Tuesday, May 06, 2008
Primer on Physician Assisted Suicide (PAS.)
Not a bad little review from the University of Washington. Clearly a secular reviewer, clearly trying to be balanced. Will give you a brief listing of ethical points.
I think the weakness of the article is its relative lack of attention to why so many people support PAS. I remember when we euthanized our dog in the living room. A family friend was a vet tech (sort of like a vet nurse) and brought over the cocktail and equipment, and he just peacefully slipped away. (DenverDoc was crying like a baby, I freely admit.) The vet tech then said, "Why can't we humans have this option?" I totally understood her emotional reaction, and yet disagree completely with her conclusion.
The major reason for PAS is, in my opinion purely emotional. Very few proponents would be able to give you a coherent ethical analysis. (and very few opponents too, unfortunately.) People fear loss of control, they fear pain, they fear the coldness of the healthcare system, they fear loss of dignity. It's fear, pure and simple.
We had a conversation about PAS in the pathology meeting room a few years back over lunch. The secretaries asked me what I thought. As I recall, I said
"The emotional desire for a less painful passing is totally understandable in each individual case. But what would it mean for all the rest of us? I fear giving doctors, who are people, absolute power over life and death. I fear what managed care companies might do with that power. I fear what greedy relatives seeing money going into treatment instead of estates might do with that power. I fear what governments, who have become managed care providers, might do with that power. I fear that the right to die would very rapidly become the duty to die.
I also know that many of those who seek assisted suicide have untreated depression, and when treated most withdraw the request. I also know that the last few months of a person's life can be incredibly meaningful in regards to confessions, re-establishing relationships, passing on wishes or stories Pulling the trigger too fast on PAS denies the patient and their loved ones that opportunity. I also recognize that our medical culture has to learn to care for patients better in terminal conditions."
I think the weakness of the article is its relative lack of attention to why so many people support PAS. I remember when we euthanized our dog in the living room. A family friend was a vet tech (sort of like a vet nurse) and brought over the cocktail and equipment, and he just peacefully slipped away. (DenverDoc was crying like a baby, I freely admit.) The vet tech then said, "Why can't we humans have this option?" I totally understood her emotional reaction, and yet disagree completely with her conclusion.
The major reason for PAS is, in my opinion purely emotional. Very few proponents would be able to give you a coherent ethical analysis. (and very few opponents too, unfortunately.) People fear loss of control, they fear pain, they fear the coldness of the healthcare system, they fear loss of dignity. It's fear, pure and simple.
We had a conversation about PAS in the pathology meeting room a few years back over lunch. The secretaries asked me what I thought. As I recall, I said
"The emotional desire for a less painful passing is totally understandable in each individual case. But what would it mean for all the rest of us? I fear giving doctors, who are people, absolute power over life and death. I fear what managed care companies might do with that power. I fear what greedy relatives seeing money going into treatment instead of estates might do with that power. I fear what governments, who have become managed care providers, might do with that power. I fear that the right to die would very rapidly become the duty to die.
I also know that many of those who seek assisted suicide have untreated depression, and when treated most withdraw the request. I also know that the last few months of a person's life can be incredibly meaningful in regards to confessions, re-establishing relationships, passing on wishes or stories Pulling the trigger too fast on PAS denies the patient and their loved ones that opportunity. I also recognize that our medical culture has to learn to care for patients better in terminal conditions."
