Oregon's "Death With Dignity" Act should be a national law
Debate Rounds (3)
The process by which patients receive the fatal dose is in place to prevent hasty decisions. First,the law states that, in order to participate, a patient must be: 1) 18 years of age or older, 2) a resident of Oregon, 3) capable of making and communicating health care decisions for him/herself, and 4) diagnosed with a terminal illness that will lead to death within six (6) months. It is up to the attending physician to determine whether these criteria have been met. Secondly, patients who meet certain criteria can request a prescription for lethal medication from a licensed Oregon physician. The physician must be a Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.) licensed to practice medicine by the Board of Medical Examiners for the State of Oregon. The physician must also be willing to participate in the Act. Physicians are not required to provide prescriptions to patients and participation is voluntary. Additionally, some health care systems (for example, a Catholic hospital or the Veterans Administration) have prohibitions against practicing the Act that physicians must abide by as terms of their employment.
Finally, there are steps to be taken for the patient to be given the medication. 1) the patient must make two oral requests to the attending physician, separated by at least 15 days; 2) the patient must provide a written request to the attending physician, signed in the presence of two witnesses, at least one of whom is not related to the patient; 3) the attending physician and a consulting physician must confirm the patient's diagnosis and prognosis; 4) the attending physician and a consulting physician must determine whether the patient is capable of making and communicating health care decisions for him/herself; 5) if either physician believes the patient's judgment is impaired by a psychiatric or psychological disorder (such as depression), the patient must be referred for a psychological examination; 6) the attending physician must inform the patient of feasible alternatives to the Act including comfort care, hospice care, and pain control; 7) the attending physician must request, but may not require, the patient to notify their next-of-kin of the prescription request. A patient can rescind a request at any time and in any manner. The attending physician will also offer the patient an opportunity to rescind his/her request at the end of the 15-day waiting period following the initial request to participate.
Physicians must report all prescriptions for lethal medications to the Oregon Health Authority, Vital Records. As of 1999, pharmacists must be informed of the prescribed medication's ultimate use.
I propose that this act be made a national law, because it's the humane choice, and the parameters for the law make it legally acceptable.
Euthanasia is also one of those issues where many people, including me, sympathise with the arguments both in favour of legalisation as well as those against.
For example, if I saw a badly-injured animal in great distress, suffering a lingering and agonising death, I'd put it out of its misery. That would be the kindest thing to do. However, if I were to extend the same act of kindness to a human being in similar circumstances, I would expect to be charged with murder. Nevertheless, I am opposed the legalisation of euthanasia.
I think we should accept that there is no "right" or "wrong" on this issue: we just have to weigh up the pros and cons to reach a decision on whether or not euthanasia should be legalised based on the balance of the arguments put forward.
My primary concern with legalising euthanasia is that terminally-ill people could be placed under undue pressure to end their lives prematurely and, whilst I recognise the various checks and balances the State of Oregon has put in place to protect vulnerable patients from succumbing to such pressure are robust, it is still open to manipulation and interpretation: no legislation is infallible.
For this, and other reasons, currently, there are very few places in the world where euthanasia is legal but one of those places is Switzerland where perhaps the world's best-known establishment specialising in assisting people to end their lives, Dignitas, is located. This private clinic arranges "accompanied suicide" for clients from around the world. (1)
We need to ask ourselves if assisted suicide is always in a patient's best interest, even though they fully agree to the procedure. Consider, if you will, this tragic but all-too-common scenario:
A couple in their early twenties, both with good jobs, buy a nice house, get married and look forward to starting a family together. However, soon afterwards, the husband is diagnosed with a debilitating and incurable condition. Within months the ailment has rendered him housebound and he has to give up his job. Then, as his illness worsens he requires around-the-clock care so his wife gives up her job to look after him.
As the months turn into years, the wife, though she loves her husband dearly, realises that the best years of her life are passing her by and also that her biological clock is ticking: if she doesn't have children soon she never will. This thought upsets the wife greatly as her main goal in life has always been to have children, and her parents desperately want grandchildren too.
Sadly, her husband's illness has made him infertile and, in any case, looking after young children and her husband at the same time would be a physical and financial impossibility.
One day her parents come to visit the couple and, out her husband's earshot, she discusses her regrets about missing out on a proper family life with them. Her parents are, naturally, very sympathetic and are also concerned about their daughter's long-tem happiness, so, on their journey home they discuss what could be done to resolve the situation.
A couple of weeks later, it is the morning of the couple's wedding anniversary and the wife is opening the mail at her husband"s bedside. One envelope is addressed to both of them and, recognising the handwriting, she realises it is from her father. She opens it and pulls out a greeting card and as she does she discovers it also contains some documentation: two air tickets to Zurich, one return and the other one-way, together with some gift vouchers from Dignitas.
Inside the card her parents had written: "Happy wedding anniversary but we think it would be best for everybody if this was the last."
The immediate reaction of the wife is shocked embarrassment while her husband is, understandably, outraged. However, as his wife explained the background to the incident to him he becomes calm and reflective, and finally he turns to her and says, "Darling, I love you with all my heart and I always will, but you deserve to be with a man that can give you what I never will be able to: children and a normal family life; but whilst I am still around that will never be possible. You have sacrificed a lot for me over the years and my conscience won't allow me to be any further burden on you. It's time for me to make a sacrifice for you for a change, but don't feel sorry for me, I've always wanted to visit Switzerland."
This harrowing tale illustrates how a terminally-ill man reached the decision to end his life prematurely by being prompted to do so by his relatives, even though they were well-meaning.
Furthermore, there are some families who are more motivated by financial gain and sometimes the beneficiaries of a terminally-ill patient's will or life insurance policy might be anxious to get their hands on the money without delay. The prospect of ready cash can be a powerful incentive for them to put undue pressure on the patient to take his life early.
Other patients might decide on euthanasia mainly because they feel neglected. In evidence given to the Canadian Senate Committee on Euthanasia and Assisted Suicide one expert stated: "I have seen . . . AIDS patients who have been totally abandoned by their parents, brothers and sisters and by their lovers.
In a state of total isolation, cut off from every source of life and affection, they would see death as the only liberation open to them.
In those circumstances, subtle pressure could bring people to request immediate, rapid, painless death, when what they want is close and powerful support and love." (2)
In conclusion, there are many reasons why euthanasia should be permitted but I hope you will agree that the prospect of ending human lives unnecessarily early when that is not in the patients' best interests means that we must err on the side of caution and resist calls for it to be legalized.
ms_duckett forfeited this round.
I'd like to point out, that while my opponent is correct in stating that no law is infallible, I can assure you that no law in the United States will allow a man to take his own life simply because he is unable to produce children. While I applaud my opponent for his in-depth hypotheticals, I believe they are a misrepresentation of what actually occurs in Oregon and Washington state.
Take this as an example:
There is a man living in a state such as Louisiana who is dying due to necrosis of his liver tissue. There is nothing they can do for this man, as he was previously an alcoholic and his liver sustained severe damage. He is a veteran in the war, has children and grandchildren, and has lived a full, happy life, but he is ready to die.
He asks the doctors how it will happen, they say his liver will fail, followed shortly by the rest of his organs. It is likely this will be a several-day process. He asks how long he has, and the doctor simply shakes his head; not long at all. He then asks if it will be painful and slow, and the only reply given is that they can try and manage his pain. He loves his wife and kids, and tells the doctor he doesn't want them to see him suffer. Offhand, a nurse mentions that it's a shame he doesn't live in Oregon, he could die with dignity. He asks the doctor about it, and he tells him that he would have to live in Oregon to receive the drug. He says he'll move to Oregon, when the doctor tells him he won't live long enough to establish residence.
Slowly, the man's health starts to decline. He gets thinner and thinner as the doctors pump more fluid into his system to prolong the process. He moves a hospital bed into his home, so he doesn't bother his wife with the machines. And one day, his wife and eldest son find him doubled over in pain on the floor next to his bed, in a pool of his own urine, because he was in too much pain to make it to the restroom. It has been only two months since his diagnosis.
He moves permanently into the hospital in which he was diagnosed, under careful watch of his doctor and his children at all times. Finally, and one-by-one, his organs shut down. His grandchildren say their final goodbyes, and he dies in his sleep one night, with his wife at his side who was awakened by his screams of pain. He did not choose this death.
I realize that was a deep and graphic example, and my opponent may argue that this man lived a full life. Take this as another example.
A woman, age 23, a native of the state of Oregon is diagnosed with stage 4 colon cancer, with only six months to live. Her grandfather was a doctor, and so she knows about the Death with Dignity Act, and what her rights are. At 23, she begins the process of hastening her demise.
Months later, after a full psych evaluation, approval from two doctors, and the acceptance of her family, she is given the dosage. The family plans, the woman writes her will, all the while that fatal dosage sits in her bedside table and the woman's condition worsens. It looks as if she might not even live her estimated six months. One day, five months after she is diagnosed, she is able to get out of bed, and it's as if she was never sick in the first place. Coming from a religious family, her family proclaims it a miracle, and when the oncologist tells her that the tumors are vanished, she believes it. But the medication stays in her bedside table.
After being in remission for three weeks she asks what to do with her lethal dosage, then brings it to the doctor to properly rid of it. Though she did not use the drug, it brought her peace to know that she would not suffer and die, and that peace was brought to her family.
See, the great thing about this law is two-fold. One: it ends the senseless suffering of the dying; and two: it brings peace to the minds of those who do not wish to make their families see their pain.
My mother has severe Rheumatoid Arthritis. While this is not a terminal disease, I know what it is like to watch a person suffer day in and day out, and not get out of bed most days. Do I wish her dead? Never. But do I wish she didn't hurt? Every day. Seeing her in that pain and knowing the stories I've previously listed make me certain that if I were terminally ill, I would choose Death with Dignity in a heartbeat. No one deserves to suffer, and no family deserves to witness their loved ones suffering.
I thank my opponent for accepting this topic, and the voters for voting.
Before commenting on my opponent's own scenarios, please allow me to indulge in a short addendum to the scenario I described in the first round wherein the husband agreed to assisted suicide at Dignitas in Switzerland so as to no longer be a burden on his wife, and to give her the opportunity to re-marry and have children.
So, having said her final goodbye to her husband, the wife is sitting in the departure lounge at Zurich Airport reading an English-language newspaper and she is aghast when she reads a headline: "CURE FOUND FOR THE DREADED LURGI". The dreaded lurgi was her recently-departed husband's condition.
"Oh dear!" she exclaimed, "if only I hadn't agreed to help him commit suicide, we could have had a family together after all. Still, never mind, there's no point crying over spilt milk. On the plus side the house all belongs to me now, and, of course, the life insurance money will be of some comfort to me in my time of grief."
So, we can see that, in this case, a young man killed himself in vain, and it is similar to the case my opponent cited where a young woman "miraculously" recovered just before the doctors killed her because it would have been very different if she had taken the lethal dose a few weeks earlier. Then she too would have died needlessly.
But what about the suicide clinics position in all this? In most countries in the developed world health care is funded by the state so that treatment provided according to need rather than the ability to pay. However, in the United States health care is run along commercial lines.
With this being the case, suicide clinics will be in it for the profit and the primary responsibility of the clinics' management will be to the shareholders rather than the patients, creating an obvious potential for conflicts of interest.
Let's look at the way estate agents are remunerated, for example. The more houses they sell, the more they get paid, so there is an obvious incentive for them not to be completely open and honest and about properties with potential buyers.
It's a similar situation with used car salesmen, or investment bankers, or lawyers, or any amount of other professions where pay is performance-related.
So will we see doctors in suicide clinics paid according to how many patients they kill? I hope not, but even so, there will be pressure on them to make money for the clinic.
Let's now consider the position of a physician in a suicide clinic, Doctor Kindheart, who is very conscientious and who ensures that no patient takes their own life unless there is absolutely no possibility of recovery and their decision was wholly their own made without any undue influence from their family.
However, this professional approach means that he assists many fewer patients to take their lives than his colleague, Doctor Snuff, who dispatches patients on a wholesale basis without due regard for medical ethics.
One day the hospital manager calls Dr Kindheart into his office.
"What the hell are you playing at, Kindheart?" the manager rants. "The Cohens are our best clients, we've euthanized three wealthy relatives of theirs so far this year but when you and Dr Snuff were asked to sign off the fourth, you refused to play ball."
The manager then takes out a report and reads from it. "Dr Snuff"s considered medical opinion," he says, "is that 'the patient is suffering from acute Allergic rhinitis with severe complications. It is only a matter of time before the patient dies and his life isn't worth living', while you have concluded that 'the patient is suffering from allergic rhinitis, more commonly known as hay fever, which is a treatable condition and not, in itself, fatal. The patient's condition is complicated by the fact that he is also clinically depressed and, therefore, is not in a fit state of mind to give his consent to be euthanized.' What do you say to that, Kindheart?"
"My report," replied Dr Kindheart, "was written in strict accordance with the guidelines and, furthermore, I consider it my professional duty to protect the interests of vulnerable patients from abuse of the system from families with vested interests in their deaths. In this case, as beneficiaries of the patient's estate and I concluded that the Cohen family had put their own financial interests ahead of the patient's best interests. I'm sorry, sir, but I firmly believe in upholding medical ethics."
"Screw medical ethics, Kindheart," raged the manager "I'm running a business here, not a charity, and unless you get your act together you'll be heading for the door. Now get out of my office and get back to what I pay you to do: that's kill patients."
That manager is not a very nice man, is he boys and girls? But ruthless businessmen operating in cut-throat commercial marketplaces where competition is fierce cannot afford to be nice and that's another reason why I affirm that assisted suicide should not be legalized in the United States.
No votes have been placed for this debate.
You are not eligible to vote on this debate
This debate has been configured to only allow voters who meet the requirements set by the debaters. This debate either has an Elo score requirement or is to be voted on by a select panel of judges.