Physician-assisted suicide is not the answer for doctors or patients

Physician-assisted suicide is not the answer for doctors or patients
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We all mourn suicides and our hearts go out to the families of people like Kate Spade and Anthony Bourdain. We rightly put millions into suicide prevention programs. How is it that the assisted suicide lobby considers it different when illness and a doctor are involved? Suicide can never be medical care.

Thankfully, we are seeing less and less disagreement about the public policy that morphs suicide into a supposed medical “treatment,” undermining the integrity of the medical profession — the very trust upon which the patient-physician relationship is based — and that puts everyone living in jurisdictions with legal assisted suicide at risk of deadly harm through mistakes, abuse, and coercion.  

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The American Medical Association’s (AMA) internationally respected Council on Ethical and Judicial Affairs (CEJA), after two years of thorough study of assisted suicide, both here in the small handful of U.S. states and in the few countries abroad that have legalized it, produced a report recommending that the AMA maintain its long-standing opposition position to physician assisted suicide. This recommendation will likely be ratified by the AMA’s House of Delegates at their annual meeting, solidifying their position for years to come that “Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.”

 

It will come as no great surprise if the AMA, the largest medical society in the nation, follows suit with the second largest, the American College of Physicians (ACP), who also doubled down on their opposition last year. And, as we’ve seen in Washington, D.C., only 2 of approximately 11,000 physicians signed up to participate in the suicides of their patients. In fact, not a single resident has opted to kill themselves with the law. Given past examples of unethical behavior by medical professions, it is possible that residents trust their doctors even less now that suicide is touted as medical “treatment” in the District.

As the ACP’s statement says:

“The power to prescribe assisted suicide carries a profound potential for misuse and abuse. The creation of a formal role for physicians to assist patients with suicide in an era of health care cost containment is especially troublesome. A broad right to physician-assisted suicide in a country with no general right to health care would be, at best, ironic.”

Countries that have legalized assisted suicide started where American proponents suggest we start and have ended up with expansion to assisted suicide and euthanasia for nearly any reason and eroding the little protections there were for vulnerable people. Here in the U.S., even with the great poverty of data and oversight of assisted suicide in legal states, there has been too many cases of people being subject to deadly harm through mistakes, abuse, and coercion.  

As the medical community continues to point out its dangers, Congress should summarily reject assisted suicide public policy by passing H.Con.Res.80 — a truly bipartisan bill “expressing the sense of the Congress that assisted suicide puts everyone, including those most vulnerable, at risk of deadly harm and undermines the integrity of the health care system.”  

But this is only part of the appropriate response. The medical profession, as the ACP said, should remedy their failure to provide good care and comfort at the end of life. After all, according to Oregon’s public health department, the top five reasons people list for asking a doctor’s assistance in suicide have nothing to do with physical pain, but rather are all matters of existential suffering and disability.

Meanwhile, advances in medical science have all but dispelled physical suffering at the end of life through multi-disciplinary palliative care —and in the rare extreme cases, sedation of the imminently dying. But access to the gold standard of palliative care is regretfully abysmal, a problem that has been shown to drive people to assisted suicide. When a great many patients have no other choice but suicide, the illusion of augmenting patient autonomy with this dangerous public policy becomes crystal clear.  

Congress, state legislatures, and medical licensure boards should act to promote access to, availability of, and training in high-level multidisciplinary palliative care and to support both the home and facility based personal care needs of people with chronic life-threatening illness and advanced disability, which under assisted suicide law, qualifies a person as “terminal”. Take your cue from the AMA and the medical community – the next life you save or the next good end-of-life experience you afford may be your own.

Matt Vallière is the executive director of the Patients’ Rights Action Fund.