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Janelle Spira ~ NegationResolved: Physician-Assisted Suicide Should Be Legalized in the United States“Whether 'tis nobler in the mind to sufferThe slings and arrows of outrageous fortune Or to take arms against a sea of troubles, And by opposing end them. To die- to sleep”Good evening, ladies and gentlemen of The Philodemic Society. We are gathered here tonight to discuss an issue of life and death. Physician-assisted suicide tackles the conundrum that Hamlet once contemplated: whether ‘tis better to die, to sleep, or whether life is inherently precious. Tonight, we are not merely discussing physician-assisted suicide. I desire for this debate to blossom into a discussion of the human experience and what it means to possess meaning in life. Ultimately, the question of meaning gets at the crux of this debate. On the affirmation, you are going to hear heart-breaking stories about people who no longer find meaning in live and desire to end their lives. The affirmation may tug at your emotions, but we on the negation will entreat you to think beyond emotional appeals and consider the axiological implications of euthanasia. First, I will discuss the role of the physician. To put it simply, doctors don’t kill people. They heal and make whole again. They don't make dead. PAS goes against the very nature of being a doctor and violates the Hippocratic Oath which says primum non nocere, “first, do no harm.” Death is the ultimate harm. The principle of nonmaleficence is foundational to Western medical ethics and recognizes the fact that human life commands respect and veneration. The doctor-patient relationship depends on the patient trusting his doctor to value his life and do everything he can to preserve it. We want doctors to fight for their patients until the end. Not give up them and say that they would be better off dead. PAS distorts the doctor-patient relationship and violates the very nature of what it means to be a physician. Now let’s discuss the affirmation’s rallying cry: autonomy. Autonomy is usually meritorious; however, autonomy is not unlimited. The law, the cornerstone of the stable polis, depends on autonomy restriction. Simply put, people should not be allowed to do whatever they want. The affirmation promotes assisted suicide as a “right” to autonomous requests. However, sometimes we refuse people’s requests. For instance, you cannot walk into your doctor’s office and demand a drug. Limitless autonomy is not a good idea. The people most likely to commit assisted suicide are not only suffering from terminal illness, but also from depression, loneliness, and despair. Research shows that 95 percent of people who kill themselves have a psychiatric illness in the months preceding suicide. When patients who request assisted suicide are treated by a physician who understands their despondency, treats their depression, and relieves their suffering, their wish to die often disappears. Depressed, suicidal patients cannot make truly autonomous decisions about ending life. They need treatment, not help killing themselves. We should not let an ephemeral desire lead to an everlasting consequence. Another point we should consider is the fallibility of medical judgment. Under Oregon’s law, patients can attain PAS if they are terminally ill and within 6 months of the end of their lives. Who makes that crucial prognosis? Doctors. The reality is that doctors make mistakes and are frequently wrong about prognoses. Dr. Ilona Finlay asserts that even expert physicians have a 50/50 chance of being wrong about life expectancy. Death is a permanent consequence that should not hinge on a fallible judgment. If the doctor’s prognosis is wrong, it takes away someone’s potential life, the most precious thing we possess. Some of you may believe in the sanctity of human life, and think that it is always wrong to end life; however, I know that not all of you share the same convictions. Therefore, instead of focusing on that, I am going to look at practical consequences of PAS and show why legalizing it would be hazardous for our society. First, it would endanger the weak and vulnerable. PAS threatens the most marginalized members of our society because of the cultural pressures and economic incentives that drive it. The New York Task Force on Life and the Law concluded in its report that “legalizing assisted suicide and euthanasia would pose profound risks to many patients. The practices will pose the greatest risks to those who are poor, elderly, disabled, minorities, or without access to good medical care.”PAS puts marginalized groups in perilous conditions in which they may be misled and coerced to make decisions. Vulnerable groups may choose assisted suicide because of external pressures. Oregon reports show that the sense of being a burden is a prime reason for desiring assisted suicide. Old and disabled people might feel that they are a burden to their families, and consider suicide for this reason. Disadvantaged populations may choose assisted suicide because it is less expensive for their families. PAS harms our culture by increasing the temptation to view the weak and vulnerable as burdens and lesser human beings.It is crucial to note the economic consequences of approving euthanasia. Physician-assisted suicide will create perverse incentives for insurance companies. Assisted suicide will become a more “cost-effective” measure than actually caring for patients. Drugs for assisted suicide cost $35-45 dollars, significantly less than the $88 billion dollars that Medicare spends on palliative care each year. $88 billion dollars is a lot of money; one poison pill is so much cheaper. In Oregon, medical systems are already offering people assisted suicide in lieu of chemotherapy. Cancer patient Randy Stroup got a letter from the state saying it would pay for his assisted suicide, but not his chemotherapy.?Insurance companies will put pressure on patients and doctors to commit assisted suicide because it saves them money. PAS allows insurance companies to put a price on human life. Lastly, we need to prevent PAS because it betrays human dignity and equality before the law. The affirmation presented you with the idea that physician-assisted suicide ends suffering and allows people to seek death as a release from woeful life. However, behind that emotional appeal, lies a hidden value judgment: by supporting physician-assisted suicide, you are effectively saying that some people’s lives are not worth living and should be terminated. Contrary to what the affirmative led you to believe, the most common reason why patients seek assisted suicide is not pain and suffering, but rather a diminished quality of life. People who seek assisted suicide say that they can no longer participate in activities that gave their lives meaning. In other words, they used to have infinitely special abilities and now that those have been taken away from them, they no longer think their lives are worth living. Consider what this means for people who were born without the things that supposedly give life meaning. The mentally ill, handicapped, and disabled live very similar lives to the lives of people who desire assisted suicide. If we affirm PAS, we affirm the judgment that some lives are inherently less valuable than others and should not be preserved. This is deeply disturbing. By promoting PAS, we create a society in which there are two classes of citizens: those with worthwhile lives and those with lives no longer worth living, better off dead. If we move to such a society, what is there to stop us from ending the lives of people who do not request it, but are judged to have lives that are not worth living? Allowing patients, by law, to choose death is a logical slope and will lead to abuse of the system. To evaluate whether a logical slope is truly plausible, it is helpful to look at the first country that legalized assisted suicide. In the Netherlands, PAS was legalized in 1984 and since then, euthanasia has expanded rapidly. Dr. Herbert Hendin sums up the present situation: “The Netherlands has moved from assisted suicide to euthanasia, from euthanasia for the terminally ill to euthanasia for the chronically ill, from euthanasia for physical illness to euthanasia for psychological illness and from voluntary euthanasia to involuntary euthanasia, [in other words: legalized murder].’ The Dutch now terminate the lives of psychiatric patients and deformed babies.”If we legalize PAS, we are opening Pandora’s box to a vast range of abuses that undermine human dignity and equality under the law. We do not possess enough safeguards to prevent abuses and even if we had sufficient safeguards, we would still have no way of enforcing them. By wading into the sea of voluntary euthanasia, we risk being swept up by the rapacious rip tides that lead to legalized murder. Instead of helping people kill themselves, we should give them better medical care. We should respond to suffering with true compassion that helps people find meaning in life rather than declaring that some lives are not worth living. ................
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