Physician Assisted Suicide

Fundamentals of Criminal Law by Adam J. McKee

Physician-assisted suicide refers to the practice where a doctor provides a patient with the means to end their own life, often through lethal medication, at the patient’s voluntary and informed request. This act is undertaken to allow the patient to avoid unnecessary suffering or prolonged illness, especially in terminal conditions. Unlike euthanasia, where a physician directly administers a life-ending action, physician-assisted suicide requires the patient to perform the act themselves.

Legislative Concerns Surrounding the Act

The primary aim of laws against physician-assisted suicide is multifaceted. Firstly, these laws uphold the sanctity of life. Every life is considered valuable, and laws serve as a testament to this societal belief. Secondly, there’s an inherent risk that vulnerable populations may be unduly influenced or pressured into making decisions they wouldn’t otherwise make. Protecting these groups from potential exploitation is a core legislative concern. Additionally, laws ensure medical ethics and standards remain intact. Medical professionals traditionally adhere to the principle of  “do no harm,” and assisted suicide can be viewed as contravening this principle. Lastly, the legislation aims to prevent potential misuse where the line between voluntary and involuntary might blur.

Classification of Physician-Assisted Suicide in Legal Codes

In many jurisdictions, physician-assisted suicide is categorized as a criminal act, often under statutes relating to homicide or manslaughter. However, this classification varies, with some regions recognizing exceptions, provided specific conditions are met.  Some states, such as Arkansas, have specific statutes to deal with such circumstances (see below).

Categorizing Physician-Assisted Suicide among Other Crimes

This act is distinct from other criminal offenses. Falling under “crimes against persons,” it deals with direct implications on human life. Unlike “crimes against property,” which center on material assets, or sexual crimes that breach individual sexual autonomy, physician-assisted suicide raises unique moral, ethical, and legal dilemmas rooted in human life and dignity.

Historical Trace of Physician-Assisted Suicide

Historically, the concept of taking one’s own life, with or without assistance, has been a topic of moral debate for centuries. Ancient Greek and Roman cultures had varied opinions on the act. Some philosophers, like Socrates, opposed it, while others, like Seneca, viewed it as an acceptable choice under certain conditions (Noble, 2007).

In medieval Christian Europe, suicide and assisting in it was strongly condemned, based on religious and moral grounds. This stance was largely influenced by prominent theologians, like St. Augustine and St. Thomas Aquinas, who believed that life was a divine gift and only God could take it (Minois, 1999).

Moving into the modern era, attitudes began to shift during the Enlightenment, with increased emphasis on individual rights. Prominent figures like philosopher David Hume argued against the moral condemnation of suicide (Hume, 1783).

However, it wasn’t until the late 20th century that physician-assisted suicide became a prominent legal and ethical debate, with countries like the Netherlands and Belgium decriminalizing it under strict conditions. The U.S. has seen varying stances, with states like Oregon legalizing it through the Death with Dignity Act in 1997 (Oregon.gov, 1997).

As societies continue to evolve, so does the discourse on the ethical implications, safeguards, and societal roles concerning physician-assisted suicide. The tension between an individual’s right to autonomy and societal value for life remains at the heart of the debate.

MPC on Physician-Assisted Suicide

According to the Modern Penal Code (MPC) — while the MPC itself doesn’t directly address physician-assisted suicide — it delves deep into various forms of criminal homicide. To understand physician-assisted suicide under the MPC, it’s crucial to examine the definitions and gradations of criminal homicide. As per MPC §210.1, criminal homicide constitutes murder, manslaughter, or negligent homicide. Although physician-assisted suicide might not fit neatly into these classifications, the underlying considerations focus on intent, causation, and the nature of death (MPC, 1980). Some states that have referenced the MPC for their criminal laws might interpret physician-assisted suicide as fitting under one of these categories, especially if it’s not explicitly addressed in their statutes. Thus, the act’s legality and classification vary widely across jurisdictions.

The Arkansas Example

The Arkansas Code § 5-10-106 has explicit provisions addressing the act of physician-assisted suicide, delineating its scope, defining the act, and specifying the related penalties. Here is an examination of the specific provisions in the statute:

Definition and Scope

Per the Arkansas Code:

Physician-assisted suicide refers to an act wherein a physician or healthcare provider engages in a medical procedure or purposefully prescribes any drug, compound, or substance with the intent of aiding a patient in intentionally ending their own life.

However, the definition does not encompass individuals involved in executing someone sentenced to death by lethal injection by a court.

Prohibited Acts and Penalties

The statute explicitly renders it illegal for any physician or healthcare provider to:

  1. Prescribe any drug, compound, or substance to a patient for the express aim of facilitating the patient’s intentional end of life.
  2. Assist in any medical procedure designed specifically to aid a patient in intentionally ending their life.

Violation of the above provisions is classified as a Class B felony in Arkansas, which means that individuals found guilty could face substantial prison time and hefty fines.

Exceptions to the Rule

The statute ensures clarity by specifying what does not fall under the crime of physician-assisted suicide. Accordingly:

  1. Physicians or healthcare providers executing an advanced directive or living will are not violating the law.
  2. The act does not impede a physician’s ability to prescribe any drug, compound, or substance intended specifically for pain relief, ensuring that patients have access to necessary pain management even at the end of life.

In essence, while the Arkansas Code aims to deter acts of physician-assisted suicide, it simultaneously ensures that patients have the right to dignified end-of-life care, including adequate pain management.

Summary of Key Elements

  1. Mens Rea (Mental State): The conscious decision by a physician to provide means for a patient to end their life.
  2. Actus Reus (Action): The act of providing lethal medication or means to the patient.
  3. Concurrence: The mental state and action must coincide. The physician’s intent to assist should align with the act of providing the means.
  4. Causation: The provided means or advice by the physician should be a direct factor in the patient’s death.
  5. Harm: The resultant death of the patient.
  6. Attendant Circumstances: The patient’s terminal illness, intolerable pain, or the clear and informed request to end their life.

Summary

Physician-assisted suicide refers to the medical practice of intentionally aiding a person to end their life, often to relieve intractable pain or suffering. It remains a contentious issue, both ethically and legally, across many jurisdictions. The practice primarily involves physicians or healthcare providers administering or prescribing lethal doses of medications upon the explicit request of patients.

Historically, arguments against physician-assisted suicide highlight the sanctity of life and the potential slippery slope of broadening euthanasia criteria. Conversely, advocates stress individual autonomy and the humane aspect of allowing terminally ill patients to end their suffering on their own terms.

Legislatively, the approach to this sensitive issue varies globally. Some regions, like the Netherlands and Belgium, have decriminalized the act under stringent conditions, while many others, like Arkansas, have explicitly criminalized it. In Arkansas, aiding a patient in ending their life, whether through prescribing lethal drugs or assisting in the act, is deemed a Class B felony. However, exceptions exist: Arkansas law doesn’t consider participation in court-ordered executions as physician-assisted suicide, and it allows physicians to carry out advanced directives and prescribe pain relief medications.

In essence, physician-assisted suicide remains a polarizing topic. While some view it as a compassionate response to terminal suffering, others see potential ethical and moral complications. Legal stances on the issue differ widely, reflecting the broader societal and cultural perspectives of different regions.

References

  • MPC. (1980). Modern Penal Code and Commentaries. American Law Institute.
  • Noble, R. (2007). Assisted suicide and historical attitudes. Psychology Press.
  • Minois, G. (1999). History of suicide: Voluntary death in Western culture. Johns Hopkins University Press.
  • Hume, D. (1783). On suicide. Retrieved from https://www.gutenberg.org/.
  • Oregon.gov. (1997). Death with Dignity Act. Retrieved from https://www.oregon.gov/.

Modification History

File Created:  07/17/2018

Last Modified:  09/28/2023

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This work is licensed under an Open Educational Resource-Quality Master Source (OER-QMS) License.

 

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