A series of related questions (you don't have to answer all -- just pick 1-2)
* What is the role of physician? Healer, comforter? Does that include relief of suffering? To what degree? Could PAS be included? Could palliative sedation (sedation to control pain or symptoms which might, but doesn't necessarily intend to stop life)?
* Might having PAS as a possible option bring comfort to people? Explain.
* What is autonomy? What's the value of autonomy? How is autonomy related to dignity? Is it important to protect dignity?
* Is there value in suffering?
I believe that physicians are comforters and providers. By this I mean they diagnose an individual and provide them with either medicine or guide them in the direction of what their next medical decision should be. They could be considered healers, but to a small degree because they do not physically perform surgeries, they provide prescriptions to help patients. I also believe that they provide patients with relief from suffering when they are in MEDICAL need of medicine. I mean this strictly on basis on medical need and not want.
ReplyDeleteAs far as PAS I think that there should be another set of physicians who deal with people who want medicine simply to take their life. I do not agree that people should go to physicians to seek medical means to kill themselves, but it is their own decision to do so, However, if the people who want the medicine make the decision themselves, then it is rightfully their own decision. Just I stated in Rob's blog, people have to live with their own decisions, but in this case they will die with their decision.
Autonomy is "the right to self-government. Autonomy is a concept found in moral, political and bioethical philosophy. Within these contexts, it refers to the capacity of a rational individual to make an informed, un-coerced decision. In moral and political philosophy, autonomy is often used as the basis for determining moral responsibility for one's actions. One of the best known philosophical theories of autonomy was developed by Kant. In medicine, respect for the autonomy of patients is an important goal, though it can conflict with a competing ethical principle, beneficence. Politically, it is also used to refer to the self-governing of people" (I really liked this definition!) In my own words I would say that it is having control and choice over your life and actions.
ReplyDeleteI would say that autonomy is valued because of its usefulness and that it is essential to obtain the "good life". I say this because when I think of an autonomous person, I think of someone that reaches certain goals such as: happiness, reason, success and security. Another reason I think autonomy is valued is because it is our own choices that we make in our life and we have the control/power over them, which is almost like a freedom.
Autonomy is a part of human dignity. Human dignity is basically the "worth" of humans, which relates to autonomy.
I would say that it is definitely important to protect dignity because human dignity comes from God and it is sacred.
As far as suffering goes, I would say that there is some value in suffering. I think that sometimes when we suffer it allows/teaches us to trust in God. I also think that it makes us think about our actions/choices that we wouldn't think about otherwise. Pain/suffering can make you stronger.
I believe a physician has a certain limited role. As Jeramie said, I believe that it is the physicians job to inform the patient on all of their possible options for medical treatment and give their professional advice as to which one, in their opinion is the best. I also believe that it is their duty to relieve suffering, but not by any means necessary. The wish of the patient must be expressed and followed as closely as possible as long as they are in the right state of mind. I think that there are certain cases where PAS is right. As long as the patient is in accordance and there is an extreme circumstance (has a terminal illness and is suffering immensely with no other option to relieve the pain). So, having PAS as an option could bring comfort to people who are in these situations and have exhausted all other medical treatments to help them have a "good death". There would have to be major stipulations for such thing to be put into effect.
ReplyDeleteI think that a physician fills the role of a healer. Now, there is some discrepancy in use such a broad term. In my book, healer mean to make better what is possible to make better and provide comfort for those situations that can't be bettered at all. Within this comfort may include PAS. If the patient is terminally ill (as Emily mentioned) and wants PAS rater than experience the progressive degradation of the disease.
ReplyDeleteIn extension, I think PAS should be an option for patients who qualify. Having that as an option would ease the mind in the sense that they know they will have an out should the pain or suffering get too bad. It is interesting that the US Supreme Court turned the ruling of whether or not PAS should be legal to the states and only one made it legal.
I think that having PAS as an option could bring comfort to people. They know that if anything gets worse to the point where they cannot bear it anymore, there is a way out. They do not need to use it, but it is comforting to know that it exists. It is like having a cache of money in case of emergency. There is a good chance that you will never need to use it, but it is there if you need it. You do not need to worry as much as you would otherwise.
ReplyDeleteAs for the value of suffering, I think that depends upon the person who is suffering. Some people will use it to better themselves. If they survive, every moment seems better because they aren't suffering anymore. However, suffering can cause other people to become bitter. Of course, the amount and type of suffering is also an important factor. Physical suffering is quite different from emotional suffering. No one wants to suffer, but it does happen to all of us, and it is up to us what we do with our experiences.
There is value to suffering. I advocate this seemingly preposterous claim because to me the saying that there can be no pleasure without pain holds a lot of weight. Elation and pleasure usually only come after one has worked towards something or sacrificed; and hence, experienced a little suffering and without this suffering the victories that we accomplish wouldn’t seem so sweet or they might not even feel like victories at all. Obviously, the suffering felt by a terminally ill patient or those inflicted with any type of illness is not the same sort of suffering as that which is associated with working towards a goal because this pain appears pointless, there is no reward associated with it after the pain is over. However, the suffering of the terminally ill patients can be beneficial to them because suffering can lend them a new perspective on their life; and for some, suffering can negate some of the wrong that each us commits in our life. In short suffering is valuable to both the healthy and the sick for many reasons such as, making one’s life pleasures more keenly felt or lending a person some perspective on their life.
ReplyDeleteWhile I agree with your idea that suffering can bring new perspectives on life, and only through suffering to some degree can you really experience pleasure, what about the individual who is suffering from a disease that reduces their mental capacity? Or even worse, what if they never regain consciousness? Some people would say this individual is suffering because they are "being deprived of life." While I wouldn't say this person is suffering (because this person isn't aware of their surroundings or their own condition in life), we can't deny that their quality of life has decreased to a level that a well-functioning person may consider sufferable. So, in this situation, would there be value to suffering? Would the value be to the individual who is suffering, or to other people around the individual suffering?
DeleteTo answer my own question, I think there is still value in the suffering based on the influence it has on other people. The ill man in my previous scenario probably won't value his suffering if he is aware of it. But family members might, as well as the doctors that treat him. The quality of empathy allows us to place ourselves in others shoes: maybe the shoes of someone who is suffering. Even if we never experience the suffering ourselves, we may get value from the experience because it prompts reflection within ourselves. In the worse case scenario, the value that comes from the suffering isn't recognized; but I believe value can be found in most situations of suffering.
DeleteI can recognize that suffering is essential (only because of the Law of Opposites - without one, there can't be the other) in such that there can't be pleasure without pain, as btburwinkel said. I wouldn't go as far to say that suffering is desireable for the purpose of bringing new perspectives to light. I think there are other ways of doing that without involving sufferingg.
DeleteI believe that the role of a physician and a double sided sword. I believe that they should attempt to heal a person if possible with the knowledge that everyone cannot be healed, which transforms them into a comforter. I think it is the physician’s job to free their patients of pain, but not to the extreme as to help aid in their death. Maybe to some PAS can bring comfort to people as an option. As humans, we want to be able to choose in our own way of life and sometimes death. Having all the options can be comforting to some, even if they do not choose PAS.
ReplyDeleteAutonomy is the independence, the own free will a person has. I believe, as others have stated, it is the value of dignity. Dignity is something that everyone needs. Even when I have helping residents at the assistant living facility that I work at, I still give them the dignity that they deserve. I don’t just go in/get out like some resident assistance I’ve seen do. I speak to them while I’m helping them, explaining what I’m doing and how it is helping them. I allow them to still have their dignity in some way, even though I know I am invading on privacy.
Physicians are healers, that means that their job is to relieve people from any kind of medical condition that is causing them pain or discomfort. This being said, I believe doctors should be able to provide PAS. After reading up on this topic and discovering that the majority of patients only ask for PAS for a comfort reason, I believe its wrong to deny people this service. Patients that are approved to receive PAS are people that have no control of what happens to them and by providing them with PAS, they gain some control in their lives. If providing patients with some control in their lives comforts the, then I believe that it is wrong to not provide this form of comfort to these people.
ReplyDelete