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Physician Assisted Suicide Survey of Issues in

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					PHYSICIAN-ASSISTED SUICIDE




THE MORAL ISSUES
PROHIBITIONS
• STANDARD ARGUMENTS
  – THEOLOGICAL (SOCRATIC) --- GOD GIVES LIFE
  – SOCIETAL (ARISTOTELIAN) --- DENY A RESOURCE
  – ECONOMIC (FEUDAL) --- DENY KING A TAXPAYER
• ORTHODOX JEWISH
  – ONLY “GOSSES” (ACTIVELY DYING) REMOVE LIFE SUPPORTS
• EASTERN ORTHODOX
  – HUMILITY AND THE EXAMPLE OF THE CROSS
• ROMAN CATHOLIC
  – RESPONSIBILITY TO GOD (MASTER OF LIFE)
  – STEWARDS OF OUR LIVES
• PROTESTANT
  – FORBIDDEN BY COMMANDMENTS
  – OUTSIDE DIVINE PROVIDENCE
SECULAR ARGUMENTS FAVORING
PHYSICIAN-ASSISTED SUICIDE
• AUTONOMY
  – EXERCISE CONTROL OVER MATTERS DIRECTLY
    AFFECTING INDIVIDUAL
  – PROCEDURAL SAFEGUARDS PROTECTING
    AUTONOMY
• PLURALISTIC SOCIETY
  – RIGHT TO DETERMINE LIFESTYLES, DEATHSTYLES,
    AND TIME AND MANNER OF DYING
• CAUSAL ARGUMENT
  – NO MORALLY RELEVANT DIFFERENCE BETWEEN
    “KILLING” AND “LETTING DIE”
  – “INTENTION” NOT RELEVANT
  – PHYSICIAN’S ROLE AS “HEALER” INCLUDES ULTIMATE
REASONS AGAINST: “FROM THE BEDSIDE”
E.D. PELLEGRINO


•   PAIN RELIEF IS POSSIBLE
     – MALPRACTICE IF NOT PROVIDED
•   RESPECT FOR AUTONOMY REQUIRES NOT TALKING ADVATAGE
    OF THE VULNERABLE AND SUGGESTIBLE
•   ADVANCE DIRECTIVES TO CONTROL DYING
•   MORAL ABANDONMENT NOT TO SUFFER WITH PATIENT
•   LAST GIFT TO FAMILY
•   UNDERMINES TRUST IN PHYSICIAN
•   DESENSITIZE THE PROFESSIONAL
•   DEVALUES GROUPS IN SOCIETY
•   MANAGED CARE = MANAGED DEATH?
•   UNDERMINES DISTINCTION BETWEEN “KILLING” AND “LETTING
    DIE”
•   SLIPPERY SLOPE: LOGICAL, PSYCHOLOGICAL, EMPIRICAL
OREGON’S COMPLIANCE CHECKLIST
•   PHYSICIAN MAY CHOOSE WHETHER TO PARTICIPATE IN PAS
•   PHYSICIAN WHO ELECTS NOT TO PARTICIPATE MAY NOT ABANDON PATIENT
•   PATIENT QUALIFICATIONS FOR PAS
      – AGE --- AT LEAST 18
      – RESIDENCY --- ONLY RESIDENTS OF OREGON
      – CAPABILITY --- ABLE TO COMMUNICATE AND FREE OF MENTAL ILLNESS OR
        DEPRESSION
      – VOLITION --- FREE OF COERCION
      – TERMINAL ILLNESS --- 6 MONTHS TO DEATH
•   INFORMED DECISION --- DIAGNOSIS, PROGNOSIS, RISKS, ALTERNATIVES
•   TWO ORAL AND ONE WRITTEN REQUESTS
      – 1ST ORAL 15 DAYS BEFORE PRESCRIPTION; 2ND ORAL 15 DAYS AFTER FIRST;
        WRITTEN 48 HOURS BEFORE PRESCRIPTION
      – PHYSICIAN INQUIRIES INTO REASON FOR REQUEST
•   TWO WITNESS TO REQUEST; NOT PHYSICIAN
•   PATIENT MAY RESCIND AT ANY TIME IN ANY WAY REGARDLESS OF MENTAL
    STATE
•   ATTENDING PHYSICIAN --- OVER ALL RESPONSIBILITY FOR PATIENT
•   REFERRAL TO CONSULTING PHYSICIAN REQUIRED
•   TWO FORMS TO OREGON HEALTH DIVISION
•   PRESCRIPTION MUST BE SELF-ADMINISTERED

				
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posted:9/25/2012
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