Euthanasia

Euthanasia

By Carrie Gordon, from James Dobson's Focus on the Family tackles some common questions.

© 1997 The Christian Institute

Contents

Talking Points: Physician - Assisted Suicide

Aren't doctors being compassionate when they help end the lives of patients suffering from incurable diseases?

Shouldn't terminally and chronically ill patients be given the opportunity to escape their misery, even if that means death?

Doesn't everyone have a right to die? Shouldn't patients have control over their own lives?

If a patient is terminally ill, why be concerned if a doctor helps end her life a few months earlier than when she would have succumbed to age or illness?

How about the patient who has given up on life and is bent on committing suicide anyway? Why not permit professional assistance?

What right do you have to force someone to stay alive?

By refusing assistance to a patient who wishes to die, aren't you sending the message that her wishes are irrelevant?

Don't your efforts interfere with the doctor/patient relationship?

Physician - assisted suicide is a private matter that doesn't impact you. Why don't you mind your own business?

References

The Northern Territory of Australia has legalised Euthanasia. In Holland it is now commonplace. Pressure is growing in Britain to legalise Euthanasia (otherwise known as Physician-Assisted Suicide).

Talking Points: Physician - Assisted Suicide

The legalisation of physician - assisted suicide is a raging controversy in America being debated in the media, Congress, state legislatures and the courts. Pro-lifers are stepping forward to debunk the myth that euthanasia is a form of compassion.

Aren't doctors being compassionate when they help end the lives of patients suffering from incurable diseases?

Doctors who offer death by assisted suicide as a medical option communicate hopelessness, not compassion. They send the message to the elderly, the disabled and dependent citizens that their lives are not worth living.

Shouldn't terminally and chronically ill patients be given the opportunity to escape their misery, even if that means death?

Doctors take an oath to be healers, not killers. In seeking to remedy pain, physicians are obligated to utilise medical alternatives to death - alternatives that do exist. Today's pain - management techniques offer true death with dignity by safeguarding terminally ill patients from suffering a painful death. (1), (2), (3)

Hospice care is another alternative to physician - assisted suicide. Hospices address not only the physical challenges of dying patients, but the emotional and spiritual needs as well.

Doesn't everyone have a right to die? Shouldn't patients have control over their own lives?

This debate isn't about the right to die; it's about the right to help patients kill themselves. Although patients may request to be euthanized, doctors are the ones being granted a radical new authority: deciding whether or not patients should continue living. In other words, instead of giving autonomy to patients, assisted suicide is about giving a powerful option to physicians, enabling them to directly participate in ending another person's life.

If a patient is terminally ill, why be concerned if a doctor helps end her life a few months earlier than when she would have succumbed to age or illness?

Predicting death is an inexact science at best. Doctors can and often do make mistakes. Consider a survey of Oregon physicians published in the Feb 1, 1996, issue of The New England Journal of Medicine. Researchers found that one half of the nearly 2,800 physicians responding were not confident they could predict that a patient had less than six months to live. (4)

How about the patient who has given up on life and is bent on committing suicide anyway? Why not permit professional assistance?

By agreeing to help a patient commit suicide, a doctor is ignoring what may be a legitimate cry for help. Suicidal thoughts often indicate the presence of a condition that is treatable: severe depression. A study of terminally ill hospice patients found only those diagnosed with depression considered suicide or wished death would come early. Patients who were not depressed did not want to die. (5)

Yet one third of the physicians who responded to the New England Journal survey indicated an uncertainty about their ability to recognise depression in patients who requested a lethal dose of medication. These are the same doctors who, under Oregon's "Death with Dignity Act," are allowed to assist in patients' deaths, provided the doctors can recognise depression and predict that death will occur within six months. (6)

What right do you have to force someone to stay alive?

There is a vast difference between relinquishing efforts that delay death and initiating procedures that cause death. Being pro-life does not necessarily mean advocating the forcible postponement of an impending natural death. Medical ethics do not require doctors to use all means of artificial life support available to extend the life of someone who is dying. (Providing nourishment and sustenance to a comatose patient is not considered artificial life support.) A patient's sincere request to terminate further death - delaying treatment should be honoured.

By refusing assistance to a patient who wishes to die, aren't you sending the message that her wishes are irrelevant?

No. Rejecting suicide as an option is a way of expressing value for life. A society that embraces physician - assisted suicide will inevitably lead many patients to believe that they have a "duty" to die. Already, there are voices in our society calling on the sick and elderly to die as a "reasonable" means of curbing health - care costs.

Don't your efforts interfere with the doctor/patient relationship?

This question misses the more important issue. The practice of physician - assisted suicide itself threatens to destroy the delicate trust relationship between doctor and patient. Patients demonstrate their faith in the medical profession every day by taking medications and agreeing to treatment on the advice of their physicians. Patients trust that the doctors' actions are in their best interests, with the goal of protecting life. Physician - assisted suicide endangers this trust relationship.

Physician - assisted suicide is a private matter that doesn't impact you. Why don't you mind your own business?

Physician - assisted suicide is not a private act. The debate is a matter of public concern because it involves one person facilitating the death of another. A major concern is that acceptance of assisted suicide will likely lead to involuntary euthanasia - the direct and intentional killing of a patient by a physician without the patient's knowledge or consent. A case in point is in the Netherlands, where doctors have practised physician - assisted suicide and euthanasia for more than a decade. In an attempt to determine the extent of abuses, the Dutch government commissioned a study in 1990. Researchers found nearly 6,000 cases in which patients died at the hands of physicians - without the patients' consent. (7)

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References

(1) Foley, K.M. The Treatment of Cancer Pain, The New England Journal of Medicine, vol 313, July 11, 1985, pp 84-95
(2) Byock, Ira R. Kervorkian: Right Problem Wrong Solution, The Washington Post, Jan 17, 1994, p A23
(3) Colburn, Don Assisted Suicide: Doctors, Ethicists Examine the Issues of Pain Control, Comfort Care and Ending Life, The Washington Post. 14 Sept 1993, pZ7
(4) Lee, Melinda A.; Nelson, Heidi, D.; Tilden, Virginia P. ;Ganzini, Lina ; Schmidt, Terri A. and Tolle, Susan W., Legalising Assisted Suicide - Views of Physicians in Oregon, The New England Journal of Medicine, vol 334 Feb 1, 1996, pp 310 - 315
(5) Brown, James Henderson; Henteleff, Paul; Barakat, Samia and Rowe, Cheryl June, Is It Normal for Terminally Ill Patients to Desire Death? American Journal of Psychiatry vol. 143, February 1986, pp 208 - 211(6) Lee, Melinda A. et al. Op cit.
(7) van der Maas, J.; van Delden, J.J.M. and Pigenborg, L. Euthanasia and Other Medical Decisions Concerning the End of Life: An Investigation Performed Upon Request of the Commission of Inquiry into the Medical Practice Concerning Euthanasia, Elsevier Science Publishers, Amsterdam, 1992, pp 73, 75, 181 - 182.

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ACKNOWLEDGMENT: This article was first published in Focus on the Family's "Citizen" magazine and is reproduced here with the kind permission of the publishers.

STOP PRESS: Rod Dent, son of Bob Dent, the first man to die under in Austrialia's Northern Territory euthanasia law, has announced that he has changed his mind and no longer supports euthanasia. According to a report in The Times on December 4th 1996: "Mr Dent said that he believed his father, who suffered from advanced prostate cancer, would not have committed suicide if he had had access to proper palliative care."

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