Tragedy often comes like a thief in the night, sudden and unexpected. My good friend Rick's father faced deep calamity a couple of months ago. He was diagnosed with liver cancer. The prospects for survival were not good and his family came home to be with him.
Rick's dad was in a situation that thousands of Americans find themselves in every year battling a terminal illness. This painful subject evokes fears of pain, incapacitation, even financial ruin. It is out of a very real concern about terminal illness that the doctor-assisted suicide debate has surfaced in this country. In fact, the Florida Supreme Court is about to make a potentially sweeping decision on this issue.
Proponents of this practice argue that physician-assisted suicide offers patients a choice about their future, and a way to relieve pain quickly. Both of these are worthy goals. Unfortunately, doctor-assisted suicide does not offer much compassion or hope. Indeed, it is likely to lead to a variety of serious problems for our society.
We all support the freedom of choice, but unbridled freedom can lead to disaster. We have laws against suicide because we don't want love sick teens, pink-slipped middle managers, the disabled, the lonely, or the depressed, feeling that killing themselves is acceptable and life is not worth living. What makes doctor-assisted suicide a particularly thorny issue, however, is that it involves more than individual choice. This is called doctor-assisted suicide precisely because this is not an individual private act. Indeed, this is a public act, that involves at least two individuals. If doctor-assisted suicide becomes the norm, physicians will be granted a radical new authority -- the authority to participate in ending another person's life.
But this runs contrary to more than 4,000 years of medical tradition. The Hippocratic Oath says "I will give no deadly medicine to anyone if asked." It is precisely because doctors are healers and not killers that the American Medical Association and the Florida Medical Association oppose physician-assisted suicide.
But the push for allowing people to "choose" doctor-assisted suicide could lead to a circumstance where life and death in the case of terminal illness is actually determined by doctors -- without the consent of the patient. The experience of The Netherlands indicates this is not scare-mongering and speculation. No other country has as much experience with doctor-assisted suicide. The Dutch government allows it to go on freely. But according to a 1991 study by the Dutch government cited in the New England Journal of Medicine, it was discovered that at least 1,800 victims of doctor-assisted suicide had never made a request to be killed. Doctors had apparently taken it upon themselves to make the decision to kill.
Compassion is another powerful argument advanced in favor of doctor-assisted suicide. Death is an escape from suffering and physical pain, the argument goes. But this argument ignores advancement by medical science in recent years. According to Ira Byock, president of the American Academy of Hospice and Palliative Medicine, "Pain can always be alleviated." Our medical profession has an important responsibility to ensure that effective medication, advanced equipment and current techniques are available to meet the physical needs of those who are suffering from pain. "Beyond morphine and skilled medical care," says Byock, "it is possible to attend the dying in ways that honor and even celebrate their lives." Doctors who offer death by assisted-suicide as a medical option communicate hopelessness, not compassion.
Often the despair that drives people to seek the option of doctor-assisted suicide is depression and psychological distress. A network of hospice care facilities around the country has been working for decades to offer terminally-ill patients the care they need physically and psychologically to meet the challenges of coping with their illness. It is these individuals in the hospice movement that have demonstrated real compassion with decades of work. And it is important to note that the American Academy of Hospice and Palliative Care and other hospice organizations are strongly opposed to doctor-assisted suicide, precisely because they find that promoting death is not compassionate.
As my friend's father faced the news, he accepted his condition and lived his remaining days to the fullest. He passed away a month ago. In those last remaining weeks of his life, he saw his family brought together by the tragedy. Wounds were healed, and divisions in the family were erased. By grieving together, his family reconciled, rekindled the family spirit, and celebrated his life. Rick, I know, was happy for that.
