physician assisted suicide (PAS) Flashcards
what is PAS and how is it different from euthanasia
- sometimes called “the right to die”
- differs from euthanizing someone because in euthanasia the doctor gives the drug themselves
- in PAS the physician provides the necessary means or information, but the patient performs the act
how many physicians have received requests for PAS
57%
what states allow PAS
CA, CO, DC, MO, OR, VT, WS
- Hawaii now allows it
- New Jersey now allows it
very similar legislation in all states
what is the difference between passive and active PAS
active: give someone something that makes them die (pill)
passive: take care away
explain PAS worldwide
8 western countries legalized one or more of the practices
explain PAS process
- many states have similar process to Oregon (first state to legalize)
- give prescription of pentobarbital that when taken in excess leads to death (type of barbiturates)
- have to make sure someone has a sound mind when they request this
- has to be a plan B, have to try other forms of treatment before choosing this
- certain amount of time has to pass before PAS
what are the actual rules for PAS
- 2 oral requests to physician separated by 15 days
- written request to physician signed by 2 witnesses
- 2 physicians must confirm diagnosis and prognosis (prescribing and consulting)
- physicians must confirm the patient is mentally capable to make decisions
- if physician believes patients judgement is impaired the patient must get psychological exam
- patient must be told to alternate treatment methods
- patient requested to alert next of kin of decision
- life expectancy of 6 more months
explain Oregon stats of PAS
- there are people given the meds but some people choose not to use it
- increase in # of prescriptions and # of deaths
- small majority is female
- median age 73
- large majority white and bachelors or higher degree
- majority with government assisted insurance
explain washington stats
increase in # of deaths
small majority male
most common age 65-74
large majority white with bachelor degree or higher and majority with government assisted insurance
what happens in washington during PAS
- majority of time physician not present and die at home (most die within 5-90 minutes)
- no one called for intervention after ingestion (no one changed their mind)
why do patients choose PAS
loss of autonomy and inability to engage in enjoyable activities are primary reasons
illnesses resulting in PAS
similar patterns across states in oregon: -72% cancer -6% ALS -heart disease rate increase
explain physician characteristics
many doctors are agreeing to this practice
- washington: 142 physicians and 49 pharmacists
- oregon: 106 different physicians
explain don’t ask don’t tell
PAS not actively prosecuted as long as not openly discussed
-organizations exist that help people complete the PAS process (volunteers aid in the process)
explain primary arguments against PAS
- sanctity of life: stems from religious beliefs
- passive v. active distinction: could choose passive death
- potential for abuse: hippocratic oath is do no harm
- professional integrity: vulnerable groups might be pushed to this choice
- fallibility of profession: mistakes/uncertainty about diagnosis or prognosis (some people live longer than 6 months)
