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Almost every family has had to watch the slow and agonizing death of a loved family member from cancer, neurological disease, or other chronic terminal illness. To those who have had to live through such an experience, the idea of doctor-assisted suicide appears to be, at first blush, a merciful alternative. But is it? What are the ethical questions surrounding this explosive issue? What has been the experience in countries where the procedure is permissible? And what has come from a permissive attitude on this question in the past?
Death with dignity became an end-of-life care option in 14 with the popular passage of the Oregon law. However, despite international coverage of the law itself, widespread reform in end-of-life healthcare practices and attention from public policy, medical, legal, and human rights groups across this country, misconceptions persist.
Death with dignity is not euthanasia. Euthanasia is not legal anywhere in the United States. Death with dignity expressly prohibits lethal injection and it is not an Americanized version of Dutch healthcare policy. Death with dignity is unique, to be sure, but it has become the catalyst for end-of-life care improvements its positive influence has been felt well beyond the borders of Oregon.
Throughout North America, committing suicide or attempting to commit suicide is no longer a criminal offense. However, helping another person commit suicide is a criminal act. One exception is the state of Oregon, which allows people who are terminally ill and in intractable pain to get a lethal prescription from their physician. This is called Physician Assisted Suicide or PAS.
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The American Medical Association recognizes the solemn commitment of physicians to life. An AMA policy statement on physician-assisted suicide spells this out quite clearly. It says Physician assisted suicide is fundamentally inconsistent with the physicians professional role. The policy statement goes on to explain, It is critical that the medical profession redouble its efforts to ensure that dying patients are provided optimal treatment for their pain and other discomfort. The use of more aggressive comfort care measures, including greater reliance on hospice care, can alleviate the physical and emotional suffering that dying patients experience." We can ignore such sound advice only at our peril. The risks that can arise from neglecting such principles have already been revealed to us elsewhere. Just witness the Netherlands. But even the stark, disturbing statistics that follow do not tell the full story of the moral venality that lies beneath them.
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