Read the following negative position to a resolution. Then develop a Negative Constructive Speech Outline:

Resolved: The U.S. Should Legalize Physician Assisted Death

Negative: Argues Against Implementation of the Resolution

The resolution to legalize physician assisted death (PAD) in the United States should not be implemented. When concerning end-of-life care, there is no significant problem or need for change as there are various options for patients that do not include death to end suffering. The United States offers programs that are currently operating to substantially care for terminally ill people. Additionally, legalizing PAD will not effectively solve the problem faced by those suffering, nor will it prevent harmful consequences. The potential damages of PAD far outweigh any perceived benefits.

To better understand the negative impact of the resolution to legalize PAD, it is important to analyze PAD and what it entails. According to Dieter Birnbacher from the International Encyclopedia of the Social & Behavioral Sciences, PAD and euthanasia go hand in hand, despite the United States ban against euthanasia. Birnbacher states they are the act of, "Caring for the dying by relieving suffering psychologically and medically, and by spiritual assistance; letting die suffering patients by not artificially prolonging life; actively hastening death to shorten suffering by assisting patient suicide, by voluntary or nonvoluntary active euthanasia; withholding life-sustaining treatment from a patient in a persistent state of unconsciousness; and ending the lives of children and adults seen as a burden to society or to their families" (2015).While euthanasia may be issued involuntarily in some cases, PAD is not. Proponents argue that PAD provides a humane option for terminally ill patients seeking relief from unbearable suffering. However, despite the implication that PAD offers relief from suffering in any capacity through which it is administered, the underlying factors must be investigated to expose its harmful effects.

While some individuals advocate for PAD, it is crucial to recognize that most people with life-threatening illnesses choose to live with dignity and seek comfort through palliative care or hospice, depending on their illness. Arthur R. Derse, M.D., from Academic Emergency Medicine argues, "Because all human life is sacred, human beings should not choose to hasten their deaths. Therefore, they should not take their own lives and should not seek or receive the assistance of physicians in committing suicide" (2019). The demand for PAD is not significant enough to warrant a change in the law, as most patients prioritize pain management and symptom relief over expediting their death.

There is not a pressing need to legalize physician-assisted death to address end-of-life suffering when existing programs are already effective in managing it. Hospice care and palliative care offer comprehensive comfort and support for individuals with life-limiting illnesses, focusing on pain management and symptom relief. These approaches align with the goal of dignified, comfortable living, making it a more suitable option than PAD. Such care provides patients with the opportunity to focus on making the most of their remaining time, surrounded by loved ones and professional caregivers who prioritize their comfort and well-being.

Hospice and palliative care programs are better equipped to address the needs of terminally ill patients. "Palliative care and hospice services improve patient-centered outcomes such as pain, depression, and other symptoms; patient and family satisfaction; and the receipt of care in the place that the patient chooses" (Meier, D. E., 2011). These programs focus on pain management, emotional support, and spiritual guidance, to improve the quality of life for patients nearing the end of life.

Legalizing physician-assisted death could undermine the development and accessibility of these programs by shifting the focus away from improving end-of-life care and towards facilitating death as a solution.Daniel Sulmasy, M.D., states, "Just as true martyrs accept their inevitable deaths at the hands of their oppressors but do not provoke their oppressors into killing them, so it is permissible to accept one's inevitable death from disease but never permissible to bring one's own death on oneself" (2021). Legalizing PAD will not address the underlying issues that lead some patients to consider it. Instead, it is crucial to improve access to quality care, mental health support, and end-of-life planning, which can genuinely alleviate suffering and provide a sense of control for terminally ill patients.

Furthermore, there are significant ethical, legal, and practical challenges associated with implementing such a policy that legalizes PAD. For instance, determining eligibility criteria and safeguarding against coercion or abuse are complex tasks that may not be adequately addressed by legalization. Moreover, vulnerable populations, including the elderly and disabled, are disproportionately affected by such policies. This indicates that legalizing physician-assisted death may exacerbate existing inequalities rather than provide a meaningful solution.

The criteria for eligibility for PAD have also gradually expanded to include individuals who are not terminally ill but suffer from chronic conditions or disabilities, such as depression, which ultimately destroys the protection of vulnerable populations."Up to half of patients with cancer suffer from symptoms of depression. The elderly also suffer from high rates of depression and suicide. Because depression often manifests somatically, if patients are not screened, clinicians miss half of all cases of clinical depression" (Dugdale, L.S., et al, 2019). If physicians are legally capable of administering PAD without properly screening all patients for depression or other non-terminal conditions that are treatable, then the number of deaths will rise dramatically.

Dr. Frankin G. Miller of Weill Cornell Medical College states, "While I have long advocated for physician-assisted death as a last resort option, I contend that it would be a serious mistake to extend this intervention to those with 'treatment-resistant depression' who are not terminally ill" (2015).People with non-terminal conditions should not meet the criteria to even consider death-assistance as an option. Miller further supports such claims in stating, "Patients with treatment-resistant depression and lacking a terminal medical condition are not soon to die as the result of their disease condition" (2015).Thus, it would be unethical to administer PAD to patients that can continue to live with their conditions, as they are not life threatening.

This poses a significant risk to the sanctity of life and could lead to a culture where certain lives are deemed less valuable. St. Godard from the Canadian Family Physician stresses, "The solution to our medicalized lives and deaths is not another syringe, and not more pills. We must talk openly about the end of life, and be less squeamish about the alarmingly ordinary sights, sounds, and smells of normal dying. Although we must not welcome or glorify suffering, neither should we strive for an artificial, sanitized, and idealized death" (2015). Patients may feel pressured to choose death over continued suffering due to societal attitudes that make them feel as if they are burdens to loved ones. They also believe death is a medical problem and that they are entitled to treatment to avoid a natural process of dying.These two sentences need supporting evidence.

Removing someone from such processes also eliminates the chance of healing at the end of life in terms of reaching a mental totality. Ewan Goligher suggests, "The dying process will certainly have unwanted negatives in terms of pain and suffering (for which we advocate aggressive and much improved approaches to palliative care), the dying process can also be a time of existential and spiritual healing through growth in personal and relational wholeness as well as individual learning for patients, their loved ones, and those caring for them" (2018). The intentional act of removing a person to circumvent the process of dying further violates the worth of a person. Thus, normalizing the idea that some lives are not worth living could have severe detrimental consequences.

When concerning the physician-patient relationship, PAD may also undermine trust in medical professionals by blurring the line between healing and killing. According to the Yale Journal of Biology and Medicine, "Some opponents of PAD express concern that once doctors are involved in the business of hastening patients' deaths; they have already slid down the slippery slope" (Dugdale, L.S., et al., 2019). Are medical professionals losing compassion for their patients too easily and quickly?St. Godard suggests, "As subspecialists too often appear to abandon patients once there is "nothing left to be done," so does a society that legalizes and normalizes euthanasia and physician-assisted suicide risk abandoning its most vulnerable members" (2015).A lack of compassion from physicians tarnishes the importance of patients, often pushing them to consider PAD.

The Journal of Religion and Health notes, "Preserving opportunity for physicians to act (or refrain from acting) in accordance with the dictates of conscience in their professional practice is important for preserving the integrity of the medical profession as well as the integrity of the individual physician, on which patients and the public rely." (Fowler, 2023).Legalization will harm both physicians and the mission of the medical field, which is to protect and care for the lives of patients. The goal of medicine is not to intentionally inflict death on any person.

Additionally, other significant unintended consequences, such as the deadly interaction between assisted suicide and managed health care will worsen if PAD is legalized. According to the Disability Rights Education and Defense Fund,"Again and again, health maintenance organizations (HMOs) and managed care bureaucracies have overruled physicians' treatment decisions because of the cost of care. These actions have sometimes hastened patients' deaths. Financial considerations can have similar results in non-profit health plans and government-sponsored health programs such as Medicare and Medicaid, which are often under-funded. The cost of the lethal medication generally used for assisted suicide is about $300, far cheaper than the cost of treatment for most long-term medical conditions. The incentive to save money by denying treatment already poses a significant danger. This danger is far greater where assisted suicide is legal. Direct coercion is not necessary. If patients are denied necessary life-sustaining health care treatment, or even if the treatment they need is delayed, many will, in effect, be steered toward assisted suicide" (2012). The deadly impact of legalizing PAD especially puts financially disadvantaged people at risk due to their inability to access substantial medical resources.

Considering the inadequacy of the need for change, the availability of alternative solutions, the ineffectiveness of PAD in addressing the problem, and the potential harm it may cause, the argument against legalizing physician-assisted death in the United States outweighs any benefits to legalizing it. It is essential to prioritize and invest in improving end-of-life care and mental health support for those facing life-threatening illnesses, rather than pursuing the path of assisted death that could lead to unintended and detrimental consequences.

Negative Constructive Speech Outline (use direct quotes in "Data")

Disadvantage One

Disadvantage Two

Disadvantage Three

Thesis

• Claim A: Data: Data:
• ClaimB: Data:
• ClaimC: Data:

Conclusion

Summary of disadvantage arguments with an explanation why they outweigh any benefits from the resolution. Urge the audience to reject the resolution.