Wednesday, January 21, 2015

Final Literature Review

Topic/Problem Statement:

I chose to do my literature review on the legalization of doctor-prescribed suicide and the Death with Dignity Act. It had been a conversation in my house and I had been interested in the subject when I heard. I chose to research it to learn more about the topic and the pros and cons behind assisted suicide.

Literature Review Question:

What does the literature say about doctor-prescribed suicide and the Death with Dignity Act?

Literature Review:

              At some point in our lives, we are forced to face the inevitable that is death. We can only hope and pray that this will come later in life, when one’s skin is covered in wrinkles and their legs move a little slower. But in an instant, we can become forced to think about death and the end of our lives sooner than anyone would hope. How one approaches the idea of death, whether they choose to seek medical attention and use sciences in attempt to prolong their life expectancy, or meet death head on to preserve the joys and pleasures of living, is a controversial topic up for debate throughout the nation. In Oregon and Washington State, it is legal for a patient with the life expectancy of approximately six months or less, to visit a physician and receive a prescription to end their lives (Barber). The Death with Dignity act allows doctors to prescribe patients a lethal injection, as long as the patient is lucid and aware of the decision they are making, and it’s their decision. Some doctors stand beside this act, respecting and agreeing with the patient’s decision to end their life on their own terms, before the effects of illnesses take away life’s pleasures. Others disagree, arguing that writing a prescription is no different than pulling a trigger and that injecting the lethal poison into one’s body shouldn’t be considered dignified, and is the same as overdosing on a bottle of anti-depressants. What does the literature say about doctor-prescribed suicide and the Death with Dignity Act?

            Many positives can be associated with the doctor-prescribed suicide, and can justify the legalization of the Death with Dignity Act throughout the nation. This Act allows patients who don’t want to see life and the world from a more disabled viewpoint to terminate their lives on their own terms. Patients who also don’t want to feel suffering or feel pain also take the more permanent route. Many also argue that whether or not one believes doctor-prescribed suicide is ethical, they don’t have the right to prevent one from using this option if it’s their preference. The Death with Dignity act has multiple arguments as to why it should be a legalized act throughout the Unites States.

            When thinking about any illness, whether it is cancer or a minor head cold, symptoms and side effects are always present. Some can be painful, cause discomfort, and take away one’s ability to do different tasks. Avoidance of pain and an inability to deal with side effects and symptoms only to face what has been diagnosed as inevitable death is one of the reasons patients choose to end their lives on their own terms. Many patients do not wish to prolong suffering only when they know death is near. In a survey, the family members of patients who underwent the Death with Dignity Act described how patients felt. Patients experienced “loss of control of bodily functions (68 percent), loss of autonomy (63 percent), physical suffering (53 percent), and an inability to participate in activities that make life enjoyable (47 percent)” (Sullivan). Fourteen of 19 family members discussed that the patient wanted to feel control over their death, and how it happened (Sullivan). “Eleven of these 14 family members, plus 3 others mentioned the patient's wish to avoid a prolonged death; 4 specifically noted the patient's fear of ending life in a coma and on a respirator” (Sullivan). Patients wish to end their lives in their own terms, as way to end suffering, pain, and fear, yet many wish to stop them, to let them suffer. The Death with Dignity Act “exists only for dying patients whose mental, physical, and emotional suffering has become intolerable and who wish a peaceful and dignified passing” (Is the Oregon Death). Many people suffer from all kinds of illnesses, many of which are terminal. Death with Dignity allows them to control how much suffering they can endure. “It will be unfair and inhuman to allow them stand the intolerable pain” (Death with Dignity Act).The Death with Dignity Act allows patients who wish to end their suffering on their own terms and to take control of their bodies, which is a positive thing and can be used in the argument for nationwide legalization.

            Every adult is capable of making their own decisions, as every adult should have the right to make the best decision for them. So if someone feels the best possible decision is to terminate their own life, then shouldn’t they be allowed to make that their decision for them self? Another argument supporting the Death with Dignity Act is the fact that we shouldn’t have the ability to take away someone’s decision about how they want to handle situations. “The very existence of Oregon's Death with Dignity law gives comfort and peace of mind to terminally patients at life's end--regardless of whether or not they choose to use it” (Is the Oregon Death). Whether or not you support the act, or agree in doctor prescribed suicide, it’s not up to you what someone else does with their life. If someone feels that this option is best for them, and it’s what they want, then they should have the ability to make that decision for themselves. “Whether or not you would consider assisted dying as a personal option, we should allow others to exercise their preferences” (Cohen). Adults are capable of making their own decisions, and with the legalization of the Death with Dignity Act, they can choose for themselves and not be forced to suffer.

            Many things can support the Death with Dignity Act’s legalization. It allows suffering patients a release, a way to take control of their destiny. It gives patients who have lost control of themselves and want to end their life on their own terms a way to make that happen. It’s the patient’s own, personal decision how they choose to handle their situation, and they should have all options available to them when dealing this life decision. The Death with Dignity Act has many positives to it, and, as Lewis Cohen stated, “it is time we became pro-choice at the end of life.”

            While there are many positives that walk hand-in-hand with the legalization of the Death with Dignity Act, there are also plenty of signs which point to a road full of cons. Many argue that the act is plain suicide, there’s no dignity about it, and calling it dignified is ridiculous. Allowing the legalization of the Death with Dignity Act also can allow unethical actions to occur, a shady doctor or a crazed family member can convince a patient that this is the best option for them, when that may not be the case. The patient way also have false intentions of what they plan to use the prescription for; instead of injecting the lethal drug into their own arm, it may end up in someone else’s. There are many cons that suggest the legalization of the Death with Dignity Act will be a negative effect on society.

             Suicide is almost always seen as a tragedy and a loss, for both the victim and the family. No one should meaningfully encourage one to take their own life. But, the Death with Dignity Act is essentially encouraging people to take their own life. It’s telling people, “Take your life, kill yourself, it’s a way to go with dignity.” But what about those who choose to live as long as they are able to, those who fight against their illness until their last breath? Calling suicide “dignified” can distort the whole meaning of the word, and “those who are morally opposed to suicide may then fail to pursue other dignified ways of controlling their destiny” (Ubel). Calling suicide a dignified makes fighting look silly and weak, when in reality, many can argue that it is the opposite. “There are plenty of other ways for terminally ill patients to control the circumstances of their death, making it wrong to equate dignity with suicide,” (Ubel) which is one reason the legalization of the Death with Dignity Act can be negative for the nation.

            With the idea of a doctor-prescribed suicide, many concerns about false intention come up almost immediately. The patient may be receiving this lethal prescription for all the wrong reasons. Maybe their real plan is to “slip it into hubby’s coffee” or use it as a get out of jail free card for some extreme debts (Capriotti). As a horrible of a thought as it is, there are who could take their illness, use this option, but inflict pain onto someone else instead of using the injection for its real purpose. The fear of people taking advantage of this act is another con and arguments against its legalization.

            Along with the patient’s misguided intentions, there’s also a fear of malice from doctors and family members. You would hope you can trust your doctor, especially when discussing actual life and death, but there could always be that one shady man with a screw loose in the head. Before, a woman in Oregon had been prescribed assisted suicide; even though it was clear she didn’t fully understand her decision and her daughter was really the one asking for it (Is the Oregon Death). There could also be family members who heavily influence the patient’s decision to take the assisted suicide route. “An unscrupulous family member, the one eye-balling the big inheritance, who convinces the patient that this is the best thing to do for ‘everyone concerned’” (Capriotti) could be the reason the patient chooses to undergo doctor-prescribed suicide, even if they themselves are not fully aware of their decision. The unpredictable malice that can occur within the patient’s trusted circle of friends, family, and doctor’s is an example of the cons to the Death with Dignity Act.

            Doctor-prescribed suicide alone sounds like a negative thing, never mind the cons that go with it. The Death with Dignity act can make those who fight against their terminal illness feel like their fight is unnecessary and ridiculous, and turns around the meaning of dignity and twists it inside out. Outside sources could be the driving force behind the person’s wish to end their life, or the patient could have other intentions in how they plan to use the lethal injection given to them. Maybe the fact that it’s just plain suicide and homicide is enough to turn the nation against the Death with Dignity Act. Maybe the negatives are far greater than the positives for nationwide legalization.

            The Death with Dignity Act creates a lot of controversy throughout the nation. Some may argue that it’s plain suicide, and that there are far too many negative outcomes that could occur with a nationwide legalization of the act. Many believe that “Death with Dignity or mercy killing is ethically incorrect and must be prohibited by law” (Death with Dignity Act). Others state that it’s not their business what each person does with their own lives, and that the legalization of the Death with Dignity Act is a positive thing for the nation. They say that “when the patient's primary objective is not to end an otherwise open-ended span of life, but to find dignity in an already impending exit from this world” (Barber) then why fight the act? The literature revealed many things about the different opinions on the Death with Dignity Act and its nationwide legalization.

Gap Identification:

The research I found had mainly focused on the opinions and studies developed by doctors or people in the medical field. None of the research was taken from the opinions or the current thoughts of this generation’s teens. The fate of this act will have the most effect on the upcoming generation of adults, yet there is no information about their thoughts on Death with Dignity.

Research Question:

What is the opinion of teens on the legalization of the Death with Dignity Act?


For my data research, I chose to do a qualitative survey to understand the minds of teens and their attitudes towards the Death with Dignity Act. “Qualitative research is a broad approach to the study of social phenomena. Its various genres are naturalistic, interpretive, and increasingly critical, and they typically draw on multiple methods of inquiry” (Marshall 3). The ideas of teens and their opinions cannot be fully be understand in a series of numbers, or in percentages. “Qualitative research typically is enacted in naturalistic settings, draws on multiple methods that respect the humanity of the participants in the study, focuses on context, is emergent and evolving, and is fundamentally interpretive” (Marshall 2). In my survey, I ask teens to speak their opinions. Using a qualitative methodology is the better choice when compared to quantitative because better research can be conducted and better conclusions can be drawn if the participants fully express their opinions.

Data Collection Process and Instrument:

In order to understand teen’s opinions on the subject of legalizing the Death with Dignity Act, I created a qualitative survey in which was given to 25 students at Norton High School. They were assigned to answer 4 questions regarding assisted suicide, after reading a small paragraph to help everyone better understand the act. The first question asked “How do you feel about the Death with Dignity Act and the idea of assisted suicide?” Students then answered the question however they felt fit. The second question read “In your opinion, is it ethical for a doctor to prescribe a lethal injection to a patient?” and they answered yes or no. ”If someone has a terminal illness, and they make the decision to end their life, could you respect or understand their decision? Why or why not?” was the third question they were asked to answer. And the final question they were given asked “Do you feel the Death with Dignity Act should be legalized nationwide? Why or why not?” After they completed the survey, it was given back to me.

Sample Population:

My survey was given to 25 different freshmen, all around ages 14 and 15. More females were given the survey than males, but the survey was collected anonymously, so gender has no correlation to the results of the survey. The large sample population can correlate with the large amounts of teens that could have an opinion on the topic of assisted suicide, and the survey can help understand their thoughts.

Data Analysis:

            After collecting all of the participants’ surveys, conclusions can be made about the everyday teen’s opinion on assisted suicide and the legalization of the Death with Dignity Act. When asked the question on their opinion of doctor-assisted suicide, 15 out of 25 students said that they believed the Death with Dignity Act was a good option for those who were suffering and wanted to take the assisted suicide route, as long as it was their own decision and they were in a clear mental state. 4 students had neutral or mixed feelings regarding the act, and 6 students disagreed with the idea of the Death with Dignity Act. Students were then asked if they believed it was ethical for doctors to prescribe a lethal injection to patients in order to end their life. 16 out of 25 people believed it is ethical and okay for doctors to prescribe the injection. 8 out of 25, disagree, explaining that the doctor is basically murdering their own patient. 1 person had a neutral opinion, saying it was dependent on the situation. My third question asked students that if someone had a terminal illness, and they made the decision to end their life, could they respect or understand the patient’s decisions. 21 out of 25 participants stated that they could respect a patient’s decision to undergo the Death with Dignity Act, that it is their life and they can do what they feel is the best option for them. 4 out of 25 stated that they could not respect someone who chooses to end their life before their time had run out. The final question I asked students taking my survey was simply “Do you feel the Death with Dignity Act should be legalized nationwide? Why or why not?” 14 out of 25 students believe that the Death with Dignity Act should be a legalized act in the United States, stating that it’s the patient’s life and they should be able to handle their situation how they see fit. 9 students disagree, arguing that patients should fight to their last breath and that suicide should not be encouraged. 2 people were unsure of how they felt towards the legalization of the act or had no opinion. After completing my literature review, I was left asking myself this: what is the opinion of teens on the legalization of the Death with Dignity Act? My findings from my research can help my find the answer.


           After analyzing the results I gathered from my survey research, I can come to the conclusion that teens have mixed emotions about the legalization of the Death with Dignity Act, much like adults. The number of students who felt the Death with Dignity Act should be legalized was a similar number compared to those who opposed. 56% believed the act should be passed, which is not a large majority. And while many can understand and respect a patient’s choice, only 56% believe the act should be a nationwide agreement. Teens agree with adults when saying that the Death with Dignity Act has positives and negatives, giving similar reasons for backing up their thoughts as adults did. My research shows that teens and adults have very similar ways of thinking and their points of view on the subject are similar. Teens all have different opinions on the Death with Dignity Act, and what it’s future as an act should look like, much like adults, which can leave many thinking, positive or negative?


            After writing my literature review and conducting my own experiment, I can come to the conclusion that everyone’s opinions are divided. The pros and cons of the legalization of the Death with Dignity Act both contain valid points backing up their argument for the fate of assisted suicide as an act. Adults and teens are both divided almost in half based on their opinions of doctor prescribed suicide. How one feel towards death and assisted suicide depends in their own opinion on life and death. For now the Death with Dignity Act will remain a largely debated topic in the United States, and continue to create controversy throughout hospitals and the nation.

Works Cited:

Barber, Melissa. "The Major Myths about Death with Dignity Laws." Death with Dignity
            National Center. 27 Feb. 2012. Web. 20 Nov. 2014.

Campbell, Courtney S. "Ten years of “death with dignity.”." The New Atlantis 22 (2008): 33

Capritotti, Beth. "Hey, Can You Stop at CVS and Pick Up My Suicide Pills?" Philadelphia
             Magazine. 15 Feb. 2012. Web. 7 Nov. 2014.

Cohen, Lewis. "Physician-Assisted Suicide Was Scandalous, Then Experimental, Now
            Almost Mainstream." Slate Magazine. 29 Oct. 2012. Web. 20 Nov. 2014.

"Death with Dignity Act Pros and Cons." 14 Mar. 2014. Web. 20 Nov. 2014.

Demaine, Jim. "Death with Dignity: Issues States Need to Consider." 7 July
             2013. Web. 20 Nov. 2014.

Ganzini, Linda, et al. "Oregon physicians' attitudes about and experiences with end-of-life
            care since passage of the Oregon Death with Dignity Act." Jama 285.18 (2001):

"How Many People Die Each Year Due to Terminal Illnesses?" – Kgb Answers. 5 Nov.
           2014. Web. 20 Jan. 2015.

"Is the Oregon Death with Dignity Act a Good Law? - Euthanasia -"
 Headlines. 5 June 2008. Web. 20 Nov. 2014.

Marshall, Catherine, and Gretchen B. Rossman. Designing Qualitative Research. 5th ed.
          Newbury Park, Calif.: Sage Publications, 1989. Print.

Sullivan, Amy D., Katrina Hedberg, and David W. Fleming. "Legalized physician-assisted
         suicide in Oregon—the second year." New England Journal of Medicine 342.8
          (2000): 598-604.

Ubel, Peter. "Don't Confuse Death with Dignity with Suicide." 9 Sept. 2013.
         Web. 20 Nov. 2014.