Example research essay topic: Issues Regarding Euthanasia And Assisted Suicides – 1,287 words

The issue of whether or not to legalize
physician-assisted suicide has been front and
center as a public policy issue around the world.
Many proponents and opponents are largely
operating on assumptions as to why people
participate in physician-assisted suicide with
only a limited amount of support for their
attitudes. Not only do those that support
physician-assisted suicide often assume that
people participate in it for primarily rational
and medical reasons from usually physical
illnesses. Opponents of physician-assisted suicide
often assume that the participants are motivated
primarily by typical suicidal behavior, and push
for suicide prevention intervention. Clearly one’s
outlook toward this topic depends a great deal on
the lenses through which one views it. The present
essay has two purposes. First, we will summarize
some of the data emerging from the PAS sample we
have been studying in Michigan.

These data are
striking in a number of important ways and are
important in themselves in an attempt to
characterize motivations of people who seek PAS.
These data have been presented in detail in
several recent articles published both by our
research team (Kaplan, Lachenmeier et. al., 2000;
Kaplan, O’Dell et. al., 2000) and others (Canetto
and Hollenshead, 2000). Here we summarize these
data around gender in a particular way to meet the
second purpose of our paper: to place these
particular data set in a more general model of PAS
world-wide, focusing on differences in
gender-ratios across these samples. This model
will introduce the conception of the degree of
physician control as an ordering principle and
will examine its relationship to the gender ratio
of the PAS participants. In other words, degree of
physician control will be treated as an
independent variable, ranging across various data
sets from unassisted suicide (no doctor
involvement) on the one-hand to full euthanasia
(full doctor control) on the other.

The proportion
of women versus men participating in hastened
death will be treated as a dependent variable.
Generally, researchers agree that the relationship
between physical illness and psychiatric
symptamotology is complicated (Fawcett, 1972;
Murphy, 1977; Conwell et. al., 1990). The present
research report presents data to determine the
relative roles of psychosocial versus biomedical
factors in the PAS cases in Michigan performed by
Dr. Kevorkian and his team. Specifically, we focus
on the question of gender differences in this
regard. Sample.

The Michigan data derives from our
own IRB approved research on the PAS conducted by
Dr. Kevorkian and his team. Our research team, in
conjunction with the Detroit Free Press, has
identified 93 of these cases, and there is
evidence that even with Kevorkian presently in
prison, other members of his team have continued
to perform additional PAS both in Michigan and in
other states (Detroit Free Press, May 13, 1999).
From these 93 cases, we have administered a
psychological autopsy to friends and relatives of
the first 47 of these decedents who were assisted
in their death in the period June 4, 1990 to
February 2, 1997. This psychological autopsy
technique has been widely used in the study of
suicide and allows the reconstruction of the
psychological profile of the decedent in a manner
parallel to a physical autopsy (Barraclough et.
al., 1974; Hagnell and Rorsman, 1979; Fowler et.
al., 1986; Clark and Horton-Deutsch, 1992). This
will be discussed in more detail below. We have
also collected more cursory data gleaned from the
death certificates and from the judgments of the
medical examiners of the remaining 46 cases (Dr.
Dragovic in Oakland County, Drs.

Kahnluen and
Somerset in Wayne County, and Dr. Spitz in Macomb
County, all in Michigan). The psychological
autopsy involved collection of interview data with
regard to demographic, biomedical, and
psychosocial information about the decedent from
families and friends in addition to medical
personnel familiar with the case. The non-medical
informants were of great value in obtaining
information as to psychosocial issues regarding a
decedent. To ensure accuracy, we followed standard
psychological autopsy methodology in requiring the
agreement of two or three informants who knew the
decedent well. (Clark and HortonDeutsch, 1992;
Kaplan and Maldaver, 1993).

Specifically, we only
scored a symptom or piece of information as
positive if it was indicated as present by at
least two informants (Clark and Horton-Deutsch,
1992). Guidelines were provided for the
interviewers. For example, terminality was defined
at autopsy as a projection of six months or less
to live as determined by the respective medical
examiner. Category of disease, anatomical basis
for disease, and method of death were also defined
by the medical examiner at autopsy. Reported pain,
depression, and history of suicide attempts were
assessed from the reports of friends and relatives
regarding complaints of the decedent while
anatomical basis for pain was defined by the
medical examiner at autopsy as the physical
specification of an anatomical basis for reported
pain on the part of the decedent. This is
admittedly a very difficult judgment to make by a
medical examiner at autopsy, but we felt it was
important to attempt to distinguish reported pain
that had a specific anatomical referent from that
which did not (Detroit Free Press Staff, 1997;
Kaplan, Lachenmeier et.

al., 2000; Kaplan, O’Dell
et. al., 2000). First of all, disability (87%) and
fear of dependency (90%) seem more a factor than
terminality (31.1%) for the Michigan sample of
people dying by PAS. This is especially true among
women. This raises the question of what can be
done by society to better enable people with
physical incapacitation and disabilities to live
more full lives. A second finding indicates that
almost twice as many patients reported pain (73.6
%) than revealed an anatomical basis for that pain
at autopsy (42.6 %).

This suggests that a
considerable number of these decedents may have
experienced psychological-based rather than
anatomically-based pain. This trend seems to be
higher among women than men, with 75% of both
genders reporting pain, but men described as
having almost twice the rate of anatomical basis
for pain (60 %) as women (34.4%). This pattern is
very troubling. On the one hand, it may simply
reflect the traditional inability of male
physicians to adequately recognize the physical
basis for women’s pain and thus to
over-psychologize it. However, it may also
indicate that there may be different bases for the
pain behind the decision of men and women to seek
death, and that differential techniques may be
appropriate to control that pain. The third
finding is related.

Psychosocial factors seem as
important as biomedical factors in the Michigan
PAS sample, especially among women. For example, a
typical man choosing PAS may be suffering from
terminal lung cancer and be in a great deal of
physical pain. A typical woman choosing
physicianassisted suicide may be somewhat disabled
from chronic multiple sclerosis and as a result,
see her marriage break up and her economic
situation deteriorate. Her pain may be just as
intense as that of the man described above but
emerging from a partially psychosocial source.
Finally, the degree of physician control of the
death situation seems to interact with patient
gender. The very same factors which lead women to
utilize social support in health care settings
more than men may also affect their preferences
for more paternalistic physicians (Emanuel and
Emanuel, 1992) and more highly structured death
situations where they may be more passive (Canetto
and Hollenshead, 2000). The danger is that such
structure will create a sense of obligation on the
part of a woman, especially one who subscribes to
stereotypic sex roles (Flaherty and Richman, 1989;
Vaux and Harrison, 1983; Kaplan, Schneiderhan, and
Harrow, 2001) to complete a physician-assisted
death towards which she may be initially
ambivalent.

The role of other patient factors such
as disability, age, religiosity, ethnicity, and
socioeconomic status must also be examined in the
context of physician-assisted death. Research with
regard to the effects of the physician-patient
relation (Emanuel and Emanuel, 1992; Kaplan,
Schneiderhan, and Harrow, 2001) is clearly needed
to provide a foundation for intelligent and
informed legislation in this very important area..

Research essay sample on Issues Regarding Euthanasia And Assisted Suicides