Executive Summary

Introduction

Assisted suicide is one of the most controversial and contentious issues in the contemporary society. There are so many issues that are associated with assisted suicide; there is persona autonomy, there are ethical issues, there are legal and federal issues. This is consequently not a pro-choice / anti-choice conversation anymore owing to the other lenses from which it can be viewed. Assisted issue could be described as an important issue as far as palliative care in modern medicine is concerned. Modern medicine however, seems to be at loggerheads with modern life where law and policy seem to be the main features (Linda Ganzini, 2010). The following paper is an analysis of a case related to the topic of assisted suicide. To put matters into perspective, the analysis will review the ethics, policy and legislative aspects of this case. A comparative analysis between the demands of legal policies and ethical issues of the case will be presented. The paper will further highlight the potential impact of this case on future cases.

The Velma Howard Case: Summary and Overview of the Case

The 76 year old Velma Howard was suffering from ALS (Lou Gherig's Disease). This was a medical condition that eventually could result in the death of the patient since it prevents the diaphragm from contracting, meaning that the patient cannot be in a position to breathe. With the health status deteriorating at a very fast rate and some of her organs failing in terms of functionality, the patient decided to kill herself. She held a meeting with her close family members (husband and son) where she used help from a book to put an end to her life. The events that followed involved the arresting of Mr. Howard and his son on the charge of assisted suicide. The justification of this arrest was that there is no way that the patient could have read the instructions on her own and that the materials for assisted suicide must have been provided by the family. Despite several appeals made by the family and the fact that the case was heard by the Supreme Court, a different ruling was never arrived at. The Supreme Court still classified assisted suicide as illegal. The prosecutor involved in the case decided to drop the charges against the Howard’s, however.

Ethical Analysis

The issue of ethics is of great importance in any case of assisted suicide. Below is an enumeration of the diverse range of ethical issues that could be associated with this case;

1. The interest of preservation of life. The parties involved in the case including the state were interested in the preservation of life and thusly, based on these grounds, it was considered unethical to violate this interest of the state through assisted suicide.

2. Another ethical lens from which this case could be viewed would be that there is the ethics of preventing deaths that occur as a result of errors in medical or legal judgment. Assisted suicide goes against this ethics as it challenges the role of the state in ensuring that erroneous deaths or in this case, death due to misjudgments are avoided.

3. The ethics of autonomy. Based on autonomy, an individual has the right to make the decisions that affect him or her on their own (Materstvedt, Clark, Ellershaw, Førde, & Gravgaard, 97-101). With reference to the case study, it would be unethical for the state, through prosecution, to interfere with this liberty. The ethics come into play in this case on the basis that this would be an unfair influence over the decision of an individual since it prevents the exercise of undue or rather arbitrary actions through decision making.

4. An equally important ethical issue to address is with regard to the interests of other third parties. In this case, the third parties could be family members (Linda Ganzini, 2010). The states’ act of prosecution could be termed as infringing on the needs and interests of the third parties. Mr. Howard and his son were okay with the decision made by Mrs. Howard and it would be unethical to violate the rights as far as their interests are concerned.

5. This case did not showcase the direct involvement of the medical fraternity. Regardless, it would still raise eyebrows on the medical profession in terms of ethical duties and responsibilities. The ethical issue that would arise in this case would be on the protection of the integrity of the medical profession.

Relevant Federal Laws

The Velma Howard case is dated close to a decade ago since it happened in the 90’s. Precisely, it occurred in 1996. This was a time defined by certain federal laws in relation to assisted suicide. It is also fundamental to note the jurisdiction as the case was in the state of Missouri. As a matter of fact, the law of the state considers an individual as being guilty of manslaughter in the event that he or she knowingly assists another in committing self-murder (Kamisar, 2013). It follows that Mr. Howard and his son would have been considered guilty on this basis. Voluntary Manslaughter is classified as a class B felony.

Demands of legal policies and ethical issues; A Comparative Analysis

A sharp contrast can be drawn between the legal policies associated with this case on one hand and the ethical issues on the other hand. This can be broken down as follows;

As to the ethical issue of undue influence by the third parties, the legal policy is that the fears of undue influence are unfounded. Basically, the legal justification for this stand would be that there are other active organizations in place that would prevent undue influence of or by third parties.

The critics of assisted suicide could also go with the school of thought that by legalizing assisted suicide there are the ethics of mistakes and errors that need be considered. In other words, it would be common to make mistakes in the determination for the need of assisted suicide. However, the legal counter for those would be that the determination of whether an individual is mentally competent is a process that would be controlled by effective safeguards developed by the medical profession (Jecker, 2012). The margin of error would be insignificant.

The ethical issue that the state has the right of life preservation can also be contrasted sharply by legal ramifications. In other words, there are instances in which the state cannot possibly prevent suicide. The legal policy in this case would be that this right is strongly diminished in the event that the health condition of an individual is terminal, in that it has no cure (Materstvedt, Clark, Ellershaw, Førde, & Gravgaard, 97-101). The same also applies when the ethical argument of protection of third parties comes into play. In essence, the legal reasoning in this case is that the state’s interest is close to negligible in the event that the patient is terminally ill and thus death is eventually inevitable.

Potential Impact on Future Cases

The Velma Howard case, among other cases, has had an impact on future cases involving euthanasia or assisted suicide. While this cannot be described as a milestone case in the state of Missouri, it sure has contributed to the legal underpinnings of assisted suicide in the state. For instance the Death with Dignity Act was adopted by the state in 2014 (Battin, 2015). This is a piece of legislation that would allow patients that met certain requirements to request for life-ending medication.

References

Battin, M. P. (2015). Ethical Issues in Suicide. New Jersey: Prentice Hall.

Jecker, N. (2012). Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying . Journal of Health, Policy and Law , 186-190.

Kamisar, Y. (2013). Are Laws Against Assisted Suicide Unconstitutional? The Hastings Center Report , 32-41.

Linda Ganzini, M. G. (2010). Evaluation of Competence to Consent to Assisted Suicide:Views of Forensic Psychiatrists . American Journal of Psychiatry , 595-600.

Materstvedt, J. M., Clark, D., Ellershaw, J., Førde, R., & Gravgaard, A.-M. B. (97-101). Euthanasia ans Physician-Assisted Suicide:A View From an EAPC Ethics Task Force. Palliative Medicine , 2013.