Tayler Lamagna

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End-Of-Life-Decision-Making

The process of end-of-life-decision-making is complicated and does not only

concern the dying patient. Whether or not we should have the option to die with
physician assisted suicide (PAS) poses many questions. In the article, Assisted Suicide:
Do We Own Our Bodies? by Jarmo Tarkki (JT), a 91 year old woman lived beyond the
life expectancy of professionals. JT questions PAS and if dying patients are competent to
make such decisions due to things like depression. In the article, A moral defense of
Oregons physician-assisted suicide law, Michael Gill (MG) proposes that a law
permitting PAS is not a bad idea. MGs article focuses on the fact that he does not believe
PAS is either a good or bad idea rather patients should have a right to make their own
decisions.
JTs article discusses the issue of body ownership. JT explains that some people,
based on their beliefs, do not own their body, but God does. Therefore you do not have
the option to decide whether or not you want to die. This is only an issue to those who
believe in God. If you dont believe in God, there is no question that you do, in fact, own
your body and you do have the right to decide if you want to die. JT also questions when
the right to die can become the duty to die (Tarkki, 111). For example, someone who
knows theyre going to die who then chooses to die to decrease the financial burden on
their family is someone who has the duty to die. I believe that this will eventually
become normalized through time and people will become more comfortable with PAS.
Im not personally comfortable with JTs use of the double effect in regards to PAS.
The double effect is an ethical justification for opioid use when the goal is relief of
suffering, not the hastening of death which may occur as an unintended but not entirely

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unforeseen effect (Tarkki, 110). Although its a good way for physicians to go above the
law and unintentionally end patients lives, I believe we need to deal with the issue in a
more straight forward way to avoid this sneakiness. I do not believe that the option of
PAS will become the obligation to die. There are patients who are going to die anyways
and medicine cannot preserve their lives any longer. The limitations for an individual to
be able to chose PAS for themselves should include a fatal diagnosis, 15 day waiting
period, and a psychological evaluation to make sure there are no mental illnesses present.
Another issue JT did not discuss is that life expectancies given to patients with fatal
diseases are not actual. If a doctor says you have 6 more months to live, it could be
anywhere from a number of days to years. JT tells the story about the 91 year old woman
who was supposed to die within a couple days in the hospital that now lives a happy life
today. Some may argue that PAS would allow people to decide to end their life early
because they could possibly live longer than what the doctors tell them. I believe in the
end it should be up to the patient to decide whether or not they want to suffer through and
see if they will make it longer or not.
MG believes that patients should have the right to choose whether or not to end
their lives. Opposers of PAS worry that the patients autonomy is going to be taken from
them if they engage in PAS. Because the patient is going to die anyways, their autonomy
will end regardless and they should have the ability to choose how they want to die. The
idea that the patient should be healthy to make end-of-life decisions is a huge limitation
and is irrelevant according to MG. Physicians should participate in PAS, according to
MG, because the goal of medicine isnt always to promote health. These are patients who
are going to die and medicine cannot preserve their lives. There is also concern that

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physicians will be forced to participate in PAS. Physicians are not forced to do anything
they dont believe in. If a patient wanted PAS and the physician declined, the patient
would then have find a physician who would. According to MG, physicians cannot
preserve the lives of terminally ill patients but instead can reduce the suffering.
Both JT and MG present interesting points of view on the controversial idea of
PAS. There is not one correct way in determining end-of-life decision making. I dont
believe there should be any limitation to a patients autonomy when it comes to PAS. JTs
point of patients being incompetent due to depression is irrelevant. How can someone
who is terminally ill not be depressed? In the end, all terminally ill patients should have
the right to decide how they want to die. PAS doesnt destroy autonomy, but rather it
encourages autonomy and gives the patient the option to relieve unnecessary suffering.