End of Life (Physician-Assisted Suicide)

End of Life (Physician-Assisted Suicide)


Physician-Assisted Suicide (PAS)

The debates over physician-assisted suicide have been going on for a while. The arguments support and oppose physician-assisted dying for moral, ethical, and legal reasons. It is sad but understandable that some patients suffering from a terminal and painful illness may decide that death is the right thing to do. However, permitting physicians to engage in assisted suicide would pose serious risks to society and be difficult to control. Legalizing physician-assisted suicide may give peace of mind to a few people with a terminal illness, who may be unaware of the resources available to them, but it has huge negative implications and consequences for the many who suffer from a terminal illness and the physicians who care for them (O’Rourke et al., 2017). Amid inconsistencies in ethical, professional, and legal interpretation of physician-assisted suicide (PAS), this paper elaborates on pro and anti-PAS arguments that form the basis of laws while presenting a personal perspective.

Technical Aspects

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Patients grappling with life-threatening conditions such as illnesses and injuries are susceptible to lengthy hospitalization, increased care costs, and compromised quality of life. Terminally-ill patients often inflict an economic burden on healthcare organizations and families since they rely massively on hospice and palliative care interventions. In events where the plausibility of recovery is lacking or changes of survival are minimal, the patient’s relatives or other competent representatives may opt for physicians assisted suicide as a strategy of alleviating pain and preserving patients’ dignity during end-of-life care.

In this sense, physician-assisted suicide entails a scenario where a physician intentionally helps a patient terminate life by providing drugs for self-administration upon the patient’s voluntary and competent request (Frontalis et al., 2018). The average threshold for practicing PAS is the presence of unbearable suffering such as pain without the probability of recovering and competent decisions from patients or their representatives, including parents, family members, or attorneys. In many instances, however, terminally-ill parties lack the much sought-after competency to make informed decisions regarding their choice of PAS. This factor jeopardizes the practice by facilitating contradictions among the four bioethical principles: beneficence, non-maleficence, autonomy, and justice. As a result, the decision to authorize or legalize physician-assisted suicide (PAS) depends massively upon interpreting the interplay between bioethical principles and a thorough assessment of contextual issues.

Public Policy

Public health policies seek to protect people from health threats and eliminate conditions that compromise people’s health and well-being. One of the most profound strategies to promote public health is the provision of quality palliative and hospice care. Frontalis et al. (2018) define palliative care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illnesses, through the prevention and relief of suffering using early identification and impeccable assessment and treatment of pain and other problems, physical, psychological, and spiritual” (p. 407). When considering the rationale of palliative care in improving patient health and eliminating struggles for their families, it is essential to note that physician-assisted suicide (PAS) contradicts the overall objectives of quality hospice and palliative care.

Physician-assisted suicide is a legal and ethical issue facing healthcare providers in end-of-life care. According to Barsness et al. (2020), PAS is a subject of public policy scrutiny in the United States. In this sense, only California, Colorado, Hawaii, Maine, Oregon, Vermont, Washington, and the District of Columbia have legalized physician-assisted suicide. Also, the Montana Supreme Court ruled that the PAS does not conflict with Montana public policy. Other states prohibit physician-assisted suicide by punishing it through laws. The ongoing discussion about the ethical, legal, and professional thresholds for PAS may convince the remaining states to legalize PAS in the future.

The discussion about legalizing physician-assisted suicide entails interpreting the four bioethical principles and the moral backing of terminating a patient’s life. According to Varkey (2020), ethics is an inherent and inseparable concept of clinical medicine because healthcare professionals should benefit the patient, avoid or minimize harm, respect the values and patient’s preferences, and provide services that resonate with impartiality and equality, and justice. Although these ethical principles form the basis of nursing practice, it is essential to note that the plausibility of recovery represents the goal of delivering patient-centered centered care. As a result, legalizing physician-assisted suicide (PAS) can uphold the beneficence and autonomy principles while violating non-maleficence obligations and patient justice. Therefore, health policymakers must decide the future of PAS by consolidating insights from professionals, ethical standards, and religious doctrines of human life.

Arguments for and Against Physician-Assisted Suicide

The US standards of excellent medical care allow terminally-ill patients to decline unwanted, burdensome treatment and refuse supportive strategies such as cardiopulmonary resuscitation and mechanical ventilation (O’Rourke et al., 2017). However, physician-assisted suicide (PAS) entails medically terminating a patient’s life. Therefore, administering medication to cause death translate to an act of killing the patient. This consideration forms the basis of pro and anti-PAS arguments that narrow down to the tenets of patient autonomy, beneficence, non-maleficence, and justice.

Arguments for PAS revolve around respecting patient autonomy and the process of relieving suffering. In this sense, supporters of physician-assisted suicide argue that patients have the right to decide care trajectories and medical decisions (Fontalis et al., 2018). On the other hand, physicians can uphold patient autonomy by assisting them to terminate their lives in the event of irreversible health conditions. Therefore, PAS remains ethical, considering that patients voluntarily and competently request it to relieve suffering.

Conversely, opposers of PAS cite the inconsistencies surrounding upholding patient safety at the expense of other bioethical principles such as beneficence and non-maleficence. According to Ahlzen (2020), the Hippocratic oath prohibits physicians from facilitating patients’ suicide because such action conflicts with the principle of non-maleficence that requires caregivers to avert harm. Another argument against PAS revolves around spiritual principles that prompt caregivers to protect patients’ lives regardless of the situation.

Personal Perspective of PAS

Regardless of the existing debate about the moral and professional backing of terminating a patient’s life in a terminal illness or unbearable pain, I believe that physicians must safeguard patients’ right to life and address conditions that compromise their safety and health. However, this assertion does not overlook the principle of respecting patients’ autonomy to decide care trajectories. Instead, physicians can reserve and uphold patients’ dignity and opinion by granting their refusal to life support care when the probability of recovering is lacking. For instance, the American standard for quality palliative care allows terminally-ill patients to refuse burdensome treatment interventions to alleviate pain and preserve dignity.


Physician-assisted suicide (PAS) is among the processes that attract ethical, professional, and legal dilemmas. The process entails administering medication to terminate a patient’s life, grappling with life-threatening conditions and without the plausibility of recovery. The debate surrounding PAS rests on the interpretation of beneficence, non-maleficence, autonomy, and justice. Regardless of this debate, I believe that physicians and other healthcare professionals protect patients’ lives and not participate in terminating lives. Therefore, I am against physician-assisted suicide and other activities that end a life. Instead of aiding a patient’s suicide, caregivers need to emphasize spiritual and emotional support to help patients cope with suffering and endure dignified end-of-life care.



Ahlzen, R. (2020). Suffering, authenticity, and physician Assisted Suicide. Medicine, Health Care, and Philosophy, 23(3), 353–359. https://doi.org/10.1007/s11019-019-09929-z

Barsness, J. G., Regnier, C. R., Hook, C. C., & Mueller, P. S. (2020). US medical and Surgical Society position statements on physician-assisted suicide and euthanasia: A Review. BMC Medical Ethics, 21(1). https://doi.org/10.1186/s12910-020-00556-5

Fontalis, A., Prousali, E., & Kulkarni, K. (2018). Euthanasia and assisted dying: What is the current position, and what are the key arguments informing the debate? Journal of the Royal Society of Medicine, 111(11), 407–413. https://doi.org/10.1177/0141076818803452

O’Rourke, M. A., O’Rourke, M. C., & Hudson, M. F. (2017). Reasons to reject physician-assisted suicide/physician aid in dying. Journal of Oncology Practice, 13(10), 683–686. https://doi.org/10.1200/jop.2017.021840


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