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Physician-assisted suicide/euthanasia


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Topic Question
Physician-assisted suicide and euthanasia
Question: Should physician-assisted suicide and euthanasia be allowed for
terminally ill patients?
- Pro – Yes, it will allow to decrease the suffering of terminally ill patients
and let them die with dignity;
- Con – Does this correspond to physicians’ duty to preserve lives?


Introduction: A Brief Overview of the Issue
Physician-assisted suicide (PAS) – the procedure of intentional assistance
in taking a patient’s life (on voluntary and competent request) by providing
drugs for self-administration provided by a physician;
Euthanasia – the procedure of intentional termination of a patient’s life to
facilitate suffering:
- voluntary – conducted with a patient’s consent;
- non-voluntary – conducted without a patient’s consent (due to current
health condition).


Introduction: US Legislation Related to PAS and
Federal level laws:
- laws regulating PAS are absent;
- euthanasia is prohibited under
general homicide laws.
State-level laws regulating PAS:
- Legalized under common law: 9 states
(CA, CO, HI, ME, NJ, NM, OR, VT,
and WA) and DC;
- Applied court ruling: 1 state (MT);
- Considered illegal: other 40 states.


Introduction: Psychological Impact of Choice
Psychological impact of patients’ decision to have procedures of
PAS and euthanasia on physicians:
- distress and the feeling of guilt (frequently intensive and durable);
- the feeling of powerlessness and anger;
- loss of self-esteem (Rakel, 2016).


Cognitive biases
Socioeconomic status (one of the
Terminally ill patients may experience:
personal differences of terminally ill
- distrust in appropriate palliative care
associated with a higher risk of negative
long-term health outcomes;
- fear of constant pain;
- bitterness toward health care
- varying degrees of vulnerability (Tran et
al., 2022);
- access to end-of-life services;
- unrealistic expectations regarding
treatment efficiency.


Pros and Cons of Euthanasia and PAS
Pros of euthanasia and PAS:
comply with the principle of beneficence:
- staying alive can cause more pain for terminally ill patients;
- ending a life can relieve terminally ill patients from suffering caused by
provide respect for a patient’s autonomy.


Pros and Cons of Euthanasia and PAS Cont.
Pros of euthanasia and PAS:
provide the opportunity to avoid side effects of medications for pain
help avoid distress in terminally ill patients;
assist in dying with dignity without fear of losing physical or mental
reduce the financial burden on a family of a terminally ill person.


Pros and Cons of Euthanasia and PAS Cont.
Cons of euthanasia and PAS:
contradict the principle of non-maleficence:
- do not support the healthcare providers’ obligation to preserve lives;
- violates the integrity of physicians;
undermine the motivation to provide high-quality care to terminally ill


Pros and Cons of Euthanasia and PAS Cont.
Cons of euthanasia and PAS:
undermine patients’ trust in physicians;
discourage the search for new medicines for terminally ill persons;
lessen the respect for the sanctity of human life;
lack proper legal regulation at the federal and state levels.


Debate Questions
1. What is the difference between the procedure of PAS and euthanasia?
2. Is it fair that family members of a terminally ill patient who cannot
make decisions due to health conditions can choose non-voluntary
euthanasia for this person and why?
What other personal differences (in addition to socioeconomic) status
can affect the decision of a terminally ill patient for euthanasia or


Story about Physician-Assisted Suicide
The story of Francie and Charlie Emerick (Aleccia, 2018; website – Time):
Francie and Charlie Emerick:
- were married for 66 years;
- were terminally ill;
- applied the provisions of Oregon’s Death with Dignity law allowing to take
lethal doses of medication;
- died together in 2017.


Aleccia, J. (2018, March 6). This couple died by assisted suicide together. Here’s their
story. Time. https://time.com/5179977/assisted-suicide-couple-death/
Rakel, R. E. (Ed.). (2016). Textbook of family medicine (9th ed.). Elsevier.
Tran, M., Honarmand, K., Sibbald, R., Priestap, F., Oczkowski, S., & Ball, I. M. (2022).
Socioeconomic status and medical assistance in dying: A regional descriptive study.
Journal of Palliative Care, 37(3), 359-365.
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