Saturday, February 20, 2010

Why Legalizing Doctor Assisted Suicide Is Not A Good Idea

Yesterday we reviewed the arguments in favor of physician assisted suicide. They appeared to present an ironclad position that left little room for debate. But then, the other side rises to present its case, and things are much less clear. Here, from my 1994 article in Truth Seeker, are some of the most widely cited concerns and arguments against legalizing assisted suicide or expanding its practice.

l. Medical doctors are not trained psychiatrists. Many, if not most, people have wished they could die rather than face some difficult circumstance in their lives. Doctors who are given authority to grant this wish may not always recognize that the real problem is a treatable depression, rather than the need to fulfill a patient's death wish. Perhaps Bob Liston's posting in the General Debate Forum of America Online (1992) said it best when he wrote, "I know many individuals with significant disabilities: quadriplegia, post-polio survivors, persons with MS, etc. A number of them have tried committing suicide in the past and are now thankful that a mechanism wasn't in place that would have assured their death, because they got over whatever was bothering them at the time and are happy with life again."

2. How will physician-assisted suicide be regulated? This is Carlos Gomez's forced argument, developed after investigating the Netherlands' experience, and presented in his book
Regulating Death. "How will we assure ourselves that the weak, the demented, the vulnerable, the stigmatized -- those incapable of consent or dissent -- will not become the unwilling objects of such a practice? No injustice," Gomez contends, "would be greater than being put to death, innocent of crime and unable to articulate one's interests. It is the possibility -- or in my estimation, the likelihood -- of such injustice occurring that most hardens my resistance for giving public sanction to euthanasia."

3. The "Slippery Slope" Argument. A Hemlock Society spokesperson acknowledges this to be the strongest argument against legalization. In ethical dialogue, it is conceded that there are situations when an acceptable action should not be taken because it will lead to a course of consequent actions that are not acceptable. Our attitudes toward the elderly, people with disabilities and the devaluation of individuals for the "higher good of society" should be reflected upon. How long will it be before our "right to die" becomes our "duty to die"?

4. The "Occasional Miracle" Argument. Sometimes remarkable recoveries occur. Sometimes diagnoses are far afield of the reality. Countless stories could be told. I know a few first hand. How about you?

5. Utilitarian versus sacred view of life. This is probably a subset of the Slippery Slope argument, focusing on our cultural shift in attitude toward what it means to be human. Huxley's
Brave New World vividly demonstrates an aspect of this argument. We need to be reminded of the role social engineers, doctors and geneticists played in 1930's Germany. Are we important only as long as we are making a contribution to society? Or is value something inherent in our being human? History has shown that when we devalue human beings, we open the door to abuse. The U.S. Supreme Court, in its Dred Scott decision, declared that blacks were not persons. This devaluation helped permit slavery and inhumane treatment of blacks to continue.

6. What effect will this have on doctor/patient trust? People who traditionally rely on their doctors to provide guidance in their health care decisions may become confused, even alarmed, when one of the treatment options presented is the death machine at the end of the hall. According to Leon R. Kass, distinguished M.D. from the University of Chicago, the taboo against doctors killing patients, even on request, "is the very embodiment of reason and wisdom. Without it, medicine will have lost its claim to be an ethical and trustworthy profession." Kass asserts that "patient's trust in the whole-hearted devotion to the patient's best interests will be hard to sustain once doctors are licensed to kill."

7. What about doctors who don't believe in killing? Will they be required by law to prescribe a treatment [death] they don't believe in?


Conclusions

Clearly, the ethical dilemmas surrounding terminal health care will be with us for years to come. There are more than seventy million baby boomers in this country, most of whom are currently grappling with the issue of aging parents, or aging themselves. In decades to come we won't be getting any younger.

Ironically, our current situation is due in large part to the successes of medical science, not its failures. More people live longer today than ever in history because we have eliminated many of the diseases that once terrorized us as a society.

But some of the problem is due in part to our love affair with technology. When machines, tubes and computers take over, compassion and common sense sometimes seem to suffer. Fortunately, there seems to be an increased awareness of the intrusiveness of technology. Living wills, ethics committees and hospice care are all responses to this awareness.

The article in this month's The Atlantic made me aware that this is not an issue we can ignore. The arguments in favor of legalization are compelling, but there are good reasons not to go there. What do you think?

2 comments:

Anonymous said...

I am thankful for your balanced blog that (previously) recognizes the death wish many have, but (in this entry) also sees some of the problems. As a psychologist, I see both sides, clearly concluding that depression is treatable, that the sense of life being over is changeable, and that there is always hope. As a Christian, eternal issues also enter the picture as faith brings hope and meaning to ones life in powerful ways. The calling to Christ's Lordship in every person's life, and spiritual warfare fighting against life itself, is ongoing. Dr. Ron

ENNYMAN said...

Thanks for the note. The first step is dealing with that suffocating sense of helpless hoplelessness.
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