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Biomedical Ethics Case Study: Vulnerable Groups’ and Doctor-aided Suicide
1. FACTS
The case is centred on discussing the issues of morality regarding the legalization of PAS
and how it would affect specific groups of the population. Key facts include:
• Many U.S states, as well as some countries, have passed laws and legislation in the
matter to allow the use of PAS to terminally ill patients.
• Some people also point out that page making PAS legal may lead to elder abuse,
disabled abuse, economic abuse and other forms of disadvantageous abuse.
• Opponents claim such groups could be forced to opt for PAS out of poor health care or
due to costs and perceptions about their condition.
• Supporters of the practice argue that critical measures can be adopted to avoid cases of
misuse and that restrictions on PAS compromise patients' self-determination.
2. PRINCIPLES/VALUES
In this case, various vital moral values and principles are at stake:
Autonomy: Autonomy, or the freedom of individuals to make choices concerning their
existence and the existence of others, is one of the critical points. This element involves
respecting the rational agents and enabling them to freely choose since, according to Kant, this
amounts to respecting their persons (Beauchamp and Childress 121).
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Nonmaleficence: This leads to a consideration on whether helping in a patient’s death
violates medical ethics as articulated in the principle of ‘first, do no harm’.
Beneficence: This paper will also argue that physicians have a professional responsibility
that requires them to act in the patient's best interest, and in most cases, this means relieving the
patient's suffering at the time of dying.
Justice: Another justice consideration is equity in healthcare and healthcare
discrimination of susceptible groups.
Dignity: Human dignity and what qualifies as a ‘good’ death is the crux of the PAS
discussion.
Sanctity of life: Some claim that life holds intrinsic value and must always be
safeguarded, irrespective of the characteristics of the particular life or the patient's desires.
3. PROBLEM
The central ethical question is: Is it right for a society to allow physician-assisted suicide
despite problems that may arise concerning the vulnerable group of people?
4. ALTERNATIVES
a) Prohibit PAS entirely: This option adheres to the principles of nonmaleficence or doing
no harm and sanctity of life or preservation of life. It is intended to prevent specific subsets of
people from being forced or pressured into something or to safeguard them from possible abuse.
However, it inhibits freedom and could allow some patients to suffer for longer than necessary.
b) Legalize PAS with strict safeguards: It seeks to start by respecting the decaying
Autonomy but also is protective of vulnerable persons. Some of the measures entail
psychological tests, waiting times, and committees supervising the patients. The method
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proposed under this option is to procure and distribute PAS in a way that reduces the probability
of its misuse.
c) Legalize PAS without restrictions: This other option raises individualism to the highest
level but may put the most susceptible population in more danger. It needs the input of the
general public by granting individual freedom over and above the protection of society.
5. DECISION
My analysis makes me abide by my view that physician-assisted suicide should be legal
with certain conditions to prevent the exploitation of vulnerable groups.
6. DEFENSE
Rejecting the legalization of PAS altogether or approving it with little protection for
patients' rights and dignity harms the cardinal ethical values in play in this case most. This
approach confirms respect for an individual's freedom since no one will be forced to take a
particular treatment for an illness he or she has not contracted.
Autonomy and dignity of humans form the main principles of Kantian ethics because
people are rational beings. Insofar as we respect the Autonomy and dignity of patients, we permit
them to make rational decisions on how they want to be treated in terminal illness, especially the
right to PAS. However, Kant also speaks about the categorical imperative, which forbids doing
anything that cannot be the general law. It calls for various measures which would prevent PAS
from acting as a tool that further exposes the vulnerable in society.
Utilitarianism, which is a teleological ethical theory that mandates the promotion of the
greatest good, can help champion this stand. Thus, if granting a legal option of PAS, necessary
safeguards will prevent further suffering for terminal patients who have chosen it and avoid
adverse effects on the society that Singer believes to be true (Singer 148). This approach
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recognizes the fact that the quality of life is also essential, especially during the terminal periods
of a patient's life.
With regard to justice, one has to think about discrimination or unequal opportunities in
being treated by a healthcare provider. Thus, through using higher degrees of protection
measures that also include mental health tests, the waiting period, and oversight committees, we
shall be in a position to minimize the likelihood of the exploitation of those classes of people
whose lives are most important to them through the passage of PAS. These measures can help
determine cases where a person may be choosing PAS not because of the palliative care or lack
of care but rather PAS.
Significantly, regulating PAS with some guarantees does not at all push people to this
decision. It only offers an option for certain people who fit specific requirements and who want
to have control over the manner of their deaths. It respects the fact that there are different values
and ethical standards in society, but at the same time, it gives leeway for a person to make their
own choices.
Opponents will state that there is the creation of a 'slippery slope' whereby any form of
legalization for PAS paves the way for other forms of euthanasia and devaluation of some lives.
Unfortunately, this argument overlooks the efficiency of properly organized legal protection and
does not take into account the over-the-counter assisted suicides that take place today without
official approval.
Moreover, it is striking that, for example, the case of the conditions for legalization of
PAS in Oregon, United States, described above, has not shown that these shrill tones – abuses or
imbalance of the proportion of growth of PAS or different kinds of death proportion threats to
vulnerable groups are real (Battin et al. 593). Thus, one could assert that with proper measures of
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protection and supervision, one can use PAS in a way that will take into account the principle of
openness and Autonomy but avoid harm to those who cannot consent to receive treatment.
7. REFLECTION
In eradicating the source of this ethical concern, society should educate on providing
meaningful end-of-life care, mental health care, and social services to the affected individuals.
Thus, by making sure that all people can receive proper, quality end-of-life care, one would not
become coerced into making the PAS decision because adequate and appropriate care or support
was unavailable or insufficient.
One may argue against this decision, stating that, even with safeguards in place that
legalize PAS, some lives are considered less valuable than others and that suicide is an
acceptable way out for those who are suffering. To that, I can assert that actual PAS laws, upheld
as they should, respect the notion of Autonomy and dignity. When people rely on them to make
the right choices concerning specific aspects of their lives or their existence, it exhibits a sign of
respect that people have for the value of life and the autonomy of individuals. Also, it will be
possible to enhance the manifold protection and the optimization of the available palliative care
services to guarantee that the PAS option stays limited to the unbearable dreadful suffering that
patients experience.
Thus, the legalization of PAS under appropriate measures is an ethical justice that
delivers the patient's right to self-determination while preventing harm to elderly or mentally ill
patients. Thus, if such laws are correctly applied and supervised, society can offer more physical
options for an end-of-life process together with pursuing justice and the meaning of life.
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Works Cited
Beauchamp, Tom L., and James F. Childress.FPrinciples of biomedical ethics. Edicoes Loyola,
1994.
Finlay, Ilora G., and Rob George. "Legal physician-assisted suicide in Oregon and the
Netherlands: evidence concerning the impact on patients in vulnerable groups—another
perspective on Oregon's data." Journal of Medical Ethics 37.3 (2011): 171–174.
Singer, Peter.FThe expanding circle: Ethics, evolution, and moral progress. Princeton University
Press, 2011.
