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Modern medicine is a double-edged sword. With new innovations and treatments, Americans are now living longer than ever. Predictably, this voyage into uncharted territory brings its own host of new dilemmas. Over the years, there has been a notable shift in the leading causes of death in the United States. From the beginning of time until fairly recently, the vast majority of people were dying from infectious diseases. They would contract these diseases rapidly and with ease, and die from them at an even quicker rate. Today in America, a single infected drinking well is not causing the masses to contract and die from cholera. However, more people than ever are dying from degenerative diseases. Heart disease, cancer, chronic lower respiratory diseases, and Alzheimers disease are among the top 6 causes of death in the US. These illnesses do not lead to so-called quick and painless deaths, but rather what seems like a long and drawn-out losing battle. Euthanasia and physician-assisted suicide posses the ability to bring dignity and peace to those suffering with debilitating and deadly diseases. In 2016 alone, cancer took the lives of close to 600,000 Americans (FastStats-Leading causes of death). These 600,000 people, whose bodies had been taken over by a ruthless disease, did not have the option to make one final decision for themselves. Now, more than ever, euthanasia and PAS need to be a part of the conversation of end-of-life care.

Traditionally, before starting their careers, all physicians must take the Hippocratic oath. The key tenets of the Hippocratic oath state that it is a doctors duty to treat all patients to the best of their ability, maintain all patients privacy, and, most controversially, to never give a deadly drug to anybody who asked for it, nor& give to a woman an abortive remedy. (Medical Definition of Hippocratic Oath). These last two statements are often used as ammunition by those opposed to the legalization of euthanasia and physician-assisted suicide and, similarly, abortion. Many believe that these two procedures cause more harm than good and that it is a doctors duty to abstain from them. Since the time when Hippocrates wrote these words in the 5th century BC, some modernizations have been made. Today, two versions of the historic oath exist: modern and classical. Due to the outdated nature of the latter, most medical students graduating today will take the modern oath rather than the classical. The most notable difference between the two is an update in the modern oath that lies in the lines If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God. (The Physician’s Oath: Historical Perspectives). The modern version notably does not ban abortion or euthanasia/physician-assisted suicide but rather forbids the physician from playing God. Some argue that the word of the classical Hippocratic oath is law and that any other version should be disregarded. This outlook fails to consider the advances in medical technology and in society as a whole since the days of Hippocrates. When the classical version of the oath was written, there was no such thing as a safe or relatively humane abortion or euthanasia procedure. In the 5th century BC, these procedures were synonymous to doing harm to the patient. As the medical field evolves, so should its moral code.

In light of the relatively recent increased emphasis on personal autonomy, especially as it pertains to female reproductive care, the amount of opposition that forward-thinking end of life care receives in America is nothing short of surprising. In order to address the concerns of those opposed to the legalization of euthanasia and/or physician-assisted suicide in the United States, it is often affective to refer to countries in which at least one of these procedures is legal. A commonly voiced worry of the opposition is that one of these life-ending procedures would be carried out without the consent of the involved patient. Patient groups that this fear of exploitation extends to includes the elderly, the disabled, dementia patients, and other incapacitated individuals. This is an understandable fear of those uninformed about current euthanasia/physician-assisted suicide practices around the world. This, in theory, is a reasonable-sounding outcome of the legalization of these life-ending procedures. The results of euthanasia and physician-assisted suicide in practice, however, yield different results. Data collected in Belgium before and after the complete legalization of euthanasia showed a decline in the percentage of patient deaths without their explicit request. Furthermore, of the 1.8% of patients in hospitals who died without their expressed consent, 70% were comatose for an extended period of time before their deaths (Physician-Assisted Deaths under the Euthanasia Law&). The procedure carried out on this 70% of patients would be considered non-voluntary active or passive euthanasia, dependent upon the specific situation.

Regardless of the legal status and public opinion of these life-ending procedures, they will continue to take place. Many terminally ill individuals who have witnessed a dramatic and irreversible decline in their quality of life and seek to experience a dignified death cannot be deterred by outdated medical regulations. Stripped of the option of legally being prescribed a lethal dose of medication in 45 of the 50 American states, many of these individuals are driven to more drastic and severe options. These options include taking their suicide into their own hands, traveling to another state or country to legally undergo a life-ending procedure, or attempting to obtain a lethal prescription illegally. If they can afford it, the cost of traveling to a more forward-thinking region with more options for end of life care adds to the financial burden on the patient and their family. If the patient is not able to afford it, they are forced to let their illness further ravage their body, take illegal measures in order to acquire a lethal prescription, or take their own life. No individual should be faced with this decision, but it is a reality for many. If it is known that suicide and illegal euthanasia/PAS will take place regardless of the laws surrounding them, why have these procedures not been legalized if for no other reason than to regulate them? Regulation is the only way to protect the vulnerable individuals faced with this terrible choice.

It would be merciful to the growing population of Americans suffering with degenerative diseases to enact a nation-wide policy very similar to Montanas death with dignity policy. This policy would decriminalize the act of a physician aiding in a terminally ill patients death, without guaranteeing patients the right to receive life-ending treatment. This policy is a sufficient starting block the initiate the process of Americas advancement in end-of-life patient care. This policy allows for those suffering with ongoing debilitating illnesses to take control and willingly end their prolonged suffering. This policy is conservative in relation to the vast majority of euthanasia/physician-assisted suicide policies, allowing it to appeal to a wider audience and gain sympathy from individuals possessing both positive and negative views on the procedures. This wide appeal would make it easier to pass such a policy into legislation. Before being proposed, however, initial boundaries would need to be created. These boundaries would include details such as the minimum age of a patient, their prognosis, how long they had been seeking out the procedure, etc. These boundaries would be temporary and could be erased and redrawn in order to grow with America.

The legalization of euthanasia and/or physician-assisted suicide in the United States would inevitably bring to the forefront many more questions that no single person is capable of answering. Nothing, especially not a procedure as controversial as euthanasia, exists without its flaws. Even with the acceptance of these procedures, many issues would still reside within the grey area. For example, should there be a minimum age at which a patient is considered eligible for these procedures? Should physically healthy patients with severe mental health issues be considered for these procedures? Should a doctor be allowed to refuse a patient these procedures? While the answers to these questions exist within a region of moral ambiguity, this should not stop the legalization of physician-assisted suicide for terminally ill and mentally sound patients. An imperfect plan must first be enacted so that a perfect plan may one day take its place.

The United States must push through and seek answers to the tough questions regarding life-ending treatment in order to create regulations that are relevant to current American society. With the amount of individuals suffering for extended periods of time at the end of their lives at an all time high, the urgency of creating a nation-wide policy that decriminalizes physician-assisted suicide has reached an all-time high as well. America must continue to grow with the times, and the Dying with Dignity policy is the appropriate first step to modernizing end-of-life care.

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