Ethics

Ethics Study Guide

©2018 Achieve Page 61 of 116 The patient and his/her medical record must be examined by a second physician to confirm the primary care physician’s conclusions. Oregon physicians may prescribe, but may not administer, the requested drug. The Patient Self-Determination Act of 1991 gives every competent adult the fundamental right to self- determination regarding decisions pertaining to his/her own health, including the right to choose or to refuse medical procedures/treatments. In many situations a person may have a living will , which is a declaration of desire that life-prolonging measures be provided, withheld, or withdrawn in the event one is determined to have an end-stage condition, is considered terminally ill, or in a persistent vegetative state. These instructions only take effect when the person does not have the capacity to make a medical decision. A person may also appoint a durable power of attorney for health care, i.e. a competent adult designated by an individual to make health care decisions on his/her behalf should 2. Voluntary active euthanasia (VAE) entails the use of lethal substances or forces to cause a person’s death. It is the most controversial and problematic, and is generally legally prohibited. The philosophical distinction between acts and omissions seems a natural way to distinguish between killing and allowing the natural process of dying. On this account, if a physician does something (e.g. injects an overdose of morphine, which is an action) this should count as VAE. These actions are considered killing, and are generally prohibited. If the physician chooses to do nothing, or to not do something, it is considered VPE. For example, a doctor may choose to not provide essential antibiotics, which is an omission; this would be VPE. These actions are considered to be allowing an individual to die. Some people hold that there is a moral distinction between acts that cause death (active euthanasia) and omissions that cause death (passive euthanasia). Some consider only passive euthanasia to be morally permissible. Assisted suicide is a formof euthanasia where the patient actively takes the last step in his/her death. This differs from active euthanasia because the “assistant” provides the patient with the means (drugs or equipment) to end his or her own life, rather than ending the life for them. Physician assisted suicide has been highly debated. The basic moral objection is that this violates the physician oath to do no harm. Some argue that it violates the oath to do no harm if a physician prolongs the life of a suffering person. Currently, Oregon is the only state that allows physician assisted suicide. The Oregon Death with Dignity Act (ODWA) was passed in 1994, but went into effect in 1997, and legalized this practice. For Oregon residents to be able to ask for a prescription under the ODWDA, the following must be present: • There must be a diagnosis from their primary care physician that states that they have an incurable and irreversible disease that will likely cause their death within six months. • The physician must determine that the patient has made a voluntary and informed request, and refer patients to counseling if there is any question that a psychological disorder may be impairing their judgment. •