By Scott Middleton M.D., FACS
A 29-year-old California woman changed her mind about dying this week. Brittany Maynard, who has terminal brain cancer, moved to Oregon for the announced purpose of taking her own life, under that state’s Death With Dignity Act. She was set to commit suicide, legally, with the assistance of one of my fellow physicians.
I believe this is a tragedy. We, as physicians, certainly have a role in end-of-life care. Admittedly, we sometimes abdicate that role. In reality, there is much truth in Hippocrates’ statement that we should “Cure sometimes, treat often, comfort always.”
1) Because it provides a financial incentive for premature deaths. It’s always cheaper to give a patient a suicide pill than provide real care. Imagine the financial incentives prescribed suicide offers to HMOs, government payers, insurance companies and heirs.
2) Because it invites pressure and coercion. The “right to die” quickly changes into “the duty to die.”
3) Because it covers up abuse. The only statistical indicators in Oregon’s Assisted Suicide Act are given by state bureaucrats in a bare-bones annual report. By clever mandate of law, “the information collected shall not be a public record and may not be available for inspection by the public.” The government only reviews a sampling of records, does not verify their accuracy and subsequently destroys the records.
4) Because doctor prescribed suicide is not needed. Under existing law, every patient or his designated decision-maker has the right to refuse prolonging life by artificial means. It is ethically acceptable to refuse or discontinue futile treatment.
5) Because it would help destroy the doctor-patient relationship. Patients could not know if the doctor’s motive was to attempt to heal or to end their life.
I believe this is a tragedy. We, as physicians, certainly have a role in end-of-life care. Admittedly, we sometimes abdicate that role. In reality, there is much truth in Hippocrates’ statement that we should “Cure sometimes, treat often, comfort always.”
“Physician-Assisted-Suicide is fundamentally incompatible with the physician’s role as healer, would be difficult to control and would pose serious societal risk” — from the Code of Ethics, American Medical Association.Five of my reasons why Physician-Assisted-Suicide should not be legal:
1) Because it provides a financial incentive for premature deaths. It’s always cheaper to give a patient a suicide pill than provide real care. Imagine the financial incentives prescribed suicide offers to HMOs, government payers, insurance companies and heirs.
2) Because it invites pressure and coercion. The “right to die” quickly changes into “the duty to die.”
3) Because it covers up abuse. The only statistical indicators in Oregon’s Assisted Suicide Act are given by state bureaucrats in a bare-bones annual report. By clever mandate of law, “the information collected shall not be a public record and may not be available for inspection by the public.” The government only reviews a sampling of records, does not verify their accuracy and subsequently destroys the records.
4) Because doctor prescribed suicide is not needed. Under existing law, every patient or his designated decision-maker has the right to refuse prolonging life by artificial means. It is ethically acceptable to refuse or discontinue futile treatment.
5) Because it would help destroy the doctor-patient relationship. Patients could not know if the doctor’s motive was to attempt to heal or to end their life.
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