Drew Farrahar's List: Injustice of suicide

• Physicians have an obligation to relieve pain and suffering and to promote the dignity of dying patients in their care

• Furthermore, it is argued, we ourselves have an obligation   to relieve the suffering of our fellow human beings and to respect   their dignity. Lying in our hospitals today are people afflicted   with excruciatingly painful and terminal conditions and diseases   that have left them permanently incapable of functioning in   any dignified human fashion.
• urther, opponents of assisted suicide claim that society   has a duty to oppose legislation that poses a threat to the   lives of innocent persons. And, laws that sanction assisted   suicide inevitably will pose such a threat

• While both physician aid-in-dying and euthanasia involve the use of lethal medications to deliberately end a patient's life, the key difference is in who acts to end the patient’s life.  In physician aid-in-dying, the patient must self-administer the medications
• Suffering means more than pain; there are other physical, existential, social and psychological burdens such as the loss of independence, loss of sense of self, and functional capacities that some patients feel jeopardize their dignity. It is not always possible to relieve suffering. Thus PAD may be a compassionate response to unremitting suffering.
• Potential for abuse: Vulnerable populations, lacking access to quality care and support, may be pushed into assisted death. Furthermore, assisted death may become a cost-containment strategy. Burdened family members and health care providers may encourage loved ones to opt for assisted death and the protections in legislation can never catch all instances of such coercion or exploitation. To protect against these abuses, PAD should remain illegal.
• n both states, the Death with Dignity Act has strict patient eligibility criteria, limiting access to competent, legal residents of the state over age 18, with a terminal illness (defined as an estimated life expectancy of 6 months or less) that is confirmed by two independent physicians.

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• Liberal opponents of PAS, of which there are many, believe the strongest case against it is the danger it poses to the poor and the weak, those unable to defend themselves from coercion and social rejection.

• Those who talk of the "sanctity of life" make a fundamental mistake: it is not mere quantity of life that matters, but its quality; and since dying is a living act, the quality of experience at the end of life, or in conditions of incurable distress, is the overriding consideration.
• Baroness Warnock and the organisation Dignity in Dying to have physician-assisted suicide legalised is a simple one: it is a humane impulse of kindness, based on the realisation that we are gentler to our pets than to our fellow humans in facilitating an ultimate release from suffering when it is needed. I
• A civilised and mature society should allow the few—they will always be a very small minority—who desire this option to be granted the right to take it
• Those who talk of the "sanctity of life" make a fundamental mistake: it is not mere quantity of life that matters, but its quality; and since dying is a living act, the quality of experience at the end of life, or in conditions of incurable distress, is the overriding consideration.
• Those who talk of the "sanctity of life" make a fundamental mistake: it is not mere quantity of life that matters, but its quality; and since dying is a living act, the quality of experience at the end of life, or in conditions of incurable distress, is the overriding consideration.
• More than 90 per cent of these assisted deaths shorten life by less than a month—indeed most of them by less than a week. The number of physician-assisted deaths in the Netherlands has decreased since it was first made legal, and has stabilised at a very low level.

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• Negative autonomy is the right to be left alone. The right to negative autonomy is radical, and is accepted by all bioethicists. The right of a competent adult to refuse medical care is universally acknowledged.
• ltimately, negative autonomy--the right of the patient to refuse treatment--is always to be respected, but positive autonomy is always a merely an assertion of choice among several treatments deemed appropriate by the medical profession. Positive autonomy is always really an exercise of negative autonomy on a limited list of options.
• he issue of physician-assisted suicide hinges on whether or not killing is medical treatment. If killing is medical treatment, then patients who have a disease for which the medical profession has decided that killing is an effective and appropriate remedy have a right choose it.

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