The Pros And Cons Of Physician Assisted Suicide

Physician-assisted suicide for psychiatric patients has become a highly debated ethical issue. In the United States, only a handful of states allow for assisted death (“Physician-Assisted Suicide Fast Facts”). Growing awareness for mental health has stirred conversation about whether physician-assisted suicide should be extended to individuals with severe mental illness. For physicians, the ethical principles of beneficence, non-maleficence, and justice are in direct conflict with autonomy. Does the idea of “do no harm” outweigh the potential emotional benefit patients receive from choosing to no longer suffer from their mental illness? This paper will argue that given the moral consequences, physician-assisted suicide for psychiatric disorders,

Every mental illness and person are different, so it is difficult to determine who can decide if physician-assisted suicide is the right treatment for them. Medical ethics state that physicians must uphold the principle of beneficence where they create the greatest amount of good for their patients (Munyaradzi 2). For individuals with psychotic disorders, a key factor them are hallucinations and delusions. This could impair one’s ability to make a decision for their health (“Understanding Psychosis”). A major factor in decision-making is the dorsolateral prefrontal cortex. This region guides behavior, working memory, and inhibition (Barch and Sheffield 224). In psychotic disorders like schizophrenia, there is evidence of impaired activity in the dorsolateral prefrontal cortex (Barch and Sheffield 224). This inability to properly regulate the activity of this region could impact decision-making, such as pursuing physician-assisted suicide. While personality disorders are consistent over time, some disorders, such as borderline personality disorder, are characterized by impulsivity (Brodeur 18). This could also make providing an accurate understanding of one’s wish more difficult (Brodeur 17). For physicians to perform assisted suicide on their patients, there must be complete clarity on patient wishes, and having a mental illness that produces

Deontology would argue that the physician has a moral responsibility to respect their patient’s best interest and wishes because this framework claims actions as good or bad regardless of the consequences (Terry 190). People that are considered for assisted death have tried other treatment measures that have not worked (Van Veen et al 621). There is evidence showing a reduction in grey matter tissue, majorly impacting the superior temporal gyrus in patients with treatment-resistant schizophrenia (Anderson et al 5). Grey matter does not regenerate (“Grey Matter”), so treatment may not be able to compensate for this tissue loss. Mental illness, including personality and psychotic disorders, is a risk factor for premature death. For individuals with mental illness in New Zealand, the most common cause of premature death is suicide (Monasterio 77). Legalizing physician-assisted suicide could allow individuals with suicidal ideation to die peacefully. While this is a relevant and compelling position, it is not sufficient. Every case of mental illness is different, so they all need to be considered independently (Brodeur 19). A different deontological take would be that the physician would be violating the idea of what it is to be a physician by participating in assisted suicide. The moral line between helping someone die with dignity and helping a physically healthy individual die