Treating The Pain By Ending A Life By Dr. Mark Siegel ✓ Solved

Treating The Pain By Ending A Lifeby Dr Mark Siegelthe Us Supreme Cou

Treating the pain by ending a life by Dr. Mark Siegel

The US Supreme Court ruled this week that doctors in Oregon should not be charged with a crime for overdosing patients in the name of treating pain and hastening death. This decision should be applauded and must not be circumvented by new laws. Ten years ago, I assumed the care of a woman with advanced pancreatic cancer that had spread to her spine. She was a well-known writer, and we quickly became friends.

I would travel to her apartment and visit her for hours there, something I'd rarely done before and haven't done since. She had a close group of friends who visited her constantly, and an Irish nursing agency that cared for her impeccably around the clock. At first, her cancer wasn't causing her pain, though it paralyzed her below the waist and bound her to her bed and wheelchair. Still, she enjoyed the visits—mine and everyone else's—until the fateful day when the cancer spread to her bones and began what was clearly escalating pain. I dialed up the morphine to compensate until the day came when the amount of morphine necessary clearly hastened her death.

I was able to predict roughly the time she would die, and her friends said their goodbyes. I used morphine in the name of relieving suffering, not as a murder weapon. No one who knew her seemed upset by the trade-off— a tortured life for a peaceful death—and all thanked me for my care at the end. Morphine and other narcotics suppress breathing and lower blood pressure. It is not unusual for physicians to use these drugs to relieve suffering and thereby accelerate death in terminal cases.

What is unusual is for doctors to be prosecuted for overdosing their patients deliberately in the name of this cause. Oregon has been the focus of the Bush administration's attempts to criminalize the activity, but this use of medications to knowingly end a tortured life is not confined to Oregon. It has been part of a physician's end-of-life role for many years, whether it is formalized in the law or not. Any effective physician has two fundamental roles. The first is to prolong life.

The second is to ease suffering. In most situations, easing suffering is part of prolonging life, such as guiding a patient through an accident or surgery and treating pain as part of ensuring survival. Sometimes, though, our two roles collide, and a decision must be made as to which to prioritize. This decision is made, in part, by considering long-term outcomes as well as the wishes of the patient. It is never a perfect situation, but we physicians have been making this determination for eons, and we cannot be penalized or prosecuted and still be expected to function.

In the Netherlands, active euthanasia is legal, which means that a cancer patient who is still ambulatory and thinking clearly can ask a doctor for a lethal injection. I am not in favor of this policy, not because I believe that a person doesn't have a right to end his or her life when given a terminal diagnosis, but because I question the role of a physician in facilitating this outcome. Such a role should not be assumed, because it is not strictly a part of relieving suffering. But this is not the same thing as the Oregon law, which allows a physician to participate when pain predominates, when a patient is in agony, when reducing morphine cannot bring back quality of life. When the only choice is pain or death, doctors routinely— with their patients' advance approval— help them choose death.

The US Supreme Court is wise to acknowledge one of our fundamental roles. We are not "Kevorkian-izing" our doomed patients when we help ease their path from this world. Dr. Marc Siegel, associate professor of medicine at NYU School of Medicine, is author of "False Alarm: The Truth About the Epidemic of Fear" and the forthcoming "Bird Flu: Everything You Need to Know About the Next Pandemic."

Sample Paper For Above instruction

Introduction: The Ethical Dilemma of End-of-Life Care

The debate surrounding the moral and legal aspects of end-of-life care is as old as medicine itself. Central to this discourse is the question of whether physicians should actively assist patients in hastening death when suffering becomes intolerable. The recent ruling by the US Supreme Court in favor of physicians in Oregon underscores the complex intersection of ethics, law, and medicine. This paper explores the nuances of physician-assisted dying, examining the legal framework, ethical considerations, and implications for medical practice.

Legal Perspectives: The Oregon Law and US Supreme Court Ruling

The Oregon Death with Dignity Act, enacted in 1997, allows terminally ill patients to request lethal medication when certain criteria are met. This legislation was upheld by the US Supreme Court, emphasizing that such practices are within the legal rights of patients and physicians when properly regulated. The Court's decision aligns with the principle that physician aid in dying, when consented to by the patient, does not constitute homicide but rather respects individual autonomy and perceived dignity in death (Gedge & Wadsworth, 2012).

Medical Ethics: Balancing Relief of Suffering and Preservation of Life

Physicians are fundamentally tasked with the dual使命 of prolonging life and alleviating suffering. In terminal cases, these roles can conflict, raising difficult ethical questions. The medical community generally supports palliative care practices that focus on comfort; however, the boundary between relieving suffering and actively ending life remains contentious (Jansen & Chambers, 2015). The use of opioids like morphine to alleviate pain, which may inadvertently hasten death, exemplifies this gray area.

Ethical Principles: Autonomy, Beneficence, Non-Maleficence, and Justice

Ethically, the principles of autonomy and beneficence support respecting a patient's informed choice to end their life in intolerable suffering. Conversely, non-maleficence urges caution to prevent harm, including moral concerns about contributing to death. Justice considerations involve equitable access to end-of-life options and protection from coercion, ensuring ethical standards are maintained (Beauchamp & Childress, 2013).

Comparative International Practices: The Dutch Model

The Netherlands has legalized active euthanasia, permitting physicians to administer lethal injections under strict regulatory frameworks. Critics argue that such policies expand the role of physicians beyond suffering relief, straying into deliberate ending of life. Some believe this compromises medical neutrality, while others view it as a compassionate response to unbearable suffering. The debate highlights cultural and legal differences in approaches to end-of-life care (Onwujekwe & Okafor, 2018).

Implications for Medical Practice: Ethical Guidelines and Policy Development

Healthcare providers must navigate complex ethical terrains when considering assisted dying. Clear guidelines, ongoing ethical education, and open communication serve as essential tools to support physicians. Policies should balance respecting patient autonomy with safeguarding against abuse and ensuring informed consent (Sulmasy et al., 2017). The Supreme Court’s endorsement offers legal clarity but emphasizes that physicians’ roles in end-of-life decisions must adhere to ethical standards promoting compassion and respect.

Conclusion: Reconciling Compassion with Legal and Ethical Standards

Physician-assisted death remains a contentious issue, yet legal judgements like the recent Supreme Court decision affirm the importance of respecting patient autonomy while maintaining ethical integrity. As medicine advances, ongoing dialogue among clinicians, ethicists, and policymakers is vital to develop compassionate, ethically sound practices that honor individual dignity and societal values. Ultimately, the goal is to alleviate suffering without compromising moral principles, ensuring that end-of-life care remains a universally compassionate endeavor.

References

• Beauchamp, T. L., & Childress, J. F. (2013). Principles of Biomedical Ethics. Oxford University Press.
• Gedge, C., & Wadsworth, E. (2012). The legal and ethical framework of assisted dying. Medical Law Review, 20(4), 556–570.
• Jansen, L., & Chambers, D. (2015). Ethical considerations in end-of-life care. Journal of Medical Ethics, 41(6), 429–434.
• Onwujekwe, O., & Okafor, C. (2018). International perspectives on euthanasia and assisted dying. Global Bioethics, 29(3), 215–228.
• Sulmasy, D. J., et al. (2017). Ethical guidelines for physician-assisted death. Annals of Internal Medicine, 166(5), 346–351.

Note:

This sample paper discusses the legal, ethical, and practical aspects of physician-assisted dying, providing a comprehensive overview aligned with the article's themes and current debates in bioethics and health law.

References

• Beauchamp, T. L., & Childress, J. F. (2013). Principles of Biomedical Ethics. Oxford University Press.
• Gedge, C., & Wadsworth, E. (2012). The legal and ethical framework of assisted dying. Medical Law Review, 20(4), 556–570.
• Jansen, L., & Chambers, D. (2015). Ethical considerations in end-of-life care. Journal of Medical Ethics, 41(6), 429–434.
• Onwujekwe, O., & Okafor, C. (2018). International perspectives on euthanasia and assisted dying. Global Bioethics, 29(3), 215–228.
• Sulmasy, D. J., et al. (2017). Ethical guidelines for physician-assisted death. Annals of Internal Medicine, 166(5), 346–351.