Trial Search Research

Issue Explanation:

A person’s right to die has been a current issue that courts are arguing over. The courts are disagreeing because there isn’t a black and white answer to this issue; there is a lot of interpretation about when someone has the right to say they want to die, if they are even in the right state of mind at the time. The list keeps going, but there are arguments for physician assisted suicide and against it. Reasons for PAS are respect for the patient, dying is very personal and people should be able to choose when and how it happens. Justice, this requires that people “treat like cases alike”, because for some terminally ill patients they can refuse treatment to speed up death but other patients can’t use that as a form of death, their only option is suicide. The suffering of terminally ill patients is immense, both physical and physiological, PAS helps relieve some of that suffering. The common good wants to preserve life some people that are terminally ill have a very strong desire to end their life and they should be allowed this in some cases. PAS probably happens in secret all around the country, but if it was legalized then physicians and patients would be able to talk openly about the issue. It is also stated in the Declaration of Independence, everyone has the right to life, liberty and the pursuit of happiness.

            The opposing arguments state that, some religions believe strongly against taking a humans life. People may feel pressured to choose PAS if they are struggling with money or feel that people don’t want them anymore. Historical ethical traditions of medicine are very opposed to taking a life. It is even stated in the Hippocratic Oath. People also think that if PAS is legalized it will put a harmful public image of the profession. But the main concern is that doctors will make mistakes. They could make a faulty diagnosis and prognosis; a patient who hears they are going to die in a few months might want to do it know, but they could really not have the disease at all. People may choose PAS and they may not really be sick.

Current Interpretation:

            Currently PAS or right to die is legalized in 3 states: Oregon, Montana and Washington. Oregon has had the law passed for the longest. Their law states that a person can qualify for PAS if they are a resident in Oregon, over the age of 18, they must be able to make decisions and be suffering from a terminal illness that will result in death in the next 6 months. The patient must then make one written and two oral requests for medication that will end their life. The written request must be signed by two witnesses that say this patient is capable of making this decision. The patient’s decision must be an informed one, which means the doctor has to clearly tell the patient the diagnosis, prognosis, possible risk and complications when seeking medical treatment and the alternative of avoiding treatment and using pain control. The doctor’s diagnosis has to be confirmed by another physician. There is also a need of a counselor if the patient seems to be suffering from a mental disorder that would impair their judgment.

http://www.leg.state.vt.us/reports/05death/death_with_dignity_report.htm#Section3

There are a few states, such as Vermont, New Hampshire, Michigan, Maine, Hawaii and California, have proposed to legalize PAS but have been over ruled every time by the people since 1992.

http://www.nightingalealliance.org/pdf/state_grid.pdf

Constitutional Connection

            PAS is connected to the Fourteenth Amendment. The Fourteenth Amendment states that ‘No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the Unites States; nor shall any state deprive any person of life, liberty, or property, without due process of law.’ Every person has a right to property, liberty and life unless they have gone to court and the issue is resolved there. The country is not allowed to take away these things unless a decision in court has been made. The right to die issue is difficult to determine if it is constitutional or not because every person has the right to life, liberty and property. Which means no one should die before they have to because they have a right to life. But it also says liberty, which means that people should have the liberty to choose when and how they die if they want.

Court Cases (see more in packet):

            One well known court case is Cruzan v. Missouri. Beth Cruzan was in a car accident and was able to breathe on her own but was in a comma and had to be feed through a tube. After a few weeks her parents wanted to end her life when it was clear she wasn’t going to wake up. But the hospital said they didn’t have the right to make that decision. The court ruled in favor of Missouri because the parents did not know for sure whether or not Beth wanted to die.

            Another case involves Washington v. Glucksberg. Dr. Harold Glucksberg and a group of people involving some other doctors and terminally ill patients filed a suit against Washington’s ban and PAS. The Supreme Court ruled in favor of Washington. The court stated that they were protecting the U.S’s rights and liberties.

Interviews: 

1. Name: Angel Means, MS, RN, Director of End of Life Services

    Telephone: (802) 860-4410

    Email Address: means@vnacares.org

2. Name: Ursala Anne McVeigh, M.D.

    Telephone: (802) 847-5536

    Home/ Business Address: Medical Center Campus, 111 Colchester Avenue, Burlington VT, 05401

3. Death With Dignity Vermont

Panel Day Reflection:
    I thought that panel day was very interesting. I enjoyed hearing all of the panelists point of view on the topic of physician assisted suicide. In my room 

Dr. Robert Macauley

there where two panelists that were pro and two that were con. Dr. Macauley, a doctor and ethicist at Fletcher Allen and Claire Weis, a hospice nurse were both con. There arguments included information about how many people, according to the numbers in Oregon, would actually choose to have physician assisted suicide in Vermont. They also said a few things about how the relationship 

Dr. David Babbott

between patients and doctors would change because doctors would never be able to simply say “ what can i do for you?” without having the patient say something like help me die. The pro side consisted of retired Dr. Babbott and Marnie Wood, a
sister of a women who choose physician assisted suicide. They said that it would make the end of terminally ill patients lives so much more comfortable and if we do something similar with our pets why can’t we do this for our loved ones? They also said that not all doctors have to participate and no one, patients or doctors, will feel pressured to participate in the process of physician assisted suicide.

Marnie Wood

    I like how the panelists would debate with each other a little bit. I heard that the panelists in other rooms would just answer the same way or with one word answers. But in my room i felt they gave us good information and point of view. I wish they could have given us a bit more new information, but it was good to hear things first hand instead of reading them off the Internet. Dr. Babbott was fun to listen to, I liked how engaged he got with the audience and all of the facts he could say off the top of his head. Very interesting to listen to. Overall I think it was a good experience and it helped me understand my topic a little better.

Stakeholders:

The con side to physician assisted suicide has many points to support there side. They bring up four points. One: As seen in the Netherlands when they legalized assisted suicide in 1973. The country started abusing the law and one opposed doctor said that once we start using killing as a solution to one problem, tomorrow it will become the answer to a hundred problems. People also believe that eventually, if the law is legalized, the outlook on suicide will change from “bad” to “good’. Third, it would change the way doctors look at their sickest patients, if the patient were not around anymore money and health care supplies would be saved. Lastly, when terminally ill patients are approved for assisted suicide there is an implied message that their life is worth less than other suicidal people and their life is not worth being protected.

http://ic.galegroup.com/ic/ovic/ViewpointsDetailsPage/ViewpointsDetailsWindow?displayGroupName=Viewpoints&prodId=OVIC&action=e&windowstate=normal&catId=&documentId=GALE|EJ3010164284&mode=view

The pro physician assisted suicide side has done a lot of research to prove that death rates did not go up in the poor, elderly, women, minorities, uninsured persons, chronically ill and less educated patients, because the legalization of physician assisted suicide. A group of people working with the University of Utah found out that elderly people, women, and the uninsured living in the state of Oregon, did not die in disproportionate numbers since the law has been legalized. The same goes for minorities, the poor, minors, people with chronic physical or mental disabilities or chronic but not terminal illnesses. The rates of deaths have not spiked as a result of legalizing physician assisted suicide. Some people have also viewed the legalization of this law to be economically friendly. The cost of the lethal drug is $50 and the cost of keeping the average terminally ill patient alive until they die of natural causes is $500,000. There are two arguments that are very strongly rooted into American society, the first is the total right to personal autonomy, that people have an individual right to self-determination: the control of time, place and manner of death. The second is the belief that killing or ending a life is an acceptable answer to end suffering.

http://ic.galegroup.com/ic/ovic/ViewpointsDetailsPage/ViewpointsDetailsWindow?displayGroupName=Viewpoints&prodId=OVIC&action=e&windowstate=normal&catId=&documentId=GALE|EJ3010035291&mode=view    There are valid point for both sides and they both have strong evidence to back up their points. This is why it is such a controversial issue and why it hasn’t been decided as a state wide ban or law yet. But in Vermont it is in the legislature right now and will soon be decided.

Interview Reflection:

                I interviewed a woman named Angel Means who is the head of end of life care with the Vermont Nurses Association. I thought it was very interesting what she had to say. She told me the difference between palliative care and hospice care because I never really understood the difference before. I also learned that she was a respiratory therapist for 10 years before becoming a nurse. Hospice nurses really work on making sure that their patients are comfortable in their last months. A person can only have hospice care if they have 6 or fewer months left to live. The nurses will go to patients’ homes to help them and make sure they are comfortable.  Angel didn’t state her view on PAS, but said that she would rather focus her energy on making people more comfortable.

                My interview didn’t go exactly as planned because when I called Angel the line was busy. So I emailed her and she told me that she had a very busy day and that she is sorry she didn’t make it. But she told me that the best thing for her would be an email interview because she didn’t know when she would be able to talk on the phone for sure. But I still feel like I got good and interesting information from her even though it was in person or on the phone. She was very helpful. I didn’t think that not being able to talk over the phone was that big a deal because I don’t have a large problem talking to people I don’t know over the phone.