You Choose the Resolution!

Thank you for your response. Re: Autonomy and Alleviation of PainPro argues that bodily autonomy recognizes that there is a right to die. However, one of the greatest fears for those who are opposed to PAS is that bodily autonomy will violated and pressure those to use PAS (I'll give some examples of this when I rebut the second contention). Furthermore, if there is a right to die, then why should we limit it to those who are terminally ill? Surely anyone with depression or wants to die should be able to go and request PAS. This could lead us down a dangerous slippery slope. Secondly, it is important to recognize that rights are not absolute. Even if we accept the right to die, why should we force physicians to partake in their death and aid them in an irreversable decision? Aaron Kheriaty notes: “To abandon suicidal individuals in the midst of a crisis—under the guise of respecting their autonomy—is socially irresponsible: It undermines sound medical ethics and erodes social solidarity." (1) As physicians, we have a duty to help patients and guide them in a time of crisis. To abandon them and give them medicine to kill themselves goes against those values. The most serious issue with this contention is how do we know that the patient is acting freely and under their own choice? Kheriaty also notes (2): "Suicidal individuals typically do not want to die; they want to escape what they perceive as intolerable suffering. When comfort or relief is offered, in the form of ­more-adequate treatment for depression, better pain management, or more-comprehensive palliative care, the desire for suicide wanes. We know that the vast majority of suicides are associated with clinical depression or other treatable mental disorders; yet alarmingly, less than 6 percent of the 752 reported cases of individuals who have died by ­assisted suicide under Oregon’s law were referred for psychiatric evaluation prior to their death. This constitutes gross medical negligence." In summary, the bodily autonomy and the right to die argument fails on the account that rights are not absolute. Because terminally ill patients are often under duress and suffer from depression, it is not clear whether they are acting under their free choice. Finally, there are no safeguards to ensure that the patient is acting under competence or to guard against coercion. This strongly violates bodily autonomy. So, what are alternatives to physician-assisted death and how do we best help those who are suffering? As I already pointed out, those who are suicidal don't necessarily want to die. Rather, they need tools and resources to be able to manage their pain. Victoria Kennedy, the wife of the late Senator Edward Kennedy, stated:"My late husband Sen. Edward Kennedy called quality, affordable health care for all the cause of his life. [PAS] turns his vision of health care for all on its head by asking us to endorse patient suicide—not patient care—as our public policy for dealing with pain and the financial burdens of care at the end of life. We’re better than that. We should expand palliative care, pain management, nursing care and hospice, not trade the dignity and life of a human being for the bottom line." [3] Dr. Leon Kass further notes:"We must care for the dying, not make them dead. By accepting mortality yet knowing that we will not kill, doctors can focus on enhancing the lives of those who are dying, with relief of pain and discomfort, moral and social support, and, when appropriate, the removal of technical interventions that are merely useless or degrading additions to the burdens of dying." [4] Re 2: Current law does more damageMy opponent's examples are an argumentum ad passiones - an appeal to emotion. Pro contends that the current law does more harm by forcing those who are sick and those who are suffering to live. The argument is built on a logical fallacy. I will instead, attempt to show that legalization of PAS will do significantly more damage. In my opening statements, I mentioned that misdiagnosis was unfortunately the case with many patients - especially among the terminally ill. I was specifically waiting for this round to be able to discuss specific examples as I did not want to see my round 2 opening statements to be seen as a rebuttal.Example 1: Erica Riel [5] Erica Riel was diagnosed with terminal illeness three times and later learned that it was untrue. She wanted to give up and sought PAS to end her life. Her family, however, encouraged her to see one more doctor in Massachusetts who told her she would live many more years. In testifying before the Senate committee, Riel, in testifying against PAS, stated, "How many other people are getting wrong diagnosis? Example 2: 66 year old woman in Mississippi [6]In a tragic case, a 66 year old woman was moved to hospice care for cancer that she never even had. She died of a massive overdose of pain killers. The Mississippi Supreme Court upheld a $4 million judgement against the hospice. ------If a patient is misdiagnosed, choosing PAS could potential violate their bodily autonomy (see re: c1) because their judgement and action is based upon an error on the physician's part. Finally, the PAS laws will do more harm because physicians are not held to any standards, nor are any recourses possible should they administer PAS in negligence, as Judge Gorschue notes:"[I]t is also rather remarkable that, while physicians in Oregon are held to a standard of professional competence in administering all other treatments they provide, the Oregon assisted suicide statute creates an entirely different regime when it comes to administering this “treatment,” specifically and uniquely immunizing doctors from criminal prosecution, civil liability, or even professional discipline for any actions they take in assisting a suicide, as long as they act in “good faith.” Thus, while a doctor may be found liable for mere negligence in any other operation or procedure, there is no recourse for family members when a doctor kills a patient even on the basis of gross negligence by misdiagnosing the patient as terminal or by misassessing the patient as competent." [7] In summary, there is no guarantee that a patient is being diagnosed correctly. When a patient is misdiagnosed, their bodily autonomy is violated because their judgement, regardless of what they choose, is based on an error. Furthermore, it is alarming that Doctors are immunized from any legal or professional consequences of their error. Consequently, legalization of PAS would cause significant harm to patient choice and to healthcare. Re 3: Hippocratic OathThis is a contention from both sides. Even if we were to accept Pro's interpretation of the H.O. and conclude that PAS does not violate such an oath, it does not logically follow that PAS should be legalized. First, Pro cites ancient Greece as an example to show that it is not in violation of the oath. However, Dr. Paul McHugh notes [8]:"Since ancient Greece physicians have been tempted to help desperate patients kill themselves, and many of those Greek doctors must have done so. But even then the best rejected such actions as unworthy and, as the Hippocratic Oath insists, contrary to the physician’s purpose of “benefiting the sick.” For reasons not too different, doctors traditionally refuse to participate in capital punishment; and, when they are inducted into military service, do not bear arms." Secondly, Pro notes that the document and the oath has varied over time. While this is true, it does not follow that the document is inherently flawed and that PAS should be seen as consistent with the oath. I look forward to your reply. ______ 1. Aaron Kheriaty, “Apostolate of Death,” First Things, April 2015, p. 19 2. http://bit.ly...;3. http://bit.ly...;4. http://bit.ly...;5. http://bit.ly...;6. http://bit.ly...;7. Gorsuch, The Future of Assisted Suicide and Euthanasia, p. 119 8. http://on.wsj.com...;