End-of-life matters among terminally ill people who may wish to end their lives through assisted suicide or euthanasia have become a major topic of discussion. This debate tends to be highly contentious, with the proponents and the critics of the issue having varying viewpoints on whether or not terminally ill individuals should be allowed to make decisions to end their lives. The moral issues surrounding the right to self-determination, particularly the decision to end life, raise the question of whether it would be ethically justifiable for individuals to permit or get involved in medically assisted suicide. While the opponents of end-of-life decisions may argue for strict ethical and legal constraints, I argue that mentally competent mature individuals should have the authority to make decisions regarding their options at the end of life, as they are capable of making autonomous decisions, can engage in meaningful discussions regarding their care at the end of life, and can ascertain whether they want to live or end their life.
Mentally competent individuals have the capacity to make their own decisions, which should be respected. Such people should have the capacity to make their own decisions regarding their lives, which should be respected by the nurses and other healthcare providers attending to them. Respect for autonomy in medical settings is the key component of informed consent to medical treatment, and as a result, the aspect of autonomy should not be partially followed (Ethikrat, p.54). People should be allowed to decide for themselves how they wish to love, hence the notion of self-determination. The consideration of a person’s mental capacity should, however, be considered before the consideration of their consent, particularly regarding decisions to end their life. Granting individuals autonomy means that they can make informed choices that align with their beliefs, values, and current conditions in a way that denotes a sense of control over their lives and decisions.
Terminally ill patients who are mentally competent should be capable of making end-of-life decisions, particularly when their suffering exceeds. The Chicago Tribunal supports this view by stating that during a time to face a prolonged and agonizing passage to the inevitable end, “I would most certainly desire to have the option to end it on my own terms and to spare myself and my family the pain of that kind of death” (Chicago Tribunal, n.p). In any case, dying is inevitable, considering that everyone will eventually die. In this regard, people should be allowed to make decisions to end their lives whenever they feel that the conditions they are suffering from are incurable, instead of continuing to suffer and agonize when they eventually die. Autonomy provides people with the choice to decide when to end their lives based on how they feel due to the condition they are suffering from. Deciding on when and how to die should not be prohibited by laws or the medical profession but an individual choice of a person.
Individual decisions are dominant in the medical field and should be a determining factor that should be upheld even in cases of euthanasia. When a patient makes a request to the doctor to help them die when they are terminally ill and have made the decision out of their own free will, it is essential for the doctor to honor their wish. Ending a person’s life as a free will does not constitute any violation of the guarantee of human dignity. Talking about the preservation of life-based on the belief that humans should not choose to terminate their lives based on their belief in God assumes that people are incapable of thinking for themselves (Chicago Tribunal, n.p). In times when there is no other option that can minimize their suffering or address the conditions they are in, it is essential for people to have the opportunity and the authority to decide how they should end their lives.
Allowing mentally competent individuals to make decisions regarding assisted suicide or euthanasia is also an essential way of ensuring that their dignity is preserved. Although critics argue that the dignity of life is based on the preservation of the life itself, self-worth, respect, and integrity can be vulnerable in cases of prolonged care without any sign of improvements (Snyder Sulmasy et al., 2017. N.p). In times of extended suffering from a terminal sickness, it is highly possible for a person’s self-worth to be reduced, especially when their condition causes struggles for their family members. Although the right to a dignified death may not be regarded as a way of preserving human dignity in matters between life and death, it is based on personal dignity and commitment to humanity that human dignity should be upheld. Thus, subjecting a suffering patient to a higher suffering or purpose, which they no longer believe in by prolonging life, is pointless and undermines dignity (Ethikrat, p.55). Interventions to prolong the life of terminally ill individuals are only a way of extending their suffering.
Physicians have a duty to the patients, and the patients have the duty of deciding the medical procedures in which they want to engage. In this case, it becomes the responsibility of the physician to ensure that the patients receive the care that they want, provided that they are competent to make decisions regarding receiving such care. The medical principle of beneficence requires physicians to act in the patient’s best interest, respect their autonomy, and promote fairness and social justice (Snyder Sulmasy et al., 2017. N.p). Notably, medical ethics gives the patient the authority to refuse treatment, even if it is life-sustaining treatment. The intent to refuse the medications tends to be in line with the patient’s goals and preferences, and as a result, they should not be denied that which they deem essential, even if it is the decision to end their lives. The patient’s decision to terminate their life is usually out of a good cause and always tends to uphold the well-being of the patient, regardless of whether the physician deems it right or wrong.
Besides, physicians have the duty to relieve the suffering of the patients while also promoting their autonomy, and this includes the provision of effective palliative care even when it may foreseeably hasten death. Whenever physicians cannot adequately treat a condition to relieve the patient from pain, it is essential, with their consent, to seek alternatives to relieve their suffering, even if it means that they would end up choosing to end their life (Ethikrat, p. 17). The nature and magnitude of the pain that the patient experiences will determine the kind of decision that they make regarding their life. It is, however, the responsibility of the physician to ensure that there are no other alternatives to address the pain that the patient experiences, thus facilitating the making of informed decisions.
However, the critics of the right to determination at the end of life argue that allowing patients to decide when to end their lives can sometimes lead to wrongful or undeserved deaths, especially when there is a misdiagnosis. For instance, a patient can be wrongly diagnosed with a condition and decide to end their life to prevent any adverse suffering in the future. Also, due to misdiagnosis, a patient can be subjected to extreme pain, particularly due to the use of the wrong medication, to the extent that they will end up making a decision to end their life. In such a case, it becomes unethical and immoral for the physician to have made the patient believe that they have a terminal illness that cannot be cured regardless of the medical procedures that can be conducted. Despite these arguments and claims being true, it is important to understand that terminal illnesses take time to grow to conditions where the pain is unbearable and mostly involve numerous tests to ascertain the progress of the patient.
Others argue that the autonomy and self-determination of patients to make decisions to end their lives can lead to the devaluation of life that most people deem to be precious and, at times, result in the abuse of life. The assumption that patients can make decisions on their right to die will significantly impose a duty to kill on the doctors, provided that they would always be required to uphold the autonomy and the dignity of the patient. In such a case, it would be difficult for the doctors to uphold their duty as physicians. The value of life is high, and this means having to protect life at any cost, particularly by not helping other people terminate their preciously given lives. Besides, it might not always be those terminally ill who can decide to end their lives. Essentially, a person going through a tough time or experiencing challenges in their lives can decide to end their life in order to stop the suffering, hence the abuse of the autonomy and self-determination that patients have (Snyder Sulmasy et al., 2017. N.p). Despite these arguments being true, any decision made by the patient regarding their treatment plans, especially when they are terminally ill and decide to terminate their life, it is essential for the doctor to prevent the patient from enduring any further pain as such would be a violation of their dignity and their right to self-determination.
Therefore, mentally competent people should be allowed to make decisions to terminate their lives when they deem it a necessary alternative or option, especially in conditions where their suffering is intense. As such, the patients will minimize their suffering by deciding how and when to die when faced with situations that present them with pain that they cannot withstand. Physicians have a duty to uphold the well-being and autonomy of the patients, and this includes fulfilling their dying wishes, regardless of whether the physician deems such a practice unethical or immoral. The ethical code of contact always emphasizes the ability of doctors to ensure that the dignity and well-being of the patient are ensured. By valuing the respect for individual choices and the right to self-determination, the healthcare providers will foster an empathetic and compassionate approach to end-of-life, allowing the patient’s individual rights, wishes, and values to be honored at the end of their life.
Works Cited
Chicago Tribune. Allow adults to make life-or-death decisions in medical matters. Chicago Tribune (2024, March 2). Retrieved from: https://www.chicagotribune.com/2024/03/02/letters-allow-adults-to-make-life-or-death- decisions-in-medical-matters/
Ethikrat, Nationaler. Self-determination and care at the end of life. Opinion, Berlin (2006). https://scholarworks.iupui.edu/server/api/core/bitstreams/1f1b2187-d483-446b-bdb8-f909a937bb14/content#:~:text=This%20implies%20that%20everyone%20is,closer%20he%20is%20to%20dying.
Snyder Sulmasy, Lois, Paul S. Mueller, and Ethics, Professionalism and Human Rights Committee of the American College of Physicians*. “Ethics and the legalization of physician-assisted suicide: an American College of Physicians position paper.” Annals of Internal Medicine 167.8 (2017): 576-578. https://scholarworks.iupui.edu/server/api/core/bitstreams/1f1b2187-d483-446b-bdb8-f909a937bb14/content#:~:text=This%20implies%20that%20everyone%20is,closer%20he%20is%20to%20dying.