In 1989, Janet Adkins was 54 years old and was recently diagnosed with Alzheimer’s disease. She was a schoolteacher living in Oregon who loved hang gliding and mountain climbing (Times). And in these early stages of Alzheimer’s disease she was still playing and beating her 32-year-old son in tennis (Times). However like many people who faced a deadly disease, she feared the loss of dignity that accompanies this irreversible illness. Like others, Janet Adkins wanted to be in control of how her life ended. Even before Janet was diagnosed with this disease, she had joined the Helmock Group who supported the terminally ills’ right to assisted suicide because, at this time, assisted suicide was illegal in Oregon.
Meanwhile in Michigan, Dr. Kevorkian was a self-described death counselor who attained his medical degree at the University of Michigan Medical School. Although no longer an active doctor he wrote several articles on the ethics of euthanasia for the German journal, “Medicine and Law” (Wikipedia). Dr. Kevorkian, like Janet Adkins, was an avid supporter of the right to assisted suicide. Dr. Kevorkian had even invented an easily replicable suicide machine that could be created from materials at the hardware store for around $45 (Wikipedia). After failed attempts to advertise his creation he eventually wound up on the popular Donahue show.
In early 1990, Janet Adkins condition was worsening and after many failed attempts at experimental therapy, she accepted her incurable fate. This realization caused her to reach out to Dr. Kevorkian who she had read about in the news for his stance on assisted suicide (Times). Janet Adkins asked Dr. Kevorkian if he would help her terminate her life on her own terms. Dr. Kevorkian agreed and Janet Adkins flew to Michigan where the assisted suicide laws were murky. Janet’s husband accompanied her with hopes that she would have a last minute change of heart and come home with him. Meanwhile, Dr. Kevorkian was attempting to locate a place where he could set up a space for the assisted suicide; however, hotels, vacant buildings and funeral parlors all turned him down. As a last resort he resurrected his 1968 Volkswagen and placed a new cot and clean sheets in the van (Times). He then drove his van out to a park where electrical outlets were accessible. This was to become the place Janet Adkins would die.
When Janet Adkins arrived to the park grounds, Dr Kevorkian gave her a medical assessment finding that she did have Alzheimer’s disease but was lucid enough to give consent (Times). This was all done without aid of any hospital equipment. Dr. Kevorkian then placed Janet on a heart monitor and gave her a saline drip. Near Janet a big red button was placed that let her control when she was going to die. When she pressed the button, the saline solution was replaced by a painkiller and one minute later followed the poison potassium chloride (Times). Within five minutes, Janet Adkins heart stopped and she was pronounced dead. Immediately after, Dr. Kevorkian called the police.
Quickly after his arrest the controversy of his help with assisted suicide mounted. Some declared Dr. Kevorkian a hero for helping patients in distress; however others thought his actions were abhorred. Even some who supported assisted suicide were against his actions because there was no procedural protection in place for Janet Adkins. “Most require that patients make a witnessed, legal request in writing, with two independent doctors confirming that the patient’s condition is unbearable and irreversible” (Times). Furthermore, many doctors claimed that a person diagnosed with Alzheimer’s disease couldn’t be guaranteed to have the mental state to agree to such a procedure.
As a result of his performance of assisted suicide, Dr. Kevorkian was arrested and charged with murder. These charges were dropped on December 30, 1990 because at that time Michigan had no laws about assisted suicide. However in 1991, the state of Michigan revoked his medical license to make it clear his actions were no longer permitted (Wikipedia). Dr. Kevorkian went on to commit 130 more assisted suicide before his arrest in 1998.
Dr. Kevorkian was a key player in making assisted suicide a real issue in the United States. Since he first began his controversial practices, only one state changed its laws so that assisted suicide is permissible in some situations. On October 27th 1997, Oregon created the “Death by Dignity Act”, which allowed terminally ill patients to end their lives through self-administration of a lethal injection. With this act, certain procedures were established to ensure that the patients ending their lives not only were terminally ill but were also in the right mind to make such decisions (Oregon.gov). Although Oregon created this act, most states created statutes making assisted suicide strictly prohibited and in four states assisted suicide carries the same weight as homicide (Exhibit, 1). Using the consequentialist theories, specifically utilitarianism, the key ideas of this debate are established and can shed light on whether assisted suicide is not only morally wrong but also if it is unethical for doctors to “assist”.
Consequentialism is an ethical theory that holds that an actions morality is based on the outcomes or consequences of the action. Essentially a morally right action is the action that will produce a good outcome. “An act’s rightness or wrongness is determined solely by the act’s consequences and not by any feature of the act itself” (Snoeyenbos, 17). One of the most used examples of consequentialism is if one breaks a promise. The actual act of breaking the promise is neither good or bad, it solely is dependent on the outcome of this action. Utilitarianism is a consequentialist ethical theory because it promotes picking the action the will provide the best consequence or most utility for the affected parties. An action is morally right only when the balance of benefit to harm of the affected parties is greater (Snoeyenbos, 17).
When examining the ethics of assisted suicide, there are arguments for both sides using the same consequentialist theory. Several consequentialists have argued that if we accept assisted suicide as morally right, “ we demean the concept of the sanctity of life, leading to a gradual erosion of its value, with subsequent liberalization for criteria for euthanasia, the deformed, and even the nonproductive” (Terry, 1259). This argument believes that by allowing assisted suicide we would be opening Pandora’s box and eventually we would have so little respect for life. This would lead to the circumstances for which euthanasia was acceptable would grow until practically everyone could do it if they wished, essentially condoning suicide. However, some use the same consequentialist theory and argue for the use of assisted suicide. With the improvement of medicine and our disregard for patients wanting to end their own lives, patients and physicians have claimed that this has led to untold and unnecessary suffering for patients. Such practices that prolong the dying and suffering of patients has a negative consequence and thus, possibly making the action immoral. Also by refusing assisted-suicide, we are denying patients their right to control their own life, another negative outcome (Terry, 1259).
Using utilitarianism we can follow four general guidelines to help establish whether assisted suicide is morally correct. The first guideline is to look at all the relevant other acts that are available. In this situation, the only other act is to allow the patients to continue suffering. The next guideline is to list all parties that will be affected. The main parties in assisted suicide are the patient, family and friends. The third guideline is to establish how this and alternate acts will effect the parties. Family and friends will have to suffer the loss of this patient regardless but by delaying the process they have to endure watching their loved one suffer. The patient is hugely effected because their prolonged life means increased suffering. The last guideline is to pick the act that provides the most utility. One would think that utilitarianism act would be assisted suicide (Snoeyenbos, 18). However with this idea, the long-term consequences are not considered nor the effect it has on doctors.
The consequentialist who believe that assisted suicide will decay the value of human life bring up an issue that this act could blur the role of physicians. Even if we find that assisted suicide is moral right based of utilitarianism, is it ethical of doctors? Many believe that assisted suicide is “incompatible with the mission of doctors” (Wolf, 13). In fact the Hippocratic oath states, “But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God” (Wikipedia). If doctors violate this oath, it will lead to patients to mistrust their doctors. They may not longer believe that the doctor’s have their best intentions and be afraid that their doctors will coerce them into an early suicide. Doctor’s administering the suicide drug would completely deteriorate the doctor-patient relationship (Terry, 1259). Another argument about the long-term effects assisted suicide may have on doctor is that, “they will no longer view as before their broader roles as comfort and care givers and consequently may try less vigorously to develop and promote more effective comfort and care measures near the end of life in all patients” (Terry, 1259). Physicians may not see the need in developing new medicine and medical devices to aid the elderly if there is the second option of assisted suicide. The one benefit assisted suicide may have is that health care cost would be lowered, but at the erosion of the value of life. The possible long-term consequences of physicians playing God make the action of assisted suicide immoral.
On this basis, Dr. Kevorkian acted unethically when helping to administer the suicide drug to Mrs. Adkins. Furthermore, if we were to address the utilitarian guidelines again for Jane Adkins particular case we would see different effects. Firstly, Mrs. Adkins was not a terminally ill suffering patient. The only thing Mrs. Adkins benefited from the suicide was not being in fear of the future. Her pain was not ended because she was, at the moment, not suffering. In this particular case, the little benefit that this action created was drastically outweighed by the negative consequences the assisted suicide did and could create.
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“Frequently Asked Questions | Death with Dignity Act.” Document Moved. The Oregon Government. Web. 16 Apr. 2012. <http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/faqs.aspx>.
Gibbs, Nancy. “Ethics: Dr. Death’s Suicide.” Time Magazine U.S. Time, 18 June 1990. Web. 10 Apr. 2012. <http://www.time.com/time/subscriber/article/0,33009,970389-3,00.html>.
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Ray, Julie. “Assisted-Dying Debate in U.S., Canada, Britain.” Gallup. Gallup, 9 Sept. 2003. Web. 11 Apr. 2012. <http://www.gallup.com/poll/9217/assisteddying-debate-us-canada-britain.aspx>.
“Support for Doctor-assisted Suicide Decreases If the Question Mentions “suicide”” Public Agenda. Public Agenda. Web. 16 Apr. 2012. <http://www.publicagenda.org/charts/support-doctor-assisted-suicide-decreases-if-question-mentions-suicide>.
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