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Physician-Assisted Suicide and Active Euthanasia:
An Annotated Bibliography
Courtney Garroutte
Academic affiliation: Oklahoma State University
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Batlle, Juan Carlos. "Legal Status of Physician-Assisted Suicide." Journal of American Medicine 289.17 (2003). ProQuest Direct. Oklahoma State University Library. 29 September 2003 . This article relays the fact that most physicians understand the differences between physician-assisted suicide, euthanasia, and withdrawal of life support however, the public tends to confuse these terms and their meanings. Common misconceptions about euthanasia, physician-assisted suicide, and withdrawal of life support create problems with the physician/patient relationship. The public's misconceptions are possibly due to the negative overtones associated with end-of-life issues. Emotions are usually unrepressed at the time most people have to consider end-of-life issues so rational consideration is hard to attain. Data and surveys conclude the confusion is due to ambiguities in the way society interprets legal and ethical behavior of end-of-life matters. Several court cases have upheld the decision that terminally ill individuals have the right to choose euthanasia or assisted-suicide. This article was written to summarize the current legal status of physician-assisted suicide. It provides valuable information pertaining to physician's rights and obligations in cases where end-of-life decisions must be considered.

Bernat, James L., Bernard Gert, and R. Peter Mogielnicki. "Patient Refusal of Hydration and Nutrition: An Alternative to Physician-Assisted Suicide or Voluntary Active Euthanasia." Biomedical Ethics. Thomas A. Mappes and David DeGrazia, eds. Boston: McGraw Hill, 2001. 436-442. The option to refuse hydration and nutrition provides the terminally ill an alternative to physician-assisted suicide and euthanasia. This article surveys the possibility that a rational and competent patient can refuse hydration and nutrition as a way to end their suffering and/or life without the ethical problems associated with PAS and euthanasia. The authors insist that physicians should grant a patient's request for refusal of treatment necessary to sustain life. The authors do not believe that a new law needs to be made; they simply think that it is a physician's moral and legal duty to honor a patient's requests. This article was written in a scholarly tone that maintains an ethical approach to patient refusal of hydration and nutrition.

Brock, Dan W. "A Critique of Three Objections to Physician-Assisted Suicide." Ethics 109 (1999): 519-547. If the right to physician-assisted suicide is not protected by the Constitution, states can enact laws that extend PAS to some individuals but not to all. This author focuses on three main objections to PAS. The first argument that PAS is unethical involves a correlation with terminating life support. The argument concludes that patients have the right to bodily integrity therefore; they have a right to remove life support. The second objection to PAS states that PAS is morally wrong because its intention is death, whereas, in foregoing life support death is hasted but not intended. The last objection considers the potential for abuse. In 1997 states were then given the choice to regulate, prohibit, or permit PAS. Political and policy advantages exist when the decision is left for the states to decide. Due to the terminology and in-depth explanations concerning moral ethics, this article is geared more towards experts.

Brody, Howard, John C. Fletcher, Lawrence O. Gostin, Diane E. Meier, and Franklin G. Miller. "Regulating Physician-Assisted Death." Biomedical Ethics. Thomas A. Mappes and David DeGrazia, eds. Boston: McGraw Hill, 2001. 424-429. Legalization of physician-assisted suicide should occur, but only as a last resort and only with strict regulations or safeguards. These safeguards would reduce the occurrences of abuse and protect the individual requesting euthanasia. All possible measures must have been taken to alleviate the pain before physician-assisted suicide is considered. The authors recommend that physician-assisted suicide should be an option, not only for those that are terminally ill, but also to those that suffer from incurable diseases. Physicians are also taken into consideration and have every right to abstain from this practice. Once legal, physician-assisted suicide and its' regulations would protect physicians from lawsuits and patients would not have to continue unnecessary suffering. This article was written in obvious support for legalization of PAS.

Cassel, Christine, Diane E. Meier, and Timothy E. Quill. "Care of the Hopelessly Ill: Proposed Clinical Criteria For Physician-Assisted Suicide." Morality in Practice. James P. Sterba, ed. Boston: Wadsworth/Thomson Learning, 2001. 421-424. The care of terminally ill patients is a sensitive and controversial topic. Nonetheless, a policy for the care of these patients is needed to prevent abuse or coercion from doctors, institutions, and family members. The definitions of euthanasia and physician assisted suicide make a clear distinction between the two very similar acts. In physician assisted suicide the final act is performed by the patient, where in euthanasia the physician carries out the act. To prevent undue suffering to terminally ill patients, assisted suicide should be a viable option for patients. However, certain criteria must be met under the supervision of a physician before this measure should be taken. This article is a very in-depth look at the reasons supporting legalization of physician-assisted suicide. It provides critiques of arguments in support of active euthanasia and maintains the unethical qualities of its practice.

Emanuel, Ezekiel J. "What is the Great Benefit of Legalizing Euthanasia of Physician-Assisted Suicide?" Ethics 109.3 (1999): 629-642. Emanuel asserts that the real issue at hand when considering legalization of physician-assisted suicide deals with the ramifications associated with making it social policy. When deciding the benefits of legalizing physician-assisted suicide one must assume and predict several outcomes. Emanuel states that the benefits of legalizing physician-assisted suicide include: honoring an individual's autonomy; reducing unnecessary suffering and pain; and psychological reassurance of the dying patient. Although the benefits of legalizing physician-assisted suicide are obvious, the issues associated with its disadvantages are more difficult to evaluate. Legalizing physician-assisted suicide my possibly: undermine the integrity of the medical profession; create psychological anxiety and distress in patients and their surviving family members; coerce patients to use PAS against their will; allow for implementation of PAS when other options are possible or with out informed consent. This article explains the issues associated with PAS in clear and elementary manner; therefore it would be appropriate for anyone wanting to familiarize themselves with PAS.

Kamm, F.M. "Physician-Assisted Suicide, the Doctrine of the Double Effect, and the Ground of Value." Ethics 109.3 (1999): 586-605. Kamm focuses this article on addressing the permissibility of physician-assisted suicide with respect to the "Kantian" objections. Kamm believes that physician-assisted suicide and euthanasia are permissible because they waive one's right to continue living with out turning over one's rights to someone else. Kamm provides support for this claim by evaluating arguments that support the permissibility of physician-assisted suicide and euthanasia. The arguments are as follows: the four-step argument; the alternative to the four-step argument; and the argument for a duty of a physician to engage in physician-assisted suicide. This article was well researched and included the opinions of many ethicists and would be better suited for an individual that is familiar with moral ethics.

Lee, Daniel E. "Physician-assisted suicide: A Conservative Critique of Intervention." Hastings Center Report 33.1 (2003): 17-19. Lee states that he is opposed to physician-assisted suicide because he believes that it is for God to decide. Oregon's Death with Dignity act is very rigorous and maintains several requirements to avoid abuse. Patients are required to request the medication that will end their lives on two separate occasions and must put in writing that they request to die. Before administering the lethal medication, doctors have to tell the patient the options and alternatives to physician-assisted suicide. Lee maintains that opponents of physician-assisted suicide should focus their efforts on informing patients about the possible hope and life that they might have by refusing to implement physician-assisted suicide. This article is one of the few articles that express opposition to physician-assisted suicide. The article is not well researched and should not be used to base opinions about the moral permissibility of physician-assisted suicide.

McStay, Rob. "Terminal sedation: Palliative care for intractable pain, post Glucksburg and Quill." American Journal of Law and Medicine 29.1 (2003): 45-76. ProQuest Direct. Oklahoma State University Library. 29 September 2003 http://80-proquest.umi.com. argo.library.okstate.edu/. In the U.S. palliative care is observed by society as a permissible option for the terminally ill. McStay asserts that terminal sedation is a practice that is not only permissible, but also a critical option for terminally ill patients. The debate over terminal sedation focuses on whether or not it is comparable to physician-assisted suicide and euthanasia. Critics of terminal sedation say that it is impermissible for the same reasons euthanasia is; the intent of the physician and patient is death. This article affirms that terminal sedation and euthanasia are not morally similar and they must have specific laws distinct to each.

Thomson, Judith Jarvis. "Physician-Assisted Suicide: Two Moral Arguments." Ethics 109.3 (1999): 497-518. Thomson opposes the two moral arguments that object to legalizing physician-assisted suicide by suggesting they are fundamentally bad arguments. Thomson believes the arguments fail to consider a fundamental moral issue: intentions. The intention most patients and physician have when choosing to implement PAS are not intentions of death, moreover, they are intentions of relieving pain or ending suffering. This article is best understood when the reader has had a background in moral issues and ethics. The author assumes the reader understands several fundamental concepts about the morality of physician-assisted suicide. Judith Thomson has also published articles about the morality of abortion and is well known in the field of moral ethics.


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