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A primer on patient assisted dying: A case for history and bioethics
Euthanasia, also known as mercy killing, is the act or practice of deliberately killing a dying individual, who no longer wants to tolerate pain and suffering, in a relatively painless way. Physician assisted suicide, on the other hand, takes direct control out of a doctor’s hands. The doctor presents the patient with the means to end his life. Both issues are extremely controversial in the world of bioethics.
The case of Elizabeth Bouvia is probably the most famous in bioethics history. A twenty-six year old young woman, Bouvia was suffering from cerebral palsy, severe degenerative arthritis, and almost complete paralysis. After years of suffering, she wanted to be able to end her life. Bouvia admitted herself in a Riverside, California hospital in 1983. The hospital refused to help her kill herself. At the time she admitted herself, Bouvia was alert, articulate, and could think for herself.
Psychiatrists argued that a rational personal would not want to kill herself, so that Bouvia could not be competent. To prove herself rational, she would have to say that wanted to live. Trapped in this circular reasoning, there was no way for Elizabeth Bouvia to end her suffering. After California’s court did not allow her to bring about her death by starvation, she appealed to the Supreme Court. The Supreme Court declared that Bouvia was a competent, rational adult, who knew what she was doing. They gave her permission to kill herself because she deserved the choice. Surprisingly, however, the instant Bouvia had control of her life, she chose to live. It seems that all she wanted was the choice to determine the outcome of her life. Bouvia is still alive today but eschews media attention.
Even more controversial situations are those when doctors promote either euthanasia or assisted suicide. Jack Kevorkian helped hundreds of terminal patients end their lives. He was a stern believer of individual liberties and dignified dying. Like most controversial figures, Kevorkian had both passionate supporters and critics. Public opinion was mostly negative, and Kevorkian even spent eight years in prison for helping end these lives. However, the tide began changing as some states began pushing for making physician-assisted dying legal.
Currently, physician assisted suicide is only legal in two states: Oregon and Washington. In Montana, physician assisted suicide is not explicitly legal, but a state Supreme Court ruling gives legal protection to it. However, citizens of Massachusetts are voting on physician-assisted suicide in this year’s election. The law would allow terminally ill patients, those with six months or less to live, to receive a lethal prescription if they wish. If the law in Massachusetts passes, a new precedent may be set, and other states may follow. Bioethics would see another revolution.