Euthanasia, Is assisted death morally legal,

Writing questions my topic is euthanasia. I have 1 and a half papers and I need 8 pages.

see the attached file, complete my work, see my comments and you can clean up some things around. use APA format, please. I have attached another file that contains two sources please use them (do not use other resources). the last thing, I need the order of the points (paragraphs – ideas ) to go in the same order in my thesis, and each point should have an opposite opinion (a counter).

Is assisted death morally legal?

The world is choked with incurable diseases. A number of these diseases could slowly result in death, like degenerative disorder, that affects the central system. Some individuals could realize it burdensome to continue their lives with a hopeless malady in their bodies. Therefore, some could resort to what is known as euthanasia or death aid. The concept of aiding death comes from patients that could also be within the final stages of sickness, in which they prefer to make a final call to either endure the sickness or end their lives, notwithstanding the faith, politics, or government’s view (“Death with dignity, “2020). Eventually, not everybody will confirm the extent of the pain or suffering.(clarify). Assisted death should not be practiced in societies because it inserts despondency and abandonment of life, which consequently harms loved ones, and It also conflicts with the conscience of medical professionals.

(need paragraphs and counter talking about the patient for the first point “inserts despondency and abandonment of life”)

From the theoretical framework of Brown and Stetz there are possible complications that can happen during the dying process (Stacks at al., 2007). (rearrange the sentence place). Family members present at the time of death, are unable to deal with it emotionally and morally. The worries concerning legal outcomes and the societal stigma related to suicide suggested that some families felt detached and had confined support in their mourning period. These findings can fully bring one to presume that assisted death is morally not acceptable and therefore against the beliefs and values of physicians who would want to preserve their moral integrity. This is in no way conflicting with the power of choice of those who choose to end their lives but on the other hand, physicians should not be pressured to offer the suicidal drug against their will. The morality of taking away your own life or someone’s life cannot be determined by legality, but it lies within individuals.

Due to the nature of the medical oath, it is important to note that aided death should not be condoned. The oath of the Pythagorean community (Essinger, 2003) has clear sanctions against abortion and poisoning. It contains the doctor’s vow for the refusal to offer or suggest a deadly drug to anybody even upon request. therefore, the aided death is in contradiction with the medical oath.

Physicians encounter moral difficulties when it is expected of them to administer euthanasia. This is seen from the attitudes of Physicians in Tennessee, more than half of physicians responded that it is not ethical to administer euthanasia or to even suggest to the patient’s mind to end their life. Only 36% argued that there is nothing unethical about aided death or even entertaining the thought of it. 38% recommend counseling to the patients who might see aided death as the only solution, while 52% of physicians believe that assisting the patient to the grave can never be acceptable (Essinger, 2003). It is immoral and none should be recommended to go through with it. In general, the majority expressed in person that they would not administer a dose nor counsel a patient on taking a dose, whereas fewer than one-third expressed they would do either or each.

References

Death with dignity acts: states that allow assisted death. (2020, December 11). Retrieved February 17, 2021, from https://www.deathwithdignity.org/learn/death-with-dignity-acts/

Essinger, D. (2003). Attitudes of Tennessee physicians toward euthanasia and assisted death. Southern medical journal, 96(5), 427. Retrieved from https://doi.org/10.1097/01.SMJ.0000051144.80620.C1

Stacks, H., Back, A., Pearlman, R., Koenig, B., Hsu, C., Gordon, J., & Bharucha, A. (2007). Famuli member involvement in hastened death. Death studies, 31(2), 105-130. Retrieved from https://doi.org/10.1080/07481180601100483

References

Goligher, E. C., Del Sorbo, L., Cheung, A. M., Alibhai, S. M. H., Liao, L., Easson, A., Halpern, J., Wesley Ely, E., Sulmasy, D. P., Hwang, S. W., & Ely, E. W. (2016). Why conscientious objection merits respect. CMAJ: Canadian Medical Association Journal, 188(11), 822–823. https://doi.org/10.1503/cmaj.1150113

objection merits respect

In his important commentary on respect- ing conscientious objection to the provi- sion of physician-assisted death (PAD), Dr. Fletcher cites the long-standing tra- dition of tolerance within the Canadian medical community.1 We wish to point out several more reasons for respecting conscientious objection to PAD.

First, there is no duty in Canadian law or medical ethics for physicians to provide access to PAD. In the Carter decision, the Supreme Court of Can- ada explicitly stated that legalizing PAD did not entail a duty on the part of physicians to provide PAD.

Second, physicians frequently decline to offer treatments because they deem them nonbeneficial or harmful.2 Insofar as all refusals of therapy are ultimately justified by the ethical belief that the goal of therapy is to provide benefit and avoid harm, all treatment refusals are matters of conscience.

Third, the ethical justification of PAD remains debatable because it relies on uncertain metaphysical assumptions about the benefit of death3–5 and contra- venes widely held basic moral intuitions about the inestimable intrinsic value of humans.6 Because it remains distinctly possible that PAD is unethical, objecting physicians should not be forced to facili- tate access to PAD for their patients.

Fourth, physicians are ethically com- plicit when they deliberately refer a patient for a specific intervention.7 For

822 CMAJ, August 9, 2016, 188(11)

example, it is clearly objectionable to provide a referral for female genital mutilation. Analogously, if one finds PAD similarly unethical, providing a referral for PAD is highly objectionable and undermines one’s moral integrity.

Fifth, respect for conscientious objec- tion upholds the moral integrity of physi- cians,8,9 the foundation for society’s con- fidence in the profession. Disregarding conscientious objection prioritizes moral conformity over moral integrity, under- mining the trustworthiness of the profes- sion. Prioritizing moral integrity by respecting conscientious objection can foster quality medical care and enhance patient safety.10

Ewan C. Goligher MD PhD
Lorenzo Del Sorbo MD Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ont.

Angela M. Cheung MD PhD
Shabbir M.H. Alibhai MD MSc Department of Medicine, University Health Network, Toronto, Ont.
Lester Liao MD MTS
Department of Pediatrics, University of Alberta, Edmonton, Alta.
Alexandra Easson MD MSc
Department of Surgery, Mount Sinai Hospital, Toronto, Ont.
Janice Halpern MD
Department of Psychiatry, University of Toronto, Toronto, Ont.
E. Wesley Ely MD MPH
Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn.
Daniel P. Sulmasy MD PhD
Department of Medicine, University of Chicago, Chicago, Ill.
Stephen W. Hwang MD MPH
Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ont.

References

1. Fletcher J. Right to die in Canada: respecting the wishes of physician conscientious objectors. CMAJ 2015;187:1339.
2. Downar J, Warner M, Sibbald R. Mandate to obtain consent for withholding nonbeneficial car- diopulmonary resuscitation is misguided. CMAJ 2016;188:245-6.
3. Schüklenk U, van Delden JJ, Downie J, et al. End- of-life decision-making in Canada: the report by the Royal Society of Canada expert panel on end-of-life decision-making. Bioethics 2011;25(suppl 1):1-73.
4. Kortenkamp KV, Moore CF. Ethics under uncer- tainty: the morality and appropriateness of utilitari- anism when outcomes are uncertain. Am J Psychol 2014;127:367-82.
5. Goligher EC, Ely EW, Sulmasy DP, et al. Physi- cian-assisted suicide and euthanasia in the inten- sive care unit: a dialogue on core ethical issues. Crit Care Med. In press.
6. Crawshaw R, Rogers DE, Pellegrino ED, et al. Patient–physician covenant. JAMA 1995;273:1553. 7. Magelssen M. When should conscientious objec-

tion be accepted? J Med Ethics 2012;38:18-21.
8. Sulmasy DP. What is conscience and why is respect for it so important? Theor Med Bioeth

2008;29:135-49.
9. Lewis-Newby M, Wicclair M, Pope T, et al. An

official American Thoracic Society policy state- ment: managing conscientious objections in inten- sive care medicine. Am J Respir Crit Care Med 2015;191:219-27.

10. White DB, Brody B. Would accommodating some conscientious objections by physicians promote quality in medical care? JAMA 2011;305:1804-5.

CMAJ 2016. DOI:10.1503/cmaj.1150113 Are we consistent?

It is interesting that the issue of abor- tion for sex selection in Canada is raised again in CMAJ in a commen- tary1 and research study2 in June 2016.

Attempts to arrive at solutions for this problem were suggested variously in the form of laws, education and further research. Do we not as a society and a medical community preach that repro- ductive health is between a doctor and the patient? Do we not offer abortion selective for Down syndrome (and for other nonlethal anomalies)? Have we not said that other cultures and their values

1. Webster P. CIHR hikes grants to young researchers. CMAJ 2016;188:647. CMAJ 2016. DOI:10.1503/cmaj.1150110

References

Newman, N. M. (2014). In plain English: No euthanasia, please. CMAJ: Canadian Medical Association Journal, 186(10), 777. https://doi.org/10.1503/cmaj.114-0049

In plain English: No euthanasia, please

Why are Downar and colleagues so coy? Why not write in plain English? They come down squarely in favor of physician-assisted death, but don’t most physicians already assist in death? The authors,1presumably, are promoting physician-administered death. The authors have moved “beyond Yes or No” to advocate euthanasia, but they do not want to admit this. They tell us to forget our well-rehearsed debate: the sanctity of life versus patient auton­ omy, and yet they say they have no clear answer to their question of how to protect the vulnerable or incapable from receiving physician-administered death against their will. Psychiatric indications for physician-administered death by lethal injection could be equally contraindications.

The authors ask, “How can we ensure that physician-assisted death is available equitably to all patients?” Very simply, if amyotrophic lateral sclerosis or metastatic cancer are potential indi­ cations for physician-assisted death, then it will have to be offered to all patients with such diseases. A few will accept, many will be frightened and a few will feel obliged. Obviously, there would be a trade-off. The supposed ben­ efit to a few would threaten many more: this is why most doctors oppose euthanasia. Do the authors’ have any

new figures to contradict this? In my 29 years of experience, the vast majority of the frail and ill want to live — and with­ out a medically administered threat hanging over them.

The authors ask, “How can we ensure that physician-assisted death will not be considered a low-cost alternative to palliative care?” There is only one way: do not make killing the patient an alternative. Indeed, the authors do sug­ gest the answer: improve the availability of palliative care and keep physician administered-death illegal.

Nicholas M. Newman MD

Department of Orthopaedics, University of Montreal, Montreal, Que.

Reference

8. Downar J, Bailey TM, Kagan J, et al. Physician-assisted death: time to move beyond Yes or No. CMAJ 2014; 186:567-8.

CMAJ 2014. DOI:10.1503/cmaj.114-0049

Premature closure of the debate

Downar and colleagues’ are premature in their assertion that the “Yes or No” debate about euthanasia and physician-assisted death is over.

As the authors note, last August the Canadian Medical Association (CMA) voted against a change in its policy, which opposes physician-assisted death. The CMA’s blog on this issue is running at least two to one against physician-assisted death; an even larger proportion of Downar’s palliative care colleagues are opposed.2Whatever the courts may decide, apparently, the majority of Canadian physicians are unwilling to participate in physician-assisted death or euthanasia.

Downar and colleagues provide a comprehensive list of the controversies that may arise should physician-assisted death to be legalized in Canada. I wish to respond to 2 of the 13 questions in the list:

“How can we protect the vulnera­ be?” We can’t. It’s too short a step from believing that one might choose physician-assisted death to believe that it should be chosen; the vulnerable will inevitably feel a sense of coercion.

“How can we ensure that physician-assisted death will not be considered a low-cost alternative to palliative care?” We can’t. Despite the experience in Oregon in this regard, the much larger experience in the Netherlands has been an untoward delay in the development of palliative care services.3When faced with a difficult palliative case, it’s just too easy to say, “Why to bother?”

This debate is not over. For the sake of our most vulnerable patients, and for the sake of our colleagues, especially our youngest colleagues, we must persevere.

Howard Bright MD

Family physician, Chilliwack, BC

References

1. Downar J, Bailey TM, Kagan J, et al. Physician-assisted death: time to move beyond Yes or No. CMAJ 2014; 186:567-8.
2. Lapointe B, Borod M, Mount B. Opinion: Pallia­ give-care providers oppose Bill 52, Quebec should listen. The Gazette (Montreal) 2013 Oct. 11. Avail­ able: www.ehospice.com/canadaenglish/Default /tabid/10678/ArticleId/7094 (accessed 2014 May 5).
3. Gordon B, Janssens R. Euthanasia and palliative care in the Netherlands: an analysis of latest devel­ opments. Health Care Anal 2004:12:195-207.

CMAJ 2014. DOI: 10.1503/cmaj.l 14-0050 The authors respond

Newman1and Bright2both express con­ concerns about the messages of our article,3 but neither appears to have understood them correctly.

We did not express support for, or opposition to, the legalization of physician-assisted death. We posed questions that we feel should be addressed about the practical aspects of performing legal physician-assisted death in Canada. Newman1suggests we are coy in our use of the term “physician-assisted death,” but we explicitly defined this term in the first sentence of our article as including both euthanasia and assisted suicide. The term “physician-assisted death” is widely used, includ­ ing by Justice Smith in the Carter case.4

We did not assert that the “Yes or No” debate was “over.” We pointed out that the debate will be practically obso­ lete if physician-assisted death becomes legal by judicial or legislative means, and that physicians have a pro­ fessional responsibility to prepare for this possibility regardless of whether they support legalization.

We share Newman and Bright’s2 concern about the potential effects on the vulnerable. But we are reassured by data from the Netherlands that suggest that involuntary euthanasia became less com­ mon after the legalization of physician-assisted death,5 and data from Switzer­ land6and the United States7that show that vulnerable populations are less likely to receive physician-assisted death.

Newman asserts that the only way to safeguard against the use of physi­ cian-assisted death as a cost-saving measure is to ban it. This argument seems to imply a lack of commitment by physicians and other health care