Draft paper

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Brittany Roebuck

Professor Bertsch

ENGL 1100

8 April 2018

Should Physician-Assisted Suicide Be Legal?

In 1997, Oregon became the first state to enact the Death with Dignity Act (DWDA).

This act allows a person with a terminal illness to make the decision to end their own life with a

lethal medication prescribed by a physician. Since then, only four other states have legalized

physician-assisted suicide. I’m interested in this topic for two reasons. The first being I am

currently making a career change and going back to school for nursing. I ultimately want to

become a hospice nurse. I believe this is a very relevant topic in the field of providing comfort

care to terminally ill patients. The second reason is because my grandpa died of lung cancer and I

spent the majority of his last three months taking care of him. His time between diagnosis and

when he passed was very quick but also very painful. I can’t imagine if he had lived for another

year or more how difficult it would have been for him, myself, and my family. We never

discussed the option of physician-assisted suicide because it is not an option in the state of Ohio.

My grandpa had a passion for life and living it to the fullest. Knowing him well, I think if the

option had been available, it would have been something he would have considered. I wanted to

dive into this topic and find out why in the past eleven years this law has only been passed in five

states. So, I decided to do some research of my own to find out the answer to my question:

Should physician-assisted suicide be legal in every state?

When I started researching this topic, I found a lot of opposition. There are many reasons

people are against physician-assisted suicide. One being religious reasons. Religious

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organizations argue that human life is sacred and someone ending their own life, no matter the

circumstances, is morally and spiritually wrong (“Right to Die” 2). The American Medical

Association also objects to physician-assisted suicide. They argue that physicians are meant to

heal not kill (2). Another argument states that allowing physician-assisted suicide would leave

people with mental and physical disabilities open to being coerced into ending their own lives. If

someone believes they may be a financial or physical burden on their family, they may be

tempted to consider physician-assisted suicide simply to relieve that burden. Some people think

instead of helping people die, doctors and policy makers should be working on improving end-

of-life care (2). There is also an argument that minorities have less access to health care and

receive less treatment as a result. This may make a pill to end their lives feel like the only option

for them. (2)

As far as support for this movement, well, there’s less of it. Supporters argue that if a

person has the right to refuse medical treatment, they should also have the right to end their own

lives before they lose the ability to take care of themselves (“Right to Die”2). People argue that

the government has no right to interfere with this choice. Other supporters argue that it shouldn’t

even be considered suicide. If a person is diagnosed with a terminal illness with less than six

months to live, this would simply be aiding in the natural dying process. Supporters also argue

that they have no intentions of telling other people what to do when the time comes, but if they

end up with a terminal illness that causes them to lose their ability to take care of themselves and

causes extreme amounts of pain, they wat the option to end their own lives with dignity. Simply

have the ability to be in control at the end of their life is what most people who support

physician-assisted suicide are interested in.

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I decided to conduct some research of my own so that I could have enough information to

make a decision about my question. First, I wanted to know the guidelines of the Death with

Dignity Act law in Oregon. In order to use DWDA, the patient must be a resident of Oregon, 18

years or older, mentally competent, and be diagnosed with a terminal illness with six months or

less to live (within reasonable medical judgement) (“How to Access and Use Death with Dignity

Laws”). Two physicians must determine whether all these criteria have been met. You must

make two oral requests to your doctor at least fifteen days apart. You must also make a written

request witnessed by two individuals, one of whom is not related to you, entitled to any portion

of your estate, or an employee of the health care facility caring for you, or your physician. Once

your prescription has been filled, it is your choice to use it or not. You must be able to take the

medication on your own. If at any time your disease progresses to a point where you can no

longer administer the medication yourself, no one else can administer it for you (“How to Access

and Use Death with Dignity Laws”).

The next thing I did was watch a documentary called How to Die in Oregon. I wanted to

gain some perspective from people who were actually considering using the DWDA. The

documentary mainly follows a woman named Cody Curtis who was diagnosed with liver cancer

in November 2007. This was the type of cancer that has no good chemo or radiation options. The

option was surgery to go in and remove as much of the cancer as possible. After her first surgery,

she was in the ICU for fifty days. She had to learn how to walk again and couldn’t do anything

on her own for six months. She talks about never wanting to be in that position again. Her cancer

came back with no good options for treatment. She chose to use the DWDA as her just in case

option. She says she doesn’t want an extra three months if they are terrible. Her doctor discusses

coming to her decision to write Cody the prescription. She says she understood it was the best

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option for her patient to be able to have control. Towards the end of Cody’s disease, the

equivalent of three 2-liter coke bottles worth of fluid builds up around her liver, pushing on her

organs causing her tremendous pain and difficulty breathing. Food no longer tastes good. She

can’t take deep breaths anymore and walking becomes more difficult. She starts developing

infections in her body, causing her to spike fevers of 104 degrees. She goes from taking little to

no pain medication to taking 10 mg of IV morphine every hour and is still in pain. Her doctor

explains to the camera how in order for Cody to die naturally, she would require a hospital bed,

24/7 care, and help bathing and going to the bathroom. She also explains how there is no way to

know how long it will take for her to die on her own. Cody waivers back and forth with whether

she will use the DWDA drugs in order to help her die peacefully. In the end she says, “I thought

I would just drift away but my body is so strong it’s clear that I wasn’t going to drift away, it was

going to be excruciating and long.” (Richardson). She chooses to use the medication to end her

own life, surrounded by her family and her doctor.

Another person talked about in the documentary is Randy Nieldzielski. He is diagnosed

with brain and spinal cancer. This kind of cancer is very painful and has a grim prognosis. He

tries surgery, months of radiation, three types of chemo, and removal of the part of the brain that

controls balance, causing him to stumble and fall all the time. When his cancer came back he

decided he was done with treatment. He tried moving to Oregon but his doctor informed him he

wouldn’t live long enough to establish residency. He was in a hospital bed 24/7 screaming in

pain, he was incontinent, he had double vision, and his tumors made his eyes pop out so he could

no longer close his eyes. He made his wife promise she would help change the law. The

documentary shows her journey to making physician-assisted suicide legal in Washington.

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After watching the documentary, I really got an understanding of how painful it is for

people with a terminal illness at the end of their lives. It was incredibly difficult to watch,

however it really gave me great perspective through the eyes of someone suffering through a

terminal illness. I wanted to gather some information about pain in terminally ill patients. I found

a study that was done to determine just that. 988 patients were randomly selected from six US

cities. 50% reported moderate or severe pain. 29% wanted more pain therapy (Weiss et al 2).

62% wanted their pain therapy to stay the same. 9% wanted to reduce or stop their pain therapy

(2). There were many reasons for this including: fear of addiction, dislike of physical or mental

side-effects, and not wanting to take more pills or injections. Almost half of Americans die in

pain, surrounded and treated by strangers. A CNN/Time poll shows that 7 out 10 Americans

want to die at home (Cloud et al 2). Unfortunately, more than a third spend at least ten days in

intensive-care units. 3 out 5 physicians treating dying patients say they have known the patient

less than a week (2). Many terminally-ill cancer patients die in horrible pain and oncologists

don’t always know how to take that pain away (2).

When my grandpa was diagnosed with stage 4 lung cancer, I didn’t know anything about

physician-assisted suicide. It is not legal in the state of Ohio, and therefore was not on our radar

as part of his comfort care plan. I spent almost every day with my grandpa from the time of his

diagnosis to when he passed. I went to almost every doctor’s appointment. What disappointed

me the most was how short his oncologist was with him. Every time we would see him he would

say that my grandpa’s cancer was “treatable, not curable”. For us, that was a difficult statement

to understand. He didn’t take much time to explain anything or answer our questions. He also

spent the majority of our appointments pushing his clinical study on us. I would have liked to

have found a different oncologist but my grandpa didn’t like to ruffle feathers. I found a quote in

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an article from Dr. Fred Meyers, the chair of internal medicine at the University of California,

about doctors speaking more openly with patients about diagnosis and prognosis. He said, “Be

honest and say, ‘I don’t think I can cure you, but I’m not going to abandon you; you’re going to

get a good consultation, we’ll take care of your symptoms and take care of your family’” (qtd. in

Cloud et al 7). I would have loved this approach from my grandpa’s oncologist. I would have

rather him been honest with us even if that meant being blunt.

Next, I conducted my own research. I asked thirty people the following question: if you

or a family member were dying from a terminal illness that you knew would cause extreme pain

and suffering, would you want the option of physician-assisted suicide? I asked them for a

simple yes or no answer with no explanation. I didn’t want complicated answers, just yes or no,

would you like to have the option? Out of those thirty people, only two said no. That’s less than

1%. I think the key part of the question is would you want the option of physician-assisted

suicide. I don’t know that anyone could answer for sure if they would choose to end their own

life in this situation, however having the option is important.

I dove into this question with an open mind. I wanted to weigh the good and the bad of

the issue. I read the arguments for and against physician-assisted suicide. I’m not a religious

person and though I respect the religious views of others, I don’t think it’s fair to use that as a

reason to keep physician assisted suicide illegal. I also think the argument about doctors healing

instead of harming is not a fair argument. Not everyone can be healed. Death is a part of life and

I don’t belief doctors are doing their patients harm by helping them keep their dignity at the end

of their life. I do agree with the argument that end-of-life care should be better. However, I think

that is a completely different subject. The tipping point for me was after I watched the

documentary. To watch a real person experience real emotion and to see their struggle is where I

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made up my mind. After the documentary, I had a hard time seeing any other answer to my

question. I do believe physician-assisted suicide should be legal in every state. When the DWDA

bill was passed in Oregon, Judge Brown said, “I do not know what I would do if I were dying in

prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to

consider the options afforded by this bill. And I wouldn’t deny that right to others.” (“qtd. in

Right to Die” 1) I couldn’t agree with him more.

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Works Cited

Cloud, John, et al. "A KINDER, GENTLER DEATH. (Cover Story)." Time, vol. 156, no. 12, 18

Sept. 2000, p. 60. EBSCOhost,

cscc.ohionet.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&AuthTyp

e=cookie,ip,uid&db=a9h&AN=3538772&site=ehost-live. Accessed 28 Mar.2018.

“How to Access and Use Death with Dignity Laws.” Death With Dignity,

www.deathwithdignity.org/learn/access/#Eligibility.

Richardson, Peter, Melody Korenbrot, Greg Snider, and Max Richter. How to Die in Oregon. ,

2012. Accessed 27 Mar.2018.

“Right to Die: Do terminally ill patients have a right to die with the assistance of physician?”

Issues & Controversies, Infobase learning, 10 Nov.2016,

http://icof.infobaselearning.com.cscc.ohionet.org/recordurl.aspx?ID=6342. Accessed 28

Mar.2018.

Weiss, Stefan C, et al. “Understanding the Experience of Pain in Terminally Ill Patients.” The

Lancet, vol. 357, no. 9265, 2001, pp. 1311–1315., doi:10.1016/s0140-6736(00)04515-3.