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One doctor’s quarrel with assisted suicide

Post by Patrick O'Callahan on Oct. 31, 2008 at 10:36 am with No Comments »
October 31, 2008 10:36 am

We’re occasionally posting longer election-related pieces here that we don’t have the space to print as opeds (without being unfair to everyone who wants a political oped in).

This one’s from a retired doctor, Sharon Quick of Bonney Lake, who worries that I-1000 will alter the doctor-patient relationship. Her specialty was pediatric anesthesiology, pain management and critical care

The idea that patient choice is a valid argument for Initiative 1000 (I-1000) reflects a misunderstanding of the extensive ramifications of legalizing assisted suicide for patients, their families, doctors, and society.

Terminally ill patients and their families have grief work to do together. With advances in symptom management, pain can be largely controlled and fears can be addressed so that reconciliation and emotional growth can occur. Powerful experiences may happen when least expected, sometimes creating lifetime memories.

It is not in a patient’s best interest to cut short this time of grief, not only for his/her own well-being, but in consideration of the profound emotional effects that can devastate family left behind. Witnessing suicide sends a tragic message to children about how to handle suffering.

Doctors are not vending machines to provide patients with their wishes. Conflict may exist between physicians’ recommendations and patients’ desires: patients may inappropriately ask for antibiotics when they have colds, may choose to smoke, may complain about the painful breathing exercises after abdominal surgery, etc.

A competent patient always has the option to follow or to refuse the physician’s recommendations, even to their detriment; but physicians since Hippocrates’ day have never had the option to suggest or cause harm to their patients.

Rather, physicians must always advise treatments in their patients’ best interests to preserve the sacred trust between doctors and their patients who may be vulnerable to making poor decisions when they are sick, stressed, grieving, depressed, dying, or otherwise compromised.

Once physicians procure the right to harm patients, there is no logical parameter for deciding which patients can be devalued to the point where suicide is acceptable.

The suffering of patients can be similar whether they have six months or one year or more to live; whether they are chronically ill or disabled.

Yet, I-1000 forces discrimination against those that have less than six months to live, a delineation all the more nebulous since doctors and medical tests have failure rates, and there are no crystal balls to predict life expectancy.

One lawsuit invoking the Americans with Disabilities Act by a disabled individual who cannot self-administer his lethal overdose, or a few more patients, like David Prueitt, who do not die after their lethal ingestion, and euthanasia will be introduced.

Once the foundational principle of medicine — to do no harm – becomes corrupted, it is only a short step to current practices in Holland: euthanasia without consent and infanticide.

Assisted suicide is not a solo act. I-1000 requires a physician accomplice to act in violation of his/her oath to do no harm. Although I-1000 does not require physicians to prescribe lethal overdoses, it does require them to refer to doctors who will. Many doctors will refuse to violate their conscience and Hippocratic Oath by doing so. Some physicians in Oregon are considered "not in compliance" with their hospital employer for this very reason.

Paradoxically, the lure of "choice" may ultimately trap patients into losing their choice to health organizations, like the Oregon Health Plan, that refuse expensive treatment if patients’ survival rates are too low, offering a cheaper lethal overdose instead.

Your vote on I-1000 may determine which option will be mandated for you when you are frail or dying. Think about which means of comfort you would rather hold onto: a handful of lethal medicine; or the hands of caring physicians and caregivers who will stubbornly choose to see your value no matter what your circumstances.

Which legacy of dignity should Washingtonians leave for future generations?

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