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Maria Garcia
Professor Beatty
English 2010
5 March 2016
The Process of Assisted Suicide
When discussing any disease, a call to empathy is usually in order, as it allows people to
share a deeper understanding of the circumstances a patient faces. In order to understand the
reasoning behind assisted suicide, one must recognize the inevitable physical and emotional pain
that accompanies Alzheimers in its deteriorating nature. If a patient has chosen to participate in
PAS (physician assisted suicide), they likely believe that the pain inflicted is an unbearable and
futile experience. In defining unbearable suffering, investigating the side-effects of Alzheimers,
and navigating opposing positions to PAS, the reader will acquire a deeper understanding of
Alzheimers patients near the end of life. When taking into consideration the incredible amount of
unnecessary suffering experienced during an Alzheimers patients final days, reasons for offering a
choice in these moments will become clearer and the wider legalization will resurface as a
necessary step to be taken by the nation.
However, empathy is not always the first component in conversations surrounding PAS,
because often the loudest opinions are those vehemently countering the possibility altogether. One
famous argument is that of the slippery slope. PAS legalization in American has allowed doctorassisted suicide to mentally competent adults with terminal illnesses only, not for disorders like
depression and schizophrenia, (Carey). However, in the Netherlands, which is thought to be the
headquarters for end-of-life developments, farther reaching practices including severe psychiatric
problems in addition to terminal illness are active (Carey). Believing the United States will follow
in the Netherlands footsteps, many have contended that it will only be a matter of time before those

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who are remotely depressed or frustrated with everyday life will opt for assisted suicide in a world
that sees past the need for individual care and instead fosters the idea (as Orr explains) that based on
functioning, medical staff will consider people arent people anymore (qtd. in Smith 39). The
slippery slope argument is just one of the perspectives that is commonly positioned against a wider
legalization of PAS, and one that has important points to consider in terms of how the general public
and medical staff view those with atypical cognitive functioning and their value as people.
Arguing the merits of pain and what is deserving of x or y, is an elusive debate, because
it is a subjective issue. To get a better idea of the levels of pain, Dr. M. Scott Peck explains in
Denial of the Soul that, while its true physical pain in any state is daunting, pain is a blessing
(28). It serves as a helpful indication for areas that require attention within the body. However, if the
problem is being treated, there is no reason for the signal (pain) to continueIf the pain does
continue, the blessing has become a curse (28). The task of defining unbearable, has become one
of the fundamental components facing supportive and opposing positions on the matter because
each terminal illness case is unique. In Pecks view, unbearable seems synonymous with
constant. By this doctors logic, it is a crime to treat patients with temporary medicine while
witnessing physical agony when that agony could be quickly, easily, and safely relieved (30). In
the late stages of Alzheimers, communication becomes nonexistent and the body begins to break
down under the cover of forgotten language. These side effects are a result of beta-amyloid proteins
tangling within the brain to form plaques that block cell-to-cell signaling at synapses
(Alzheimers Association).The patients quality of life diminishes with the increasing levels of pain.
While gradually strengthened treatment might suppress the pain, it is a constant battle, and a patient
that is asking for death or writhing in a hospital room is fulfilling the unbearable criteria that
unfortunately becomes their waking state. That pain which is unbearable and unnecessary can only
be treated for a short amount of time, and takes over the body often in silence until the time of

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death. When the end is near in such a case, there is no purpose for pain, it exists no longer exists as
a tool, because further repairs are ineffective, unfortunatelyhere is where a choice can alleviate a
blessing-turned-curses effects, if made available.
In the same vein, emotional pain is commonly recognized as the biggest fear of those facing
Alzheimersspecifically, lost connections between patients and their families, and feelings of
loneliness or fear (57). Sandra Bem, a psychologist and professor emeritus at Cornell University
chose to participate in PAS when she was first diagnosed, but spent years leading a relatively
normal life until she set the date of her suicide (Spiegel). Before her death, Bems family held an
intimate gathering at their home to celebrate Sandras life which reportedly granted the family an
opportunity for open emotional support and a feeling of closure, which is often not the case in
natural Alzheimers deaths in hospices or nursing homes (Spiegel). More of these peaceful sort of
goodbyes could be possible if the option for PAS was presented as such (an option), because the
reality is that many families are not able to travel to the states where it is legal and jump through
hoops to get access to something that should already be offered.
In respect to family members coping with assisted suicide, Dr. Linda Ganzini has conducted
research studying 95 people fourteen months after a member of their family had chosen PAD
(physician assisted death, when a physician administers lethal intravenous substances, rather than
the patient administering himself/herself in PAS) (Ganzini, Goy, Dobscha). Family members were
asked to rate the importance of reasons why one would choose PAS/PAD. They were, respectively:
desire for control, future or current pain, future or current poor quality of life, worries about being a
burden, and loss of sense of self (Ganzini, Goy, Dobscha). This study concluded that PAD allowed
patients to maintain control, independence, and self-care in a home environment which supported
the wider availability of PAD for terminally ill patients (Ganzini, Goy, Dobscha). This desire for

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closure and control is heightened when the natural option allows the disease to run its course with a
more severe and less containable physical pain/cognitive deterioration factor to consider.
Acquiring a greater understanding of unbearable pain, acknowledging an emotional loss
of control, and gaining a knowledge of both sides of the argumentincluding the opposition as it
concerns human value and brain function, are of utmost importance in declaring a position on PAS.
Having a deeper knowledge of these categories provides the reader with context for their future
assessment of the limits regarding suffering and the availability of such a procedure to the nation.

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Works Cited
"Alzheimer Basics: Plaques and Tangles." Alz.org. Alzheimer's Association. Web. 01 May 2016.
Carey, Benedict. "Study Questions the Use of Doctor-Assisted Death.The New York Times [New
York City] 11 Feb. 2016, New York ed.: A6. Print.
Ganzini, Linda, Elizabeth R. Goy, and Steven K. Dobscha. "Why Oregon Patients Request Assisted
Death: Family Members Views." J Gen Intern Med. Journal of General Internal
Medicine 23.8 (2007): 154. U.S. National Library of Medicine. National Center for
Biotechnology Information, 23 Feb. 2007. Web. 3 Mar. 2016.
Peck, M. Scott. Denial of the Soul: Spiritual and Medical Perspectives on Euthanasia and
Mortality. 1st ed. New York: Harmony, 1997. Print.
Smith, Wesley J. Forced Exit: The Slippery Slope from Assisted Suicide to Legalized Murder.
Spiegel, Alix. "How One Woman's Plan to Kill Herself Helped Her Family Grieve." Npr.org.
National Public Radio, 23 June 2014. Web. 3 Mar. 2016.