Overview
Views on assisted suicide /Euthanasia
Lizbeth N.Peguero
Montclair State University
Assisted suicide /euthanasia is the deliberate act of taking a person's life to end their suffering, known as Euthanasia. Euthanasia might be committed, for instance, if a physician purposefully gave a patient who was suffering from a terminal illness a medication they did not otherwise require, like an excessive amount of sedatives or muscle relaxants, with the express intent of ending their life. However, instead, a deliberate act of assisting an individual to commit suicide is known as assisted suicide. A relative of a person struggling with a terminal illness may be charged with aiding suicide if the relative obtained potent sedatives, knowing the person planned to use them to end their life.
In some areas of the United States, terminally ill residents have the option of physician-assisted suicide or aid in dying, even though it is not illegal in all fifty states. We must ask ourselves if we have the right to choose how and when to pass away in light of the concept of physician assistance in dying. I must comprehend the problems with physician aid in dying and the nursing profession's stance on the subject; this essay aims to discuss physician aid in dying, its effects on the nursing profession, and its ethical and legal ramifications. To add on, something that was extremely interesting was the racial disparities in hospice use and end-of-life treatment. The intensity in the Regards Cohort," Ornstein et al. highlight previously obscure racial disparities in hospice utilization and end-level care intensity. The research reveals that there is unfairness in the availability of hospice care for different ethnic groups, resulting in most non-whites accessing less intense end-of-life healthcare threats when compared to the equivalent whites (Ornstein et al., 2020). It is highlighted with these findings that the systematic reduction of end-of-life care barriers is essential to creating a fair access setup. The Journal of Bioethical Inquiry presented the article "Understanding the reasons behind healthcare providers' conscientious objection to voluntary assisted dying in Victoria, Australia." The research illuminated nurses' viewpoints, uncovering highly suggestive ethical, moral, and professional dimensions of what nurses consider their role in Euthanasia (Haining et al., 2021). Factors like religious beliefs, personal values, and even the concern for declining a moral life status motivate nurses to become conscientious while performing end-of-life services. Moreover, Freeman et al. wrote "Investigating Palliative Care Nurse Attitudes towards Medical Assistance in Dying: An Exploratory Cross-sectional Study." It explores nurses' attitudes towards aid to Euthanasia from the perspective of palliative care (Freeman et al., 2019). The research focuses on the opposing attitudes concerning Euthanasia among the nurses who take care of hospice patients. While some support the use of Euthanasia as a way of relieving the patient's suffering, others highlight the ethical dilemma the procedure poses and the effect it has on the essential nurse-patient relationship. In the paper "Views on assisted suicide and religious beliefs." published in OMEGA - Journal of Death and Dying, the researchers examine the joint influence of religious worldviews and the position towards assisted suicide. The study comprehensively analyses the divergent religious interpretations of life as Holy and how this leads to varying views on Euthanasia(Kletecka-Pulker et al., 2022). It also examines the historical and cultural factors that shape the positions. For example, the Catholic Church based in Europe reveres the intrinsic value of life. Moreover, there is a rule against Euthanasia. At the same time, some Protestant denominations from Europe exhibit more of a flexible approach, acknowledging the hard choices faced at the end of life. Furthermore, the study investigates the navigating role with which religious teachings interact with modern bioethical principles. This is done to understand the political correctness of issues concerning Euthanasia across religious traditions. Besides this, the research demonstrates the existence of the individual believers' distinctions and the place of the variety of spiritual traditions in societies, hence the varying attitudes towards assisted suicide that are obtained globally. Similarly, the Journal of Religion and Health goes beyond a general observation of how the major world religions understand and dedicate themselves to the issue of Euthanasia. It sheds light on the delicate relationship between religious doctrines and ethical principles, proving that they significantly impact how people think and behave in life-ending decisions (Grove et al., 2022). In Christianity, there are a lot of different denominations that may offer various standpoints related to Euthanasia: one of them focuses on compassion, and others on the strict execution of life preservation rules. In the same way, the Hindu doctrine of the transmigration of souls and karma also supports a wide range of opinions as to whether Euthanasia is acceptable, with the focus of this question being not only on the current incarnation of the person but also on the existence to come. The journal says that religious considerations on Euthanasia have become more dynamic because of the existing ethical debates, innovations in medicine, and the transformation of social views. Castelli Dransart et al. (2019) published on Aging & Mental Health the article "A Systematic Review of Older Adults' Request for or Attitude toward euthanasia or assisted suicide," which has shown notable contributions on the topic from older adults' perspectives. Though older individuals' end-of-life perspectives are very diverse, the review also shows the factors that knit these attitudes together by using the perspective of literature. Besides the well-known factor of what people perceive as quality, driven lives, the beneficiaries, and how autonomous one gets to be, the review shows how cultural norms, religious beliefs, and past experiences determine the attitudes of older individuals towards Euthanasia (Castelli Dransart et al., 2019). This also underlines the significance of discovering the shades of influences that form the behavior within this generation, as it is clear that individual attitudes may be based on the unique mix of personal, social, and contextual factors. Underlying this is the systematic review, which serves as a comprehensive resource for doctors and policymakers who are having problems with defining the eligibility of old adults for Euthanasia. In the survey results, it was more than evident that those who were Christian and catholic disagreed the most with assisted suicide, and the differences were statistically significant. Currently, eleven U.S. states allow physician-assisted suicide: Oregon, Washington, Montana, Vermont, Colorado, Washington D.C., Hawaii, New Jersey, Maine, New Mexico, and California. Since Oregon was the first state to legalize physician aid in dying, the practice is most frequently linked to that state. The Oregon Death with Dignity Act (ODDA) was a ballot initiative approved in 1994 but not enacted until 1997 due to additional legal challenges. The law outlined precise guidelines for physician assistance in dying, including who is eligible to seek it, how to do so, what healthcare providers must do, and the fact that Euthanasia is prohibited. Furthermore, the ODDA requires the Oregon Public Health Department to produce a yearly report. The reports offer guidance and a framework for aid in dying. Measures such as the Oregon Death with Dignity Act were put in place to guard against abuse of medical assistance in dying. A patient must meet all requirements outlined in the act and follow the procedure for requesting a prescription to receive the medication. According to Westfield et al. (2009), p. 161, the patient must meet specific requirements, including being a resident of Oregon, being 18 years of age or older, being diagnosed with a terminal illness, and having a death sentence within six months. Furthermore, the patient needs to be capable of giving themselves their medication. Self-administration of medication is the distinguishing factor between aid in dying and the illegal practice of Euthanasia. Under their respective Death with Dignity acts, residents of Vermont and Washington must meet the exact requirements. An eligible patient must submit one witnessed written request and two oral requests to request medication. Patients may revoke their request at any point while it is being processed. All requests must be made by the person taking the drug. Following the initial oral request, two doctors, one treating the patient and the other providing consultation, must conclude that the patient fulfilling the prescription request satisfies all five requirements without fail. Should one of the doctors believe the patient is not mentally competent, they might ask for a psychological evaluation. The patient has to wait at least fifteen days after the first oral request is granted before submitting the second. Following approval of the second oral request, the patient has to give a written request for aid in dying, using the statutory form found in the state's Death with Dignity Act, to the attending physician. After doing extensive research on assisted suicide, it was extremely tough to find articles on it. These were related to people's views based on their religion, level of education, gender, and age. Some articles only provided me with perspectives of nurses on Euthanasia but not really how individuals felt towards it based on their religion. This research aimed to see people's views and whether they agreed with them based on their religion. Moreover, I was pleasantly surprised with the results and the feedback from those taking the survey. Many did not even know what assisted suicide/euthanasia was, and others mentioned that the scenarios I had created were complex and that some questions they found challenging to answer. Forty-nine people over the age of 18, representing all genders, participated in this study by answering 20 survey questions about their perspectives on assisted suicide/euthanasia. The main objective of this investigation is to determine people's thoughts on Euthanasia based on Age, race, ethnicity, level of education, social class, and political party as independent variables. The dependent variable was religion and how those being surveyed felt about euthanasia / assisted suicide based on their faith and how many who are religious believe that only God should determine when life ends. Another dependent variable was people's knowledge of euthanasia / assisted suicide and whether they considered it a form of murder. As well the trauma nurses endure is another dependent variable, and last, another dependent variable is how often they attend a religious service, measuring the level of religiosity. The goal was to survey people of all ages and cultures. I sent it to classmates via email, text, family members, friends, and coworkers. I used my social media platforms, such as Instagram, to extend my survey to more people. In this survey, snowball sampling was used because my aunt, who lives in the Dominican Republic, had sent it to some of her coworkers, and the first suicide hotline ever made in the Dominican Republic, so I knew they would have interest in taking my survey because its something they deal with on a day-day basis. I also had my cousin, who is a nurse, take it. And her first word to me was, thankfully, I never had to go through this with a patient because of the attachment and emotional bond they feel. She told me it would be challenging to watch a patient die day by day and not naturally but because of a medication. Even though I read articles on nurses' perspectives, hearing it from a nurse that I know personally struck me because before initiating my survey, I never really took into consideration the feelings of those surrounded by the patient. I only put myself in the patient's shoes, who was tired of living in pain. However, all the answers remained anonymous, and I saw that I did not only survey people in my age group, but I also saw various opinions. When it came down to analyzing my data, the composite measure of my survey was to measure the attitudes toward assisted suicide/euthanasia. The highest possible score for my Likert scale is 25, which means that the person taking the survey strongly disagreed with the statements against Euthanasia. The lowest possible score would be one representing strongly agreeing with a statement, with a score of five for those strongly disagreeing. A score of one would represent firmly being against assisted suicide/euthanasia. My initial hypothesis was nominal, and my hypothesis stated that females will disagree with assisted suicide, meaning that they will have lower scores. The only reason I believed that females were going to disagree with it is that women are known to be nurturing, birth givers, compassionate, and much more emotional. Even though my pattern was rejected, my hypothesis was confirmed. It was expected for women compared to other genders to disagree with assisted suicide, and concluded that my results were not statistically significant. However, one of the most surprising findings would be my second nominal hypothesis: Latinos will disagree with assisted suicide /euthanasia in terms of scores. Latinos will have lower scores strongly agreeing with my negative statements. I came up with this hypothesis because most Spanish-speaking countries are religious, and they are Catholic or Christian. Personally, implying my own upbringing and the Dominican Republic being the only country in the world with a bible on it made me believe most of the people taking my survey were going to disagree with this. However, my pattern was rejected, and the pattern was not as expected. Latinos didn't have the most negative perception of assisted suicide. It was Asians. My results were not statistically significant. Furthermore, when it came down to my third hypothesis that had to do with religion, I believed Christians and Jews would disagree with assisted suicide just because, based on personal encounters I've had at church, they think that only God should determine when your life ends. I was highly astonished to see that both my pattern and hypothesis were rejected, and, in actuality, the Christians and Catholics disagreed the most with assisted suicide/euthanasia. If I had sent the survey to more classmates, such as sending it in the group and posting it on all my social media, such as Twitter and Facebook, I would definitely have gotten a more comprehensive range of perspectives on the topic, different ages, and ethnic backgrounds, and had a large enough random sample. Because of how the standard error is calculated, you will always find a substantial difference between variables. However, my goal in my survey was to create complex scenarios and see how people answered these questions based on their age, race, gender, and level of education. From the feedback I received from most of my friends that I surveyed, those aged 20-22, Multiple of them had mentioned that when I came up with the scenario of "Let's say your child has been battling Chron's disease for about two years now. She has been through multiple surgeries, and this has led to depression. Doctors say she can live a long life, but this child does not wish to continue "'. Moreover, one thing that my friends mentioned was that it was easy to agree to assisted suicide/euthanasia until they got to that part of the survey. Many said parents shouldn't witness their child die, especially if they can control it and avoid it at all costs, and the doctor is giving them hope that the survival rate is high. Another scenario that I created was "A middle-aged immigrant man has gotten into a tragic accident. His wife passed away from cancer a few years ago, leaving behind three minors. If he survives, he will be in a vegetative state. Do you think his mom should lean toward assisted suicide?" Many Christians voted unsure because they took into consideration that God could grant a miracle. My following results were shocking when I ran a data analysis on qualtrics and compared gender and whether or not assisted suicide /Euthanasia should be taught in schools 33.3% of males thought yes. 40.0% said no, and 9.1% were unsure, and truthfully, I thought most males would say yes. However, it turned out that 61.1% of women believed it should be taught in schools so future generations could have some knowledge of it. At last, after reading all these articles on assisted suicide/euthanasia, I realized that critics of the proposal contend that because of their illness, terminally ill patients are not competent to make decisions about their care. It is presumed that a patient who requests physician assistance in dying is suffering from severe depression or bereavement. However, there is no stigma or judgment applied to a patient who requests to be placed on a "do not resuscitate" (DNR) code or who wants to cease receiving life-sustaining treatment. In these situations, the patient's desires are honored. Even so, there is always a chance that using lethal medication, ending treatment, or having a DNR code will result in death. Consequently, healthcare professionals who respect patient autonomy must acknowledge that the more critical a decision is, The more crucial it is for the patient to consider their values and be able to make that decision, similar to the choice to accelerate death with aid in dying. The ethical principle of autonomy states that the provider must honor the patient's wishes. While a provider does not need to support a patient's choice, they should not force their opinions on them. The right to self-determination is currently a common point of contention for the legalization of assisted dying in wealthier nations. Our right to self-determination appears unassailable, and our capacity for it is seemingly boundless. In response to questions about voluntary Euthanasia in opinion polls, the general public revealed that few people could hardly imagine not being able to make their own decisions or not having the option. Furthermore, healthy respondents to a survey might find it difficult to picture themselves in a situation where they would prefer not to have the choice. To conclude, I feel as if assisted suicide /euthanasia is extremely important, and people do not shed light on this situation because it is frowned upon by religions or looked at as the easy way out. Still, I feel as if people who are terminally ill know how much pain they can handle. It is one of those things where it is easy to talk the talk, but you cannot walk the walk. It is easy to judge others for their decisions based on their beliefs and upbringing. Before coming up with this survey, I had no thoughts on it. Growing up in a religious household, I always heard, "Only God can determine when your life ends." After doing extensive research it made I realized that we weren't placed on this earth to suffer, and if you are 18 or older and you are terminally ill, you should have the right to decide whether you want to continue or not. I would also like to include that it was somewhat challenging to get accurate data because not all of the participants chose to answer all the questions. Regarding my data analysis, only 38 out of the 49 answered all the questions. I could imagine that because I asked a lot of personal questions such as religion, political party, etc., From my survey results, I noticed that many people view assisted suicide as a form of murder, but it is hard to speak about a situation if you have not gone through it personally. There are many moral, legal, and ethical issues surrounding the debate over whether or not assisted suicide education should be taught in schools. Fundamentally, it weaves together intricate conversations about compassion, autonomy, and the sanctity of life. Proponents contend that teaching kids about assisted suicide encourages empathy, thoughtful decision-making, and a sophisticated awareness of end-of-life options. Advocates stress that this kind of instruction can enable people to have meaningful discussions about dying and death, lessening the stigma and anxiety associated with the subject. Furthermore, proponents claim that discussing assisted suicide in the classroom helps foster critical thinking regarding medical ethics and the duty of healthcare providers to respect patients' autonomy. Opponents, however, have legitimate worries about what would happen if assisted suicide is taught in schools. They contend that this kind of instruction can unintentionally normalize or glorify suicide, especially among susceptible groups like young people dealing with mental health problems. Furthermore, opponents argue that teaching assisted suicide could be in opposition to some cultural or religious values that uphold the sanctity of life and reject Euthanasia in any form. The legal environment around assisted suicide also differs significantly between jurisdictions, making it much more difficult to include it in school curricula. Teachers would have to carefully negotiate these legal nuances to ensure compliance with local laws and deliver the material impartially and objectively. Whether or not assisted suicide should be taught in schools is still a debatable topic that needs to be carefully considered in light of moral, ethical, and practical considerations. Education can be vital in promoting communication and understanding, but it must be done so with tact and respect for other viewpoints, taking into account the significant effects that end-of-life decisions can have on people, families, and society at large. However, I do believe that Schools should shed light on this topic as well as emphasize that just as hard it is for the patient to make this decision to end their life, the physicians that have to medicate these patients endure trauma and, at times,, have to lean into therapy to accept what has occurred in their hands. Because it is not just another patient, you are prescribing these medications for an individual, and knowing they have passed is something that can taunt you for the rest of your life. References Kresin, T., Hawgood, J., De Leo, D., & Varghese, F. (2021). Attitudes and Arguments in the Voluntary Assisted Dying Debate in Australia: What Are They and How Have They Evolved Over Time? 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