Source: Delaware Online
By: Michael DePietro
My extensive experience in dealing with dying patients leads me to oppose the legalization of assisted suicide. Legislation permitting assisted suicide is unnecessary to alleviate the distress of patients with terminal illness, and likely will precipitate harm to the sick and vulnerable.
It is important to make a distinction between physician-assisted suicide, where a doctor actively assists the patient in causing their own death, versus the commonly accepted practice of stopping or avoiding treatments that merely delay rather than reverse the dying process. The medical profession and society, including almost all religious traditions, recognize and endorse the patient’s broad legal right to decline medical treatments which are excessively burdensome and disproportionate to the potential benefits, even if doing so shortens the patient’s life.
The days of a dying patient left languishing in agonizing pain, as the dying process was dragged out futilely by a rigid medical system, no longer exist.
Physicians educated in end-of-life care know intentionally assisting a patient to end their life is not the only way to end suffering. Modern approaches to palliative care medicine, now a specialty in own right, have given physicians the tools to effectively treat not only intractable and severe pain, but also other kinds of suffering associated with terminal illness.
In reality, severe pain is not what is driving requests for assisted suicide. Most patients who request suicide do so seeking to relieve various kinds of emotional and societal problems, rather than physical symptoms associated with the dying process, a fact well described in the medical literature. Of course emotional and existential pain is no less deserving of relief than physical pain, but the concerns of the dying — such as loss of control, fears of placing burdens on family and friends, the perception of humiliation that can be associated with illness and loss of physical function — are well known to palliative care experts and most would agree that these things can also be effectively addressed using tools available to psychiatrists, palliative care professionals and, not least of all, the love and support of those close to the patient.
If we choose to alleviate emotional distress by helping patients die by suicide, we open the door to very disturbing practices. Once we start seeing some people as better off dead, it is a very short step to start to tell those in emotional distress that require care and love that it is really caring and loving to help them die.
I would also note that patients who kill themselves are no longer around to make expensive demands on the health care system, and one wonders when the right to die will become for such people a duty to die.
Patients with chronic illness — indeed, many who are seriously ill — are often concerned about the loss of dignity, becoming a burden and a loss of control over their life. Advocates of assisted suicide are saying quite explicitly in word and deed that patients with difficult illnesses are right to see themselves in such a dark light.
They apparently would agree that such patients are a burden, and that sickness results inevitably in loss of dignity. These concepts are deeply pernicious – and even more disturbing when agreed to by physicians, who have a particular ethical duty to uphold the value and worth of all human beings, regardless of their illness or disability.
People who require our help are not burdens and the sick do not lose their inherent human dignity on account of their sickness. That is really the message we must send, but it is not the message assisted suicide sends.
Assisted suicide legislation should be rejected — to do otherwise devalues the sick and deeply corrupts the medical profession. We can do better for those who suffer.
Dr. Michael DePietro is a Delaware physician who specializes in pulmonary and critical care medicine