Hippocratic Medicine is Hallowed Ground.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Ronald Pies

For those who read the articles that I publish, you will notice that Dr Ronald Pies has written a series of articles in response to Joshua Pagano, DO's. 

This latest article is in response to Dr Pagano's article - “Finding Common Ground in This Life.” where Pagano asks the hypethetical question if assisted suicide is acceptable when a: "terminally ill patient who has had access to marvelously comprehensive care, including “pain management,” assessment of underlying mental illnesses, personal and family counseling, and information regarding “all possible options.” Dr Pagano then opines that—notwithstanding such stellar care—there will still be “the patient who will legitimately choose medical aid in dying.”

Dr Pies responds by stating that the "hypethetical patient" is rare considering access to good end-of-life care and the availability of psychological / mental health care, nonetheless, Pies argues that physicians, are not ethically or legitimately empowered to honor the choice of assisted suicide.

Pies urges Pagano to consider the importance of Hippocratic medicine:

I would encourage Dr Pagano to reflect on our Hippocratic roots, as physicians. I am not speaking solely of the famous “Hippocratic Oath,” with its solemn vow, “I will give no deadly medicine to anyone if asked, nor suggest any such counsel…” I am referring to the entire tradition of Hippocratic medicine, over the past 2500 years. The refusal to administer a lethal drug to dying patients was a distinguishing feature of Hippocratic physicians—setting them apart from their contemporary colleagues. It is only since the rise of the consumer rights movement in the 1960s—whereby patients became “service users” and physicians, mere “providers”—that assisted suicide has been seriously advanced as a medical “service.”

Pies then quotes medical ethicist and physician Leon Kass, MD, PhD, who stated:

“In forswearing the giving of poison, the physician recognizes and restrains a godlike power he wields over patients, mindful that his drugs can both cure and kill. But in forswearing the giving of poison when asked for it, the Hippocratic physician [also] rejects the view that the patient’s choice for death can make killing him—or assisting his suicide—right.”

Pies concludes his article by stating that finding common ground is important but it is more laudable still is knowing when one is treading on hallowed ground.

Previous articles by Dr Ronald Pies:

• Physician-Assisted Suicide: An egregious boundary violation (Link).
• Assisted suicide and the autonomy myth (Link).
• 12 myths to assisted suicide and medical aid in dying (Link).

Dr Ronald Pies is professor emeritus of psychiatry and lecturer on bioethics and humanities, SUNY Upstate Medical University; clinical professor of psychiatry, Tufts University School of Medicine; and editor in chief emeritus of Psychiatric TimesTM (2007-2010).