Vermont Ethics Network
64 Main Street,Room 25, Montpelier, VT 05602-2951
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Physician Assisted Suicide …. The Continuing Debate (A Discussion Worksheet)
  The anticipated reintroduction of H.44 and S.63 in the 2007 Vermont Legislature will keep this issue before policy makers and the general public. (For a complete text of the bills, go to www.leg.state.vt.us). Many people have strongly held personal beliefs and a number of national and statewide associations have weighed in on this topic. (You can view lists of associations for and against PAS on the two websites at the end of this worksheet guide.) Definitions of some terms are discussed in a handout posted on the VEN webpage, www.vtethicsnetwork.org .

VEN hopes to help people come together to share their values and beliefs and to re-examine the issues and positions in a dialogue format that will allow an analysis of the underlying concerns about dying and choices. The goal of dialogue is not to change people’s beliefs or positions; rather, it is to open up the process of listening and communicating between people with diverse perspectives and beliefs. Whether common ground develops or not, the participants will be served by this process as they grow to understand each other better.

Here are several key points from the perspective of proponents and opponents of physician assisted suicide (PAS), based upon the Oregon model. Add more to each list.

Proponents would say:
 
  1. PAS provides another option for people who want to have more control of their dying.
  2. "Safeguards" built into the proposal provide adequate protection for those who may be depressed or for those who are susceptible to family pressure. 
  3. PAS can be used by terminally ill persons whose pain or other symptoms are not otherwise controlled.
  4. PAS in an open and regulated system can provide the reassurance that the prescribed medication will have the desired effect.
  5. PAS will prevent the isolation and guilt attendant upon other forms of suicide by some terminal patients who may now be using other means (e.g. firearms, voluntary refusal of food and fluids (VRFF), etc.)
  6. Having the PAS option available will be a means of opening dialogue with family and health care professionals about other options such as Hospice and palliative care alternatives.
  7. The experience of having PAS available in the State of Oregon has not diverted people away from Hospice and other alternatives and has not lead to a flood of people opting for this means of ending their lives
  Opponents would say:
 
  1. PAS is not needed.  All patients have the right to decline unwanted life-prolonging therapy.  Good hospice and palliative care can address the needs of almost all terminally ill patients.  In the rare situations where this is not possible, palliative sedation is professionally, legally, and morally acceptable. 
  2. "Safeguards" built into the proposal do not provide adequate protection for those who may be depressed or for those who are susceptible to family pressure.  In addition, the art of prognosis is inaccurate, so that estimating who may die in six months is often wrong.
  3. PAS is a basic contradiction to the Oath taken by Physicians to heal and minister to the sick and to “first, do no harm.”
  4. Some believe the taking of a human life through PAS is wrong, even when suffering and quality of life and patient wishes are taken into consideration.
  5. The introduction of PAS for the terminally ill will start a slide down the “slippery slope” to euthanasia (direct killing) of those who cannot take their own lives and will probably lead to being applied to seriously chronically ill and disabled individuals who are not “dying”.
  6. Growth and development can occur even in the most desperate of circumstances, including healing of relationships and a spiritual understanding of the meaning of suffering as a part of the natural dying process.
  7. Health care professionals, families and other caregivers will not give proper attention to pain control and hospice if they see PAS as a viable alternative.
  8. The respect and trust of physicians in general will be harmed if they are seen as ready to assist in suicide by their patients.
  What concerns on either side of this debate have the most weight for you?

If you were to characterize your own position as “for” or “against,” what is the most persuasive single point raised by people who hold the opposite position?

What are some areas of common ground identified in this discussion?

Has this discussion changed you views about PAS? How?

Are PAS and related matters ones that can or should be dealt with through legislation and/or regulation?

 


This worksheet has been developed by the VERMONT ETHICS NETWORK as a guide for community discussions. If you would like to schedule a session facilitated by a VEN volunteer, please contact our office in Montpelier at (802) 828-2909.

For more information about the two major opposing perspectives in Vermont you may wish to consult the following websites www.deathwithdignityvermont.org and www.vaeh.org (Vermont Alliance for Ethical Health Care). Another website for information about Oregon’s law is www.dhs.state.or.us/publichealth/chs/pas/pas.cfm