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     Physician-assisted suicide (PAS) or
euthanasia is an intense topic in the healthcare field today.  Is it morally permissible to allow a
terminally ill person to choose when it is their time to die?   According to the Ethical and Religious
Directives for Catholic Health Care Services, “euthanasia is an action or
omission that of itself or by intention causes death in order to alleviate
suffering.”1  Unconvincing arguments have been presented in
favor of allowing a terminally ill person to choose when and how they would
like to die.  A common argument is that
letting the patient choose is allowing them to die with dignity; however, without
argument PAS and euthanasia, no matter the circumstances, is morally wrong and
should never be permitted to occur. 
Euthanasia and PAS are immoral and represent a serious failure of the
healthcare system and corruption of the mission of the physician.

dates back to the Fifth Century B.C.2  From the latest date that is recorded for
this event until now, one thing is for certain…PAS has been controversial and
will remain so in the future.  Early
records suggest that groups such as the ancient Greeks and Romans supported the
concept of PAS.3
By the Twelfth Century the views of Christianity begun to be more widespread; these
views helped to reinforce the Hippocratic Oath, which did not allow euthanasia.4 At
that time, PAS and euthanasia begun to be frowned upon. Fast forward to the
future and the most notable modern physician who supported PAS and brought
national attention to the subject was Dr. Jack Kevorkian.  PAS was thrust into the national spotlight
when Dr. Kevorkian euthanized a man with Lou Gehrig’s disease on national
television.5   In 1999, Dr. Kevorkian was convicted of
second-degree murder and sentenced to jail for ten to twenty-five years.6  Dr. Kevorkian admitted to assisting over 130
people commit suicide.7 

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     Another recent
controversial headline surrounding PAS was the twenty-nine year old, Brittany
Maynard.  Brittany was a young woman
diagnosed with terminal brain cancer who resided in California. California law,
at that time, did not allow PAS or euthanasia. 
Therefore, Brittany chose to move from California to Oregon so that she
could choose when to end her own life.  In
1997, Oregon enacted the Death with Dignity Act.  The Death with Dignity Act allows “an adult
who is capable, is a resident of Oregon, and has been determined by the
attending physician and consulting physician to be suffering from a terminal
disease, and who has voluntarily expressed his or her wish to die, may make a
written request for medication for the purpose of ending his or her life in a humane
and dignified manner.”8  As expected, Brittany’s decision garnered
national attention from the media since Britney publically announced when she
would end her own life. Unfortunately, Britney Maynard did fulfill her promise
to end her own life on November1, 2014.9  Notably after Britney’s death, California did
sign into law in November 2015 the End of Life Option Act, which is similar to
Oregon’s Death with Dignity Act.10                                                                  

     Allowing PAS or
euthanasia sets a societal norm that suicide is acceptable. On separate
occasions, the Supreme Court has unanimously ruled that there is no
constitutional right to PAS; however, there are states that allow PAS by
statute.11  The states that currently allow PAS or
euthanasia are California, Colorado, Montana, Oregon, Vermont, Washington, and
Washington DC.12
Clearly, the concept of PAS and euthanasia are becoming a more widespread trend
across the healthcare system and in legislation across the United States. Once
euthanasia is considered acceptable for the terminally ill, who is to say that
this would not extend to other groups (i.e. blind, deaf, mentally
challenged)?  Permitting and/or
tolerating PAS and euthanasia to occur demoralizes human worth and sends a
message to society that human life is not respected or valued. 

can be argued that most individuals who seek physician-assisted suicide or
euthanasia suffer from a mental illness, physical illness, or simply
loneliness.13  Dr. Herbert Hendin, Professor of Psychiatry
and Behavioral Services at New York Medical College notes:

Mental illness
raises the suicide risk even more than physical illness.  Nearly 95 percent of those who kill
themselves have been shown to have a diagnosable psychiatric illness in the
months preceding suicide.  The majority
suffer from depression that can be treated. 
This is particularly true of those over fifty, who are more prone than
younger victims to take their lives during the type of acute depressive episode
that responds most effectively to treatment.14


       When patients express concern to end
their lives, more compassionate care should be expressed upon these
patients.  These patients should undergo
extensive therapy to help establish the reasoning behind their choice. Education
to healthcare workers on how to recognize signs of mental illness and
loneliness in chronically ill patients would help reduce the feelings by
allowing these individuals to seek help before they reach the point of wanting
to end their own lives. Dr. Hendin and Dr. Foley, Professor of Neurology at
Cornell University’s medical school and attending neurologist, pain and
palliative care services, at Sloan-Kettering Cancer Center, found in their many
decades of professional practice that that when patients who ask for PAS “are
treated by a physician who can hear their desperation, understand the
ambivalence that most feel about their request, treat their depression, and
relieve their suffering, their wish to die usually disappears.15Instead
of providing the option of PAS to these patients, we should offer more humane
options that align with the Church’s beliefs. 
The Ethical and Religious
Directives for Catholic Health Care Services states that, “Dying patients
who request euthanasia should receive loving care, psychological and spiritual support
and appropriate remedies for pain and other symptoms so that they can live with
dignity until the time of natural death.”16  

   PAS and euthanasia will
affect the physician-patient relationship.  Physicians are trained to treat and cure.  Allowing a physician to determine whether a
person’s life has quality is permitting the physician to ultimately play God.  In the end, this will affect the relationship
between the physician and the patient. 
The patient will start to question the motives of the physician.  Allowing PAS and euthanasia in the healthcare
setting is a slippery slope of troubles involving the physician-patient
relationship for fear that the physician will encourage or facilitate their
death. Legal philosopher, Jon Finnis, stages how PAS could change a patient’s

A new zone of
silence.  Can I safely speak to my
physician about the full extent of my sufferings, about my fears, about my
occasional or regular wish to be free from my burdens?  Will my words be heard as a plea to be
killed?  As a tacit permission? And why
does my physician need my permission, my request?17


This mistrust will
affect adversely affect the relationship.  Physicians are unable to heal by assisting
patients to kill themselves or by killing them. 
The American Medical Association (AMA) code of ethics does not allow
PAS. The AMA states: “Physician-assisted suicide is fundamentally incompatible with
the physician’s role as healer.”18  In the Backgrounder,
Ryan Anderson, PhD writes:

Introducing PAS
changes the culture in which medicine is practiced.  It corrupts the profession of medicine by
permitting the tools of healing to be used as techniques for killing.  It also distorts the doctor-patient
relationship by reducing patients’ trust of doctors and doctors’ undivided
commitment to the healing of their patients. 
Physician-assisted suicide also creates perverse incentives for
insurance providers and the financing of health care.19


addition to the AMA opposing PAS, physicians take a Hippocratic Oath to “do no
harm.”  The Hippocratic Oath was revised
in 1964 by Dr. Louis Lasagna, a physician at Johns Hopkins University.  In the modern revision of the Hippocratic
Oath, it specifically addresses euthanasia by stating: “…it may…be within my
power to take a life; this awesome responsibility must be faced with great
humbleness and awareness of own frailty. 
Above all, I must not play God.”20  If a physician writes a patient a lethal dose
of a medication to help facilitate the end of life, the physician is, in fact,
playing God and breaking the very oath they took.  Dr. Leon Kass states:

We must care for
the dying, not make them dead.  By
accepting morality yet knowing that we will not kill, doctors can focus on
enhancing the lives of those who are dying, with relief of pain and discomfort,
moral and social support, and, when appropriate, the removal of technical
interventions that are merely useless or degrading additions to the burdens of


   Physician responsibility
appears to be clear… to do no harm. Then what responsibility does the patient
have?  The patient has a moral obligation
to preserve their own life.  The Ethical and Religious Directives for
Catholic Health Care Services states that:

We are not the
owners of our lives and, hence, do not have absolute power over life.  We have a duty to preserve our life and to
use it for the glory of God, but the duty to preserve life is not absolute, for
we may reject life-prolonging procedures that are insufficiently beneficial or
excessively burdensome.  Suicide and
euthanasia are never morally acceptable options.22


The patient has a moral
obligation to comply with the Church’s teachings and beliefs.  Patients should be permitted to die a
dignified death by offering them spiritual, emotional, and physical support;
such as, palliative care or hospice.  For
example, it is permissible for a terminally ill person to request to be made
comfortable by means of pain medication; as long as the dose was not lethal. We
could use the double effect principle in this example.

act itself must be good – The act in this example would be to alleviate pain
and suffering.One
only intends the good – The intention in this example would be alleviate pain
and suffering and not to harm the patient. 
Therefore, increasing the dose to free a patient from suffering would be
evil is never the means to the good – The pain medication is being used to
treat pain and suffering and not to help commit suicide.There
is a proportionately grave reason for the act – The patient will be free of
pain and suffering.


In addition to the
double effect principle, the Ethical and
Religious Directives for Catholic Health Care Services, Directive 61 states

Patients should
be kept as free of pain as possible so that they may die comfortably and with
dignity, and in the place where they wish to die.  Since a person has the right to prepare for
his or her death while fully conscious, he or she should not be deprived of
consciousness without a compelling reason. 
Medicines capable of alleviating or suppressing pain may be given to a
dying person, even if this therapy may indirectly shorten the person’s life so
long as the intent is not to hasten death. 
Patients experiencing suffering that cannot be alleviated should be
helped to appreciate the Christian understanding of redemptive suffering.23


As referenced above,
the Church wants to help patients die a dignified death.  Given the proper education and guidance from
health care professionals, patients can be guided towards more support to help
during the difficult transition towards end-of-life. Dr. Aaron Kheriaty,
Associate Professor of Pscyhiatry at U.C. Irvine School of Medcine notes:

Suicidal individuals
typically do not want to die; they want to escape what they perceive as
intolerable suffering. When comfort or relief is offered, in the form of
more-adequate treatment for depression, better pain management, or
more-comprehensive palliative care, the desire for suicide wanes.24


   People seek PAS for
different reasons.  “In Oregon Health
Authority research, 91 percent of those who were assisted with suicide cited loss
of autonomy as their motivation to end their lives, and 71 percent cited loss
of dignity as their motivation.  Only 31
percent cited inadequate pain control.”25  Helping to provide resources for these
patients will decrease the need to pursue PAS. 

 In conclusion, PAS and
euthanasia is immoral and should never be permissible under any
circumstances.  Allowing physicians to
determine human worth, places the health care system at a disadvantage by
corrupting relationships between patients and physicians.  It impresses upon physicians the right to
determine whether a life is no longer worth living.  Patients, also, have a responsibility to
uphold when preserving the dignity of their life.  They should seek alternative options to PAS
and acknowledge the immorality of the act. 
Victoria Reggie Kennedy summed up PAS best:

My late husband
Sen. Edward Kennedy called quality, affordable health care for all the cause of
his life. PAS turns his vision of health care for all on its head by asking
us to endorse patient suicide-not patient care-as our public policy for dealing
with pain and the financial burdens of care at the end of life.  We’re better than that.  We should expand palliative care, pain
management, nursing care and hospice, not trade the dignity and life of a human
being for the bottom line.26



1 Ethical
and religious directives for Catholic health care services, Directive 60
(Washington, D.C.: United States Conference of Catholic Bishops, 2017), pp. 27.












Ryan T. Anderson, “Physician-Assisted Suicide is Always Wrong,”  Newsweek,
March 24, 2015,


Ryan T. Anderson, “Always Care, Never Kill: 
How Physician-Assisted Suicide Endangers the Weak, Corrupts Medicine,
Compromises the Family, and Violates Human Dignity and Equality,” Backgrounder, March 24, 2015,
(accessed June 15, 2017).

Herbert Hendin, Seduced by Death:  Doctors, Patients, and Assited Suicide
(New York:  W.W. Norton,                                                                      
1998), pp. 34-35.

15 Hendin
and Foley, “Physician-Assisted Suicide in Oregon,” pp. 1625-1626.

16 Ethical
and religious directives for Catholic health care services, Directive 60
(Washington, D.C.: United States Conference of Catholic Bishops, 2017), pp

17 Ryan
T. Anderson, “Physician-Assisted Suicide Corrupts the Practice of Medicine,” The Issue Brief, No. 4391, April 20,

American Medical Association, “Opinion 2.211-Physician-Assisted Suicde,” June

19 Ryan
T. Anderson, “Always Care, Never Kill: 
How Physician-Assisted Suicide Endangers the Weak, Corrupts Medicine,
Compromises the Family, and Violates Human Dignity and Equality,” Backgrounder, March 24, 2015, (accessed June 15, 2017).


21 Leon
Kass, “Dehumanization Triumphant.”

22 Ethical
and religious directives for Catholic health care services (Washington, D.C.:
United States Conference of Catholic Bishops, 2017), p. 25.

23 Ethical
and religious directives for Catholic health care services, Directive 61
(Washington, D.C.: United States Conference of Catholic Bishops, 2017), p. 28.

Aaron, Kheriaty, “Apostolate of Death,” First
Things, April 2015, p. 19.

Oregon Public Health Division, “Oregon’s Death with Dignity Act – 2014.”

Victoria Reggie Kennedy, “Question 2 Insults Kenendy’s Memory,” Cape Cod Times, November 3, 2012.


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