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According to a news report by Kenneth R. Stevens Jr., published on March 10, 2010, neither of the 59 people who sought PAS had a psychiatric evaluation. The report also states that only 1% of all the people who sought PAS have had a psychiatric evaluation, that is only 2 out of 168 people, in the span of last three years in the state of Oregon where PAS is legalized. Oregon Health Department has shown concern about the reduction in requests regarding formal psychiatric evaluation of patients. These patients receive prescriptions in compliance with the Death with Dignity Act (DWDA) but any possibilities of depression stay undiagnosed. An OHSU report stated that in the year 2008, 25% of the patients who had requested PAS were suffering from depression. It should be seen why then only 1% of the patients are advised for psychiatric evaluation. (Kenneth R. Stevens Jr., March 10, 2010)
The same report also goes on to say that the pro-assisted suicide organization Compassion & Choices is found to be involved in most of the PAS cases in the state of Oregon. They were involved in 78% of the PAS cases during last 12 years since it was legalized. With its involvement in 88% of the PAS cases in 2008 and 97% of the cases in 2009, Compassion & Choices is drawing a lot of attention. According to this news report, the members of Compassion & Choices authored the PAS law. It is therefore evident that they would not want to report anything against it for the sake of their reputation. (Kenneth R. Stevens Jr., March 10, 2010)
Elaborating on this issue, the report pointed out that according to OHD, during a period of 7 years, starting from 2001 up till 2009, out of an approximate 10,000 physicians in the state of Oregon, only 109 wrote one or more of the 271 PAS prescriptions. A small proportion of physicians wrote most of these prescriptions. It is surprising that 20 physicians wrote 61% of the total 271 PAS prescriptions. It is even more surprising that 23% of the total 271 prescriptions were written by 3 physicians only! These statistics also fail to satisfy us and lead us to conclude that PAS should not be legalized. (Kenneth R. Stevens Jr., March 10, 2010)
After having gone through both, the opposing and the supporting arguments, I have come to conclude that PAS should not be made legal. When a patient is provided with means to alleviate his or her suffering, physicians may prescribe a drug that may be necessary but potentially lethal. This would mean indirectly assisting the suicide in an unavoidable situation. The laws should distinguish these situations from intentional PAS.
It is also important to understand that allowing PAS might result in undermining the relationship of trust that prevails between a patient and his or her physician. Moreover, historically speaking, the principle aim of a physician should be providing cure and comfort to the patient. If a physician’s role were altered such that provision of comfort also means the intentional termination of the patient’s life, the fundamental alliance would be challenged.
The possibilities of abuse of the economically underprivileged, disabled, and frail, cannot be neglected. If PAS gets legalized, people would indeed be encouraged to welcome premature death due to psychological and social pressures. They would want to relieve their families and society of a burden if they come to see themselves as a burden.
It has also been observed that most people, who willingly opt for PAS, do it because of the fear of death itself. There are already many legal ways of relieving a patient from his or her suffering, for instance sedation that provides comfort. It is also legal for a person to do without life-sustaining treatments. With all these options available to a patient, PAS should not be legalized. If PSA is made lawful, the masses might resolve to hinder the expansion of resources and services that are used for the purpose of providing care to the terminally ill patients who would eventually die.
We should also try to look into the reasons that a patient presents when asking for a PAS. There is a possibility of under treated physical symptoms. Clinical depression may also make a patient ask for PAS. Hence, we need to make sure that patients are provided with a hopeful and lively environment such that they do no think about giving up on a blessing as great as their life. Patients may also be faced with spiritual or psychosocial crisis. The medical assistance should also focus on dealing with this issue.
When debating the issue of PSA, we must also look into the consequences of PSA being legalized and not being legalized. A comparison should be done in order to see if the supporting arguments outweigh the opposing arguments or vice versa. When PSA is prohibited, the patient’s autonomy is limited as far as choosing the mode of his or her death is concerned. A person with a limited life span and intractable suffering is legally authorized to forego sedation. By prohibiting PSA, physicians can maintain a reasonable balance of their obligation and commitment of provision of safe and proper care to the patients. IF PSA gets legalized, these patients may be faced with the risk of shortened life span.
Even though some people may still want assisted suicide and get in trouble if not provided physician’s involvement, it should be obligatory on physicians to disengage themselves from any possibilities of this kind. It should also be ensured that necessary medical treatment is provided to all patients.
IF PAS becomes legal, there are increased chances of euthanasia becoming legal as well. It may mean that anyone who is deemed to be ‘useless’ by the society, be it physically handicapped, homeless, demented, mentally ill, or an elderly person, could be ‘killed’ without his or her consent.