15 days. A

written request, signed in the presence of two witnesses. Confirmation of diagnosis & prognosis

by a consulting physician. Confirmation of competency by both prescribing and consulting

.physician. If either physician believes the patient’s judgment is impaired by a psychiatric or

psychological disorder, the patient must be referred for a psychological examination. The

prescribing physician must inform the patient of feasible alternatives to assisted suicide,

including comfort care, hospice care, and pain control. The prescribing physician must request,
but may not require, the patient to notify his or her next-of-kin of the prescription request.”

(Saint Joseph’s University 2011).

Many argue that Physician-Assisted Suicide is not ethical for many reasons. According to

Barbara Rockett in the article, “Physician-Assisted Dying Is Not Ethical”, she mentions how in a

terminally ill patient the last six months of life is the most expensive care. The legalization of

PAS can lead to what some refer to as a “slippery slope”, which some argue is getting very close

to the fine line of mercy killing for the benefit of society, much like the Natzi-leader Adolf

Hilter.

When entering the beginning stages of researching my topic, one name really stood out in

just about every web-generated search, Dr. Jack Kevorkian, who might be better known as “Dr.

Death”. Jack Kevorkian was born on May 26, 1928, in Pontiac, Michigan. He was a pathologist

who, on record, helped aid in the illegal act of Physician-Assisted Suicide on over 100 terminally

ill patients. Kevorkian was convicted in 1999 of second-degree murder, which carried a total of

10-25 years in prison. He was eventually freed in 2007 after only serving 8 years of his sentence.

According to this article, the lawyers of Jack Kevorkian stated he suffered from a few different

health problems and he agreed to sign an affidavit agreeing to no longer assist in any more

suicides upon release from prison (Torrey and Hinzey, RD 2011).

"It was disappointing because what I did turned out to be in vain. ... And my only regret

was not having done it through the legal system, through legislation, possibly," said Jack

Kevorkian said in a 2005 prison interview(Torrey and Hinzey, RD 2011). Kevorkian believed

that while he was aware that what he was doing was illegal, it wasn’t wrong. He was helping put
the end to people who were in pain and suffering and wanted to die on their own terms. A right I

believe we should all be able to have, the right to die on our own terms.

“The greatest human freedom is to live and die according to our own desires and beliefs.”

(Lawatsch, EdD, MSW). The Death with Dignity National Center is a nonprofit organization

based out of Portland, Oregon. This organization was founded in 2005 by Peg Sandeen, Ph.D.,

MSW. The Death with Dignity National Centers help work with qualified patients who are

deemed terminally ill in allowing them to make their own decisions for end-of-life care and that

will include deciding how they want to die. They provide support for not only the patients

themselves but for the loved ones of the patients. This organization holds the core values like

dignity, freedom, and autonomy, trust, financial stability, and finally diversity, equity, and

inclusion (Lawatsch, EdD, MSW).

I am currently working at Kettering Cancer Center I thought it would be interesting to

include two interviews, one from a Doctor and one from a Nurse Practitioner, both of who work

in the Cancer Center. I haven’t written out all the interview questions so far but I do have two as

of right now that I will include providing a little insight.

1. If assisted suicide was to become legal in the state of Ohio and your place of

employment decides they will provide that assistance but you are morally against

it, should you as an employee be forced to go against your values and risk losing

your job or have the right to say you don’t feel morally comfortable assisting?

2. The Hippocratic Oath says that a Physician will “do no harm”. Would assisting a

patient with a suicide who is in extreme pain and no relief be left to provide, is
this still violating the Hippocratic Oath by performing Physician-Assisted

Suicide?
 Works Cited

Angela Morrow, RN. “What Are the Arguments for and against Physician-Assisted

Suicide?” Verywell Health, Verywell Health, 2 Jan. 2021,

https://www.verywellhealth.com/opposition-to-physician-assisted-suicide-1132377.

Lawatsch, Elia. “Death with Dignity National Center.” Death With Dignity, Death With

Dignity, 23 Apr. 2021, https://deathwithdignity.org/about/#:~:text=The%20greatest

%20human%20freedom%20is%20to%20live%20and,and%20in%20accordance

%20with%20their%20values%20and%20beliefs.

Rockett, Barbara A. Edited by Tamara Thompson, Physician-Assisted Dying Is Not

Ethical, Gale, a Cengage Company, 2014,

https://link.gale.com/apps/doc/EJ3010375232/OVIC?u=dayt30401&sid=bookmark-

OVIC&xid=92fb8574.

Saint Joseph’s University, admin. “Is Physician-Assisted Suicide Legal? Is It Ethical?” Is

Physician-Assisted Suicide Legal? Is It Ethical?, Institute of Clinical Bioethics, 1

Feb. 2011, https://sites.sju.edu/icb/is-physician-assisted-suicide-legal-is-it-ethical/.

Torrey, Trisha. “Weighing the Benefits of Right-to-Die Legislation.” Edited by Elaine

Hinzey, RD, Verywell Health, Verywell Health, 15 Feb. 2020,

https://www.verywellhealth.com/arguments-in-favor-of-death-with-dignity-2614852.