behind the headlines

Discussion of ethical issues:

Assisted dying in other words "physician assistance in dying" of terminally-ill patients is characterised by the physician consulting the patient regarding end of life options that includes the access to a barbiturate that can be obtained only through a physician's prescription. If a patient requests for the prescription, it can confirm that the patient desires the option of hastening his death (Lindsay, 2008). Once prescribed the patient maintains the total control of its administration of the drug. ODWDA suggests that one-third of the patients never take the drug and other ingest the drugs months after it has been prescribed. Currently being banned in the UK, the Suicide Act(1961) states that any person who aids in the suicide of other or attempt by another to commit suicide is liable to prosecution. This has led to many terminally-ill patients to flee abroad to clinics like Dignitas in Switzerland where the law is legalised. Despite this, "why isn't assisted dying legalised in the UK", is the key question in every terminally-ill patient's mind who wish to spend the last few breaths in their homes with their loved ones.

It can be argued that legalisation will have too many harmful consequences (HL). Persons will be put to death who really wants to live and the quality of healthcare of dying patients will decline as there will be incentive of choosing death. Recent evidence form Oregon's experience in the past decade dispels the myth about persons being pressurised in requesting assistance in dying if it is legalised, that is the vulnerable (usually defined as women, racial minorities, the poor and the disabled) will be especially susceptible to pressure and that the quality of palliative care will decrease because the emphasis will be on killing rather than easing their suffering. The Oregon record reveals that the overwhelming number of persons requesting assistances is the white, well educated and financially secure. The gender reflects of a general population while the quality of palliative care in Oregon as improved since the adoption of ODWDA. Keeping the law apart, people have an interest of making decisions for themselves. In other words they have the interest in autonomy. We like to make our own decisions when it comes to important issues that reflect our beliefs, values and objectives. Many of our laws and policies encourage individuals to take responsibility of their own lives according to the federal Patient Self-determination Act, hospitals and other healthcare institutions need to inform patients that they have the right to specify the care they want in end-of-life situations by completing advance directives. In contrast to this, opposition to legalising assistance in dying remains strong, resulting in delay in revision of the assisted dying law in UK (HL). One preposition is based on the belief of many that assistance in dying is killing and killing is wrong (Lindsay, 2008), in other words assistance in dying violates the "sanctity of life" as this can be characterised as a religious tenet. Gorsuch (2006) argued that killing of another human is always wrong ; assisted dying involves the intentional killing of another human where a doctor intends to kill the patient and therefore it should be banned in all places. However it can be argued that the physician is firstly consulting the patient and intends to ease the patient's suffering and anxiety by providing the patient with some measure of control over the timing of his death. Thus the term "intentional killing" is inappropriate to describe this procedure. When a terminally-ill person who is competent to make decisions for herself has reached the conclusion that her life is on balance, too painful, too degrading, too restricted to be worth living (Posner, 1995), then for her there are no activities worth pursuing. In fact by forcing her to continue living will cause a violation of her autonomy thus forcing her to reorder her life and redefine herself. In this case, on the basis of Raz (1986) observation, a "person whose every decision is extracted from him by coercion is not an autonomous person."

Considering the significance of physician's role and why it is important not just to allow assistance in dying but to authorise physician assistance in dying, the role of the physician is crucial in the context of end of life care. Legalising physician assistance in dying allows the terminally ill to consult the physician openly and candidly with their doctors, discussing all aspects of the condition and treatment with a knowledgeable, caring expert. By encouraging a frank exploration of the options, a patient will be able to make an informed decision and may be persuaded to hold longer. Sensitive physicians will use the full extent of their training and experience in assessing the patient's condition and the prospects of effective palliative care. Failure to consider the importance of physician's involvement in advising the patient regarding end of life options has resulted in ideologically driven and counterproductive measures (Gorsuch, 2006).

The final most important issue of legalisation is the risks associating with abusing

In conclusion, the ban on physician assistance in dying pushes the terminally-ill to end their lives while they are still able, without discussing their plans with anyone, resulting in many precipitous or unnecessary suicides including botched attempts, which simply lead to more suffering. Not only might some bring about their deaths while they have months to live, but also others may kill themselves who, had they been able to determine whether they wanted assistance in dying, would not have found their lives unbearable. In other words, assuming we desire a regulatory scheme that encourages persons to live as long as they find their lives worthwhile (Lindsay,2008), a policy permitting physician assistance in dying for the terminally ill is much more likely to accomplish this objection of simply banning assistance in dying. Current revision.

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