Physician-assisted suicide (PAS) is a topic, which proponents often support by the affirmation of patient free will or as the exercise of patient autonomy. The purpose of this paper is to examine this argument further from an inter-disciplinary approach, regarding PAS from medical, ethical and legal standpoints and to examine the concept of free will from the philosophical discipline. Are these concepts compatible in a meaningful context and can a sound argument be constructed to support PAS on the basis of patient free will?
Derek Humphry, in Lawful Exit, defines PAS as a physician "providing the means by which a person can take his or her own life." The means, to which he refers, is a toxic substance and the directions for administration, which will produce death. Humphry argues for legal reform in order to make such acts lawful, calling them: "...the ultimate civil liberty, the freedom to select one's own manner of dying without interference from others, but with help if we choose." My academic research on Minerva 2000 produced 0 hits on the topic: US Practice of Physician-Assisted Suicide.
Certainly, the three types of presently legal and justifiable grounds for assisting other people in taking their lives which Humphry enumerates, all exclude freedom, free will or civil liberty. Why haven't the US Legislature, and the US medical community chosen to legislate and practice PAS on behalf of patient rights to exercise free will and autonomy?
In The Nature of Medicine, Gerald Dworkin refers to an article written by Leon Kass in 1989, entitled: "Neither for Love nor Money: Why Doctors Must Not Kill".
Dworkin identifies Kass's article as the benchmark publication most often cited in prominent medical journals, such as the New England Journal of Medicine, to demarcate the grounds for exclusion of PAS from medical practice. Dworkin and Kass consider this topic from the perspective of Medical Ethics. Kass's treatment of the subject of Physician-assisted suicide as evident from the title of his article, supports his argument by denying patients "the moral right to be killed" and physicians "the moral duty to kill." Dworkin quotes Kass's analysis of the argument favoring PAS on the grounds of "Freedom" or "autonomy":
...Physicians...are bound to acquiesce in demands not only for termination
of treatment but also for intentional killing through poison, because the right
to choose-freedom-must be respected, even more than life itself, and even when
The physician would never recommend or concur in the choices made. (Kass, p.27.)
Arguing against autonomy as a rational defense for PAS, Kass concludes that Considerations of mercy for the patient who is suffering, dictate the course of action in the end. Ultimately, "medicine is intrinsically a moral profession with...principles and standards of conduct that set limits on...