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Oregon’s Death with Dignity ActAlyssa ShockUniversity of Wisconsin- Eau ClaireAbstractThe NASW Code of Ethics states that they respect the inherent dignity and worth of the person. Social workers are in numerous initiatives with the end-of-life care. Social workers always want what is best for their client, so having their client choose the end of life care isn’t always easy, but one of the values of the NASW Code of Ethics is Dignity and Worth of the person. Social workers want to respect individual’s dignity and respect each person in a caring and respectful fashion. When it comes to a person coming towards the end of their life, hospice social workers help. Hospice social workers do not prescribe lethal substances for their clients to end their life. Hospice is meant to care and support individuals who are expected to live six months of less. The end of a person’s life is a unique experience that has a great impact on the person’s family system. Social workers are advocates, and now there is a greater need for people to do into hospice care with the longer life expectancy.The Death with Dignity is an act that was created to help promote the ability to meet death on an individual’s own terms. It offers choices for people who are terminally ill instead of waiting for the illness to kill them instead. There are different types of death with dignity, which is physician assisted suicide or euthanasia. The difference between the two is that euthanasia is when the physician is taking the active position to continue with what the patient requested, which usually involved a lethal substance. Whereas physician assisted suicide is when the physician makes the lethal substance available for the patient, but the patient will use the substance at their own choosing. Euthanasia is not permitted in order to end a human life. This reading will cover the background, medical aid globally, both controversial sides, and the authors perspective. There are several laws that go with the Death and Dignity act and it varies in each state. History Oregon is the first state in America to legalize physician assisted suicide. In 1993, doctors and nurses in Oregon established the political committee called Oregon Right to Die. It brought a various of stakeholders to review drafts of the bill that was going to be placed on the ballot for the next year. The Death with Dignity Act was founded in 1994 and passed in 1997. The more common name used for the act is physician-assisted dying. Within those three years, the law was approved, then on temporary restraining orders, then denied, then reviewed, then finally approved. Oregon voters were the first in America to approve of the act that would allow physicians to prescribe a lethal dose of medication to a terminally ill patient so they could choose the end of their life. According to the Oregon Encyclopedia, “when the act became law in Oregon, it was only passed by a slim majority of fifty-one percent” (Ganzini 2018). The same year the state did a second ballot and got a result of sixty percent supporting the new law. Between the years of 1998 and 2015, studies show that over five hundred patients died by lethal prescription, which is usually a high dose of a short-acting barbiturate. Once Oregon passed their law, Washington Death with Dignity Act goes into effect in March of 2009. The Washington Act passed with a fifty seven percent vote in favor. The following states continued to follow in the steps of Oregon, but there are still complications with the question of whether Death with Dignity is ethical or not. There have been cases of patients that express concern about pain at the end of their life. The patients would also express concern about being a burden to family members, friends, or other care givers about the inability to participate in activities that makes lives enjoyable. The thought of purposely ending a family members life is a heart-aching thought. Individuals always have hope in their heart that there is a cure to this illness. When this act became legal, many people thought it was unethical. Likewise, there are still those who continue to have the same thoughts.Medical Aid in AmericaThe legislature finds that at least thirty states have considered enacting laws to allow mentally competent adults who have a terminal illness to request and receive a prescription medication to allow an individual to end their life peacefully and pain free. In order to be eligible for death with dignity, people must be an adult, state resident, mentally competent, and having a terminal disease with a six-month life expectancy. If those requirements are met, it needs to be confirmed by two licensed physicians, then only the patient can make the oral request for the medication face to face. As of 2019, there are eight states in America that currently have Death with Dignity laws. “Those eight states include California, Colorado, District of Columbia, Hawaii, Maine, New Jersey, Oregon, Vermont, and Washington” (Death with Dignity n.d.). In 2009, Montana’s supreme court ruled nothing in the state law prohibited a physician from honoring a terminally ill patient’s request by prescribing medication to that specific patient’s death. There are several reasons that there are eight states to make this act legal. There is a huge debate across America discussing whether this is a beneficial act or an act that will make the country weaker. In the United States, a second doctor must see the patient to confirm that they are terminally ill and that their request is accurate. In Oregon, Washington, and Vermont, the patient must also see a mental health professional if the doctor suspects they may be suffering from a psychological disorder. If that is the case, then the doctor will not prescribe the patient with the lethal substance to end that patient’s life. In Oregon, the doctor must report each prescription and each death to the state health department. If the physician or doctor doesn’t corporate with the legal requirements, then the health department will refer the case to the body to regulate physicians. Each state is very similar when it comes to the law of Death with Dignity, but each state has their own individual smaller rules that individuals may not be aware of.Medical Aid WorldwideThere are other countries that have legalize physician assisted suicide that people can compare and contrast to. Currently physician assisted suicide is legal available in Belgium, Canada, Colombia, Luxembourg, The Netherlands, and Switzerland. In Switzerland, studies show that assisting suicide has not been a crime since suicide was decriminalized during the enlightenment. With that being said, the government did point out that if there was an assistance with selfish motives, then a punishment would be followed. Their law with physician assisted suicide is, “any person who for selfish motives incites or assists another to commit or attempt to commit suicide is, if that other person thereafter commits or attempts to commit suicide, liable to a custodial sentence not exceeding five years or to a monetary penalty” (My Death My Decision. 2018). Only the Netherlands and Belgium permit euthanasia for patients under the age of eighteen. Netherlands and Belgium require a second doctor to see the patient to confirm their request is valid and their suffering is unbearable, Belgium also has a rule that a patient under the age of eighteen may request euthanasia with parental consent. The child’s competence is required, and suffering based on a psychiatric disorder is excluded. Furthermore, in the Netherlands, both voluntary euthanasia and physician assisted suicide have been legal and accepted for those who were experiencing unbearable suffering without the hope of improvement. The Netherlands legalized physician assisted suicide in 2002, and the practice were initially tolerated under guidelines prepared by the main national legal and medical organizations.Current ControversaryThe controversy in America over the Death with Dignity act is that there are concerns and worries with the procedure. Euthanasia is a Greek word that is referred to as easy, painless, happy death. However, there are situations where the drug could be taken advantage for. The people who are against the Death with Dignity act state that it doesn’t end suffering because it passes on to similar people who now fear they are the next people in line for death. They also discuss that even when people are expected six or less months to live, studies show that almost half of those people live over the six-month life expectancy. For example, if a physician who does not know how to relieve a patent’s suffering may compassionately, but inappropriately, agree or persuade with the patient to end his/her life. The drug itself is expensive for the hospital to receive and for families to pay. The prescription depends on the physician’s assessment. “The liquid used to cost around five hundred dollars until about 2012, when the prices increased to somewhere between $15,000 and $25,000” (Death with Dignity National Center. 2018). If this drug gets into the wrong hands, it could be used to kill other people intentionally. People who have died from a drug overdose did not have freedom or choice at all, now America is trying to make authorized suicide as a ‘choice’. People believe that when it is time for someone to go, it is God’s choice to choose that. It is seen that the government is trying to take away the power of God by letting people believe that is no hope for them anymore. Specifically, Catholics believe that killing of a humane being, even by an act of omission to eliminate suffering, violates divine lawn and offends the dignity of the human person. It is also seen as wrong to make a physician’s role to be the one to end someone’s life instead of the training they have done to save someone’s life. Physicians are trained to heal, not to kill.For the individuals who support the Death with Dignity Act, their reason is because they feel it is ending someone’s suffering and giving them the option of their own life. The right to die should be a matter of personal choice. People are able to choose all sorts of things in life, such as who they marry, career, and where they will want to live. If an individual has a terminal illness, they are their own individual humans and they should have the choice about what happens to them. The medical perspective also shows that whether the physician is active, the argument that physicians should be the only healers focuses heavily on the physicians, and not on the patient. Once the healing is no longer an option, when death is probable and patients find their suffering unbearable, that is when the physician’s role should shift from healing to relieving suffering and agree with the patient’s wishes. The right of a competent, terminally ill person is to avoid extreme pain and embrace a new possibility. As far as the money situation goes, there is no financial incentive to pressure patients into their decision making. Those in favor of physician assisted suicide argue that society should allow people to die with dignity and without pain, and that they should be able to manage their life at their own time. People who are religious and support physician assisted suicide believe that it is something people should have open hearts to. Individuals say that people can believe in god and physician assisted suicide without having a burden of ending someone’s life. These people are not murdering, they are ending suffering and unbearable pain that a loved one may be experiencing. Social justice, emotion, and empathy are important traits that are needed during times like these. The individuals want what is best for their loved ones and want to grant their loved ones wishes. When patients are experiencing extreme pain, they may beg their caregivers to complete their request of Death with Dignity. The circumstances are possible consequences that convince some physicians to help their wishes. Physicians are trained to be healers, not killers. Doctors and nurses do not enjoy seeing their patients die, but they don’t enjoy watching them suffer either. Studies show that physicians do not want to deny a dying patient the option of ending their suffering and avoiding a painful, long death. The question that physicians dread the most is when the patient asks about ending their life with a lethal drug. According to a physician himself, Dr. Ronald Pies found a study showing that, “… in December of 2016, a report found that fifty seven percent of doctors agreed that physician-assisted death should be available to the terminally ill” (Pies 2018).Authors StandpointThe author’s position on the topic is to let the individuals make the decision themselves. The author feels that if someone is suffering, incapable to participate in everyday activities, or only has limited time to live, it should be the choice of that person. There should not be any persuasion or guilt for the patient to make the choice. The author fears that if people don’t get the option to do it peacefully, that individuals may choose a more painful and gruesome way to end their life. Patients should have the opportunity to die with dignity, without the fear that they will lose their physical capacities. Additionally, if the patient agrees to organ transplant, there is a possibility that their organs can be harvested and donated. Of course, that would be the decision of the patient. The reason that the author believes this perspective is because people lose loved ones every day, and people can’t go back into time and change how their death occurred or change the fact they are gone at all. The author has never experienced a loss of a family member due to unbearable pain but has personal values to consider. The author could never bear the thought of purposely ending a family members life due to their decision, but that is a topic that nobody wants to think about. This society fears death and the outcomes that comes with it, but the author believes that this world should be accepting of people in agonizing pain that is uncurable. There is a huge difference between physician assisted suicide and suicide. For individuals who experience depression, PTSD, or anxiety, those individuals may feel hopeless, but the authors values are to help those specific people find meaning and beauty in life. The author agrees with the laws of physician assisted suicide and believes the regulations are moral and ethical. These people are choosing their own wishes and how they will be living their own lives. The authors professional value considers religion and how that may affect the morals of that social status. The author is a Christian and supports physician assisted suicide. Religion is where the author can understand the perspective of the other side, but that does not mean people should be okay with others suffering until their heart finally stops beating. Life is something full of experience, adventure, and love. Each life is different in the mind set of each individual. Some people are more fortunate than others and don’t have to worry about making the decision of whether to live until they die, or they choose when they want to die.ConclusionIn conclusion, physician assisted suicide is the voluntary death of one’s own life by administration of a lethal substance with the assistance of a physician. It has been legalized in several different countries and eight other states in America. Death with Dignity is a conversation that people feel very strong towards because they may have family’s members or a loved one experiencing some symptoms of a terminally ill disease. Death with Dignity isn’t something that is supposed to be easy to cope with, it is something that people are becoming more educated about. It is perfectly normal for individuals to be on one side of the spectrum and others on the complete opposite side. This society is constantly changing laws. It is up to each individual person to decide what their beliefs are and why they might believe that. Physician assisted suicide is an uncomfortable discussion to have, but it is important to be educated on it.ReferencesChin, A. E., Musso, D., Butt Y.M., Layden, J.E., & Oregon Health Division. (1999, July 15). Legalized Physician-Assisted Suicide in Oregon – The First Years’ Experience: NEJM. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJM199902183400724Death with Dignity. (n.d.). History. Retrieved from https://www.deathwithdignity.org/about/history/Death with Dignity National Center. (2018, June 12). How Much Do Physician-Assisted Suicide Drugs Cost? Retrieved from https://euthanasia.procon.org/view.answers.php?questionID=002166#targetText=The%20next%20most%20widely%20used,at%20between%20%24400%20and%20%24500.Ganzini, L. (2018). Death with Dignity Law. Retrieved from https://oregonencyclopedia.org/articles/death_with_dignity_law/#targetText=In%201994%2C%20Oregon%20voters%20were,the%20purpose%20of%20self%2Dadministration.Hendin, H. (2004, February 1). Commentary; The Case Against Physician-Assisted Suicide: For the Right to End-of-Life Care. Retrieved from https://www.psychiatrictimes.com/articles/commentary-case-against-physician-assisted-suicide-right-end-life-care#targetText=In%20physician%2Dassisted%20suicide%2C%20the,prolong%20a%20painful%20dying%20process.My Death My Decision. (2019, July 26). Assisted Dying in Other Countries. Retrieved from https://www.mydeath-mydecision.org.uk/info/assisted-dying-in-other-countries/Pies, R. W. (2018, January 12). How Assisted Suicide Affects Doctors. Retrieved from https://www.vice.com/en_us/article/ne44nw/how-assisted-suicide-affects-doctorsSocial Work Policy. (2007, May 10). Social Work Policy Institute. End-Of-Life Care. Retrieved from http://www.socialworkpolicy.org/research/end-of-life-care.html