Physician Assisted Essay

Physician Assisted Essay-87
Both euthanasia and PAS have been distinguished, legally and ethically, from the administration of high-dose pain medication meant to relieve a patient’s pain that may hasten death (often referred to as the rule of double effect) or even the withdrawal of life support.6,7 The distinction between euthanasia/PAS and the administration of high-dose pain medications that may hasten death is premised on the intent behind the act.In euthanasia/PAS, the intent is to end the patient’s life, while in the administration of pain medications that may also hasten death, the intent is to relieve suffering.Like other individuals suffering with chronic medical illnesses, he chose suicide as a means of controlling the course of his disease and the circumstances of his death.

Both euthanasia and PAS have been distinguished, legally and ethically, from the administration of high-dose pain medication meant to relieve a patient’s pain that may hasten death (often referred to as the rule of double effect) or even the withdrawal of life support.6,7 The distinction between euthanasia/PAS and the administration of high-dose pain medications that may hasten death is premised on the intent behind the act.In euthanasia/PAS, the intent is to end the patient’s life, while in the administration of pain medications that may also hasten death, the intent is to relieve suffering.

"If I ever have an accident or a terminal disease that would affect my mind or body, I will end it." Twelve years later, he did so.

Similar sentiments are shared by a significant proportion of Americans.

They believe the patient and family should not be forced to suffer through a long and painful death, even if the only way to alleviate the suffering is through suicide.

To the advocate for PAS, legalization of PAS is a natural extension of patient autonomy and the right to determine what treatments are accepted or refused.

Introduction Palliative care and quality-of-life issues in patients with advanced cancer and AIDS have become an important area of clinical care and investigation.

Significant progress has been made in extending a palliative care/quality of life research agenda to the clinical problems of patients with cancer,1 including efforts that focus on such mental health-related issues as neuropsychiatric syndromes and psychologic symptoms in patients with advanced cancer and AIDS.2 Perhaps the most compelling and clinically relevant mental health issues in palliative care today, however, concern the desire for death and physician-assisted suicide (PAS) and their relationship to depression.Desire for death has been postulated as a construct that is central to a number of related issues or phenomena, including suicide and suicidal ideation, interest in PAS/euthanasia, and requests for PAS/euthanasia.This construct, which was initially proposed by Brown and colleagues3 and further developed by Chochinov et al4focuses on the degree to which an individual wishes his or her life could end sooner rather than later.Distinctions between withdrawal of life support and euthanasia/PAS are, in many ways, considerably clearer.Long-standing civil case law has supported the rights of patients to refuse any unwanted treatment, even though such treatment refusals may cause death.8 On the other hand, patients have not had the converse right to demand treatments or interventions that they desire.Typically, the physician’s motive is merciful and is intended to end suffering.PAS, on the other hand, involves a physician providing medications or advice to enable the patient to end his or her own life.Methods: Psychiatric and psychosocial perspectives are used to understand the factors contributing to the interest in PAS, as well as to guide interventions in the clinical care of patients with advanced disease.Results: Research and clinical experience suggest that attending to issues of depression, social support, and other psychosocial issues in addition to pain and physical symptom control are critical elements in interventions that are useful in reducing the distress of patients who desire hastened death.This distinction has had the effect of allowing a patient on life support the ability to end his or her life on request, yet a patient who is not dependent on life support does not have such a right.In fact, this difference in perceived "rights" formed the basis of the arguments made to the Supreme Court in Washington v Glucksberg9 and Quill v Vacco,10 in which it was argued that this distinction violated the due process clause of the 14th Amendment (the Supreme Court unanimously rejected this argument).

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