Physician Assisted Suicide - Ethically Defendable or Not? : A Qualitative Ethical Analysis

Abstract: Introduction: Physician assisted suicide (PAS) is the process where the patient terminateshis/her life with the aid of a physician who provides a prescription for lethal medication thatthe patient self-administers in order to commit suicide. PAS is practiced in several countriesand is now gaining support in Sweden. The debate shows some confusion regarding thedefinition of concepts and raises several ethical concerns. Aim: To provide an empirical background and clarify concepts. To analyze the ethical arguments for and against PAS. To investigate relevant ethical differences between PAS, euthanasia and withdrawal oflife-sustaining treatment. Materials and methods: Qualitative literature study based on argumentative- and conceptualanalysis on hermeneutic ground. Materials were gathered through a literature search andconsist of scientific articles, debate articles and official materials. Results: The main ethical arguments supporting PAS are autonomy, beneficence and dignity.PAS is by supporters seen as an act of compassion, which fulfills the physician’s obligation ofnon-abandonment. Opponents emphasize that PAS goes against the duty of beneficence andnonmaleficence and fear that there may be a slippery slope where more and more people willdemand PAS. Conclusion: There is no consensus on whether PAS is considered ethically defendable or not.PAS appears to involve a conflict of interest between the principles of beneficence andautonomy. There seems to be some factual disagreements as well as different positions as tohow the ethical principles should be interpreted, and which ethical principle should be valuedthe highest.