ASSISTED SUICIDE: LEGAL, ETHICAL AND MEDICAL PRINCIPLES

INTRODUCTION

Numerous individuals afflicted with terminal illnesses often encounter feelings of apprehension as they approach the final stages of their life. Individuals experience distressing emotions, such as apprehension regarding future events and the potential of being a burden to their loved ones. Additionally, they express concerns regarding the management of pain and the potential loss of control over their overall quality of life. Consequently, a subset of individuals afflicted with terminal illnesses are contemplating the option of physician-assisted suicide, which is alternatively referred to as medically assisted death or euthanasia, as a means to bring about the cessation of their existence. Euthanasia is now prohibited in the United States, although the practice of physician-assisted death has been legalized in seven states and Washington, DC. Patients have a lot of different ideas about what physician-assisted death means in terms of ethics. These ideas are based on the patient’s right to self-determination, their abilities, their views, and their values. Also, it’s clear that these decisions go against the moral and professional values of doctors. Because of this, clear and useful meanings of physician-assisted dying are needed. Healthcare personnel must be aware of various terminologies and ethical considerations associated with physician-assisted dying and euthanasia.

What is Assisted Suicide?

The term “Assited Suicide“ pertains to a clinical intervention wherein a physician issues a prescription for a dosage of medication, which the patient intends to ingest with the purpose of ending their own life.

The physician provides information regarding the methods of mortality, although it is ultimately the responsibility of the patient to make a deliberate choice to employ the medication. Giving the patient a medication is an important step in the process that ends in death, but it’s not the only or even the last step for people who take the drug. On the other hand, euthanasia usually means that a doctor puts a patient to sleep or gives them a poisonous shot to end their life. When the patient asks for it, the doctor not only gives the patient the means to die, but also actually does it.

DIFFERENCE BETWEEN SUICIDE AND EUTHANASIA:

A conceptual contrast exists between suicide and euthanasia. A suicide is defined as the intentional act of self-inflicted death, typically achieved through methods such as stabbing, poisoning, or other ways.

Undoubtedly, suicide may be characterized as a purposeful act undertaken with the intention of terminating one’s own life. Suicide refers to the intentional act or event of a someone causing their own death, often stemming from emotional distress or other contributing circumstances such as romantic disillusionment, academic setbacks, or challenges in securing employment opportunities.  In contrast, euthanasia refers to the deliberate act of one individual terminating the life of another individual. Third parties actively or passively assist in euthanasia.  Also, it’s important to note that “assisted suicide” and “euthanasia” are not the same thing in this case. Someone helps someone else commit suicide on purpose, like by giving them the tools they need to do it. This is called assisted suicide. “Physician assisted suicide” is when a doctor writes a prescription for drugs that will kill the patient and helps the patient kill himself.

Consequently, due to the patient’s active role in the act of suicide, the patient possesses complete agency over the course of events leading to their demise. The individual in question solely aids in the execution of the task, such as by supplying the necessary resources or methods. Euthanasia, on the other hand, can be active, like when a doctor gives a patient an injection that will kill them, or inactive, like when a doctor turns off their life support.

Why Do Patients Request Assisted Suicide?           

• Physical and mental pain that is unbearable.
• Not wanting to live in pain.
• Not wanting to be a burden.
• Having no desire to be reliant on others for personal care.
• Depression
• Hopelessness
• Loss of ability to maintain personal relationships.
• Problems in interpersonal relationships.
• Feelings of isolation and separation.
• Financial pressures.

The phenomenon of suicide is widely acknowledged as a significant and grave concern. Policies that try to stop people from committing suicide are meant to help the person who is depressed and wants to kill themselves. These rules recognize that everyone is responsible, and that someone who is deeply depressed and having suicide thoughts is vulnerable to pressures, no matter how small, to think they would be “better off dead.” This is related to how you should treat someone who tries to kill themselves but fails—suicide is not a crime in and of itself.

In the past, this wasn’t the case. Suicide was seen as a form of self-murder and was socially frowned upon. However, by 1961, the UK and many other countries had seen how cruel it was to have laws that let people who had survived suicide attempts be charged with the crimes they had committed out of desperation. It was also agreed that society was failing depressed people if it didn’t deal with the cause of their despair, which was generally severe clinical depression, and that programs to stop suicide needed to be improved. It was because of this that The Suicide Act, 1961 was made. It made suicide less illegal but not legal, because that would have given suicide a green light.

By the close of the 20th century, internet suicide sites tempted vulnerable young people to commit themselves, even featuring voyeuristic observers. To reflect changing social norms, the Coroners and Justice Act of 2009 expanded the  Suicide Act 1961 from ‘aiding and abetting suicide’ to ‘encouraging or enabling suicide.’  The maximum sentence for this offense is 14 years, although the courts are not obligated to set a minimum sentence.

“Washington v. Glucksberg”

Dr.Glucksberg asked the Supreme Court again about the same issue, and the court said the same thing: “the right to die,” as Dr.Glucksberg put it, is not a legally protected right.

Is Assisted Suicide Legal? 

There are laws against euthanasia and assisted death in the UK. Since March 2018, India has allowed passive suicide, but only under very strict rules. In the case of  Common Cause v. Union of India 2018 , the Supreme Court of India made passive euthanasia legal, saying that it was a question of “living will.”Based on the ruling, it is permissible for a mentally competent adult to decline medical intervention or make a voluntary decision to forgo medical care in order to accept a natural death, subject to specific circumstances.

In this case, the court made it clear that Article 21 of the Indian Constitution, which says everyone has the right to life and liberty, would still protect the rights of the patient. This was a very important decision. Euthanasia can lead to a murder conviction, and helping someone kill themselves can get you 14 years in jail. However surveys that were done anonymously show that euthanasia is done in the UK, though not very often. A poll of over 3,700 medical workers in 2009 found that 0.2% of deaths involve euthanasia by choice and 0.3% involve euthanasia without a clear patient request. No cases of assisted suicide were reported. The most well-known countries which permit euthanasia or assisted suicide are the Netherlands and Switzerland. However, many other countries do as well, with Belgium being the most open-minded. But the situations in which this is okay are very different.In the Netherlands, both euthanasia and assisted suicide are legal if the patient is in unbearable pain and doesn’t have much chance of getting better.

A request can be made by anyone over the age of 12, but if the child is under 16, their parents must agree. An important safety measure is that the doctor has to talk to at least one other doctor who is not affiliated with the hospital to make sure the patient meets the requirements. Euthanasia and assisted suicide are legal in Belgium, Luxembourg, Canada, and Colombia. However, there are some differences between the countries. In Colombia, only terminally ill patients can ask for it, but in Belgium, children of any age can ask for it (as long as they have a terminal disease).

Is Assisted Suicide Ethical? 

There are many reasons against physician-assisted suicide because it is unethical. However, these arguments are oversimplified and don’t treat the patient as a person.

As a matter of general ethics, the American College of Physicians is against both physician assisted suicide and making it legal.  This group says that doctors’ job is to care for and comfort patients, and that they shouldn’t be involved in their death because it goes against their duty as healers. hen deciding if physician-assisted suicide is moral or not, the procedure’s purpose must also be looked at. “ Practical reason is predicated on the premise of self-preservation“, according to the popular thinking. From this standpoint, it is rational to assert that the ultimate goal is to maximize one’s lifespan; thus, the practice of suicide in any form is strictly forbidden. Patient autonomy, the third ethical principle, stipulates that the patient alone has the authority to determine whether or not to forego life-sustaining interventions. The idea of autonomy, which means respect for people, comes from analytical thought and is now linked to the right to choose for oneself.

In a well-known case of medical wrongdoing, Justice Cardozo perfectly explained this point of view: “Every adult person with a clear head has the right to decide what should be done with his body.”

The fourth ethical concept is distributive justice, which says that medical resources should be shared fairly. When you compare the ridiculously high cost of barely useful end-of-life care to the fact that many people in our country can’t get the basic care they need, you can see that there are problems with justice.  The concept of justice is brought up to set it apart from decisions about end-of-life ethics made at the bedside. More and more people want to die with honor these days. It would be fair and honoring to better respect patients’ choices not to get expensive treatments that would lengthen their lives.

CONCLUSION

As a result, assisted suicide might be legal, but the rules that govern it would have to be very strict. Each case must be closely watched, with the patient’s, family’s, and doctors’ points of view taken into account, Indian culture may not be ready to handle this, as it is a matter of life and death, but time will tell.