Physician assisted suicide should be legal nationwide.

Physician assisted suicide (PAS) is a controversial practice in which a doctor ends the life of the patient at his or her request. In the United States, PAS is currently legal in Oregon, Washington, Vermont, Montana, and New Mexico [1]. Oregon was the first state to legalize PAS following the enactment of the Oregon Death with Dignity Act on October 27, 1997 [2]. The other four states, Washington, Montana, Vermont, and New Mexico followed suit with the passage of I-1000 in 2008, the expansion of the Rights for the Terminally Ill Act in 2009, enactment of the Patient Choice and Control at End of Life Act in 2013, and a 2nd District Court ruling [3]. Contention 1: PAS does not disproportionally affect vulnerable groups. Although a frequently cited British study declares that PAS violates the rights of vulnerable individuals, this study declared competing interests, as two of the authors "gave oral evidence to the Select Committee on the Assisted Dying for the Terminally Ill Bill on behalf of the Association for Palliative Medicine" and one being a member of that committee [4]. As a result, this study fails to stand in comparison with the various other non-biased studies that show equality in the application of PAS. Looking at data from Oregon, it is evident that PAS does not affect groups that are considered vulnerable at a higher rate than those that are not considered vulnerable. An analysis of 8 years of data from the Oregon Department of Health showed the following [5]: Individuals who were over 85 made up only 10% of PAS deaths, whereas 21% of the total deaths in Oregon were of those 85 and older. Only 2% of PAS deaths were of individuals with AIDS. Individuals who died by PAS were 7.6 times more likely to have a college degree. No patients who received life-ending medication were found to have a mental illness. Contention 2: Adequate screening for mental illness prevents the misuse of PAS.Terminally ill individuals are often concerned about leaving behind family members and may become anxious and depressed. While there have been studies analyzing the rates of depression in those who requested or received aid in dying, these studies have methodological problems, as targeting the desire for death in a PAS-specific manner invokes social and legal constraints [6]. For this reason, research that focuses on PAS in relation to depression rates are unreliable. As a result, scholars encourage those interested in the demographics of those receiving PAS to look into the desire for death as a whole in terminally ill patients [6]. There have been numerous studies conducted with the aim of gauging the prevalence of depression in individuals with terminal illness. For 25% of those with metastatic cancers depression is a major symptom, however "80% of the psychological and psychiatric morbidity which develops in cancer patients goes unrecognized and untreated" [7]. Thus, the key to improving the quality of life with those terminal illnesses is the training of healthcare professional in the identification of depression and providing appropriate treatment. By addressing clinical depression, the likelihood of PAS being abused is greatly decreased. Contention 3: PAS remains rare even in states where it is legal. In 2001, deaths by PAS made up 7 out of every 10,000 deaths in Oregon, which decreased since 1999 even though the number of prescriptions for life-terminating medications increased [8]. Washington state saw a similar occurrence, when in the three years since the passage of I-1000, 255 prescriptions had been written for life-ending medications but only 60% of patients chose to use them [9]. The legalization of PAS has not led to a noticeable increase in the number of patients taking life-terminating medications, dispelling the myth that terminally ill patients rushed to end their lives. [1] http://mobile.nytimes.com...[2] https://public.health.oregon.gov...[3] http://healthcare.findlaw.com...[4] http://www.ncbi.nlm.nih.gov...[5] http://www.ncbi.nlm.nih.gov...[6] http://jama.jamanetwork.com...[7] http://pmj.bmj.com...[8] http://www.nejm.org...[9] http://health.usnews.com...