A July 21, 2008 blog entry on the Pallimed blog looks at issues and current events related to euthanasia and assisted suicide on a world-wide basis.
The authors are not advocating for the legalization of assisted suicide, but rather explaining that there may be a need to discuss these issues with their patients.
The authors conclude by stating:
"Good hospice and palliative care practices can help people discover hastened death does not have to be the easy way out. If the lines are too blurred between the legal and illegal our field has significant trust to lose with the public and our peers. Being educated and aware of the public debate over hastened death is a responsibility for palliative medicine to ensure the safe, ethical, and legal care of the patients and families entrusted to us."
I think that the authors touch on, but miss two important points.
1. By emphasizing that their patients are thinking about euthanasia does not mean that a discussion about euthanasia is necessary, but rather a re-inforcement that the patient will be properly cared for, and that the patient does not need to fear the possibility of uncontrolled suffering.
2. Palliative physicians are always focusing on the medical aspects to dying a good death. The physician should be focusing on the social, psychological, and spiritual issues related to end-of-life care. People rarely want euthanasia because they are experiencing uncontrolled pain, usually requests for euthanasia are related to a sense of hopelessness, a feeling of being a burden on others, or a loss of purpose in their life.
There needs to be a new focus on the way that euthanasia directly threatens the lives of the most vulnerable in our culture. We cannot separate the effect on society if it becomes legal to intentionally cause the death of others. Those who are socially devalued will be treated differently.