Speech on physician assisted suicide remaining illegal
The issue of optimal medical care and the most appropriate ways of dealing with pain and suffering, while maintaining human dignity as debilitating diseases bring us toward the ends of our lives, is extremely important, and one that warrants much more public discussion than it has received. It is an issue that strikes at the core of what it means to be a physician, and what it means to treat and heal people. I will argue that there has never been a time in human history in which the means to take one's life were unavailable - they have always been at hand - and yet only in the last several years has there been a public call for legalization of physician-assisted death (PAD). It is ironic, in fact, that this call comes at a time when we have better means than ever for treating pain. For this reason and others, I will argue that the call for PAD is not being made now primarily out of fear of a prolonged, painful dying process or of a loss of dignity and control in the face of advancing technology. Although each of those plays a part, the call for PAD arises from a shift in society's view of what determines the value of life and a growing mistrust of the commitment of physicians and family members to provide attentive care when one reaches a state of debilitation and decline. I will attempt to communicate a vision for life in which value is based on objective truth, transcends the boundaries of birth and death, and is therefore independent of ability; and a vision for caring and compassion that will virtually obviate the need to consider assisted death. I will also argue that because the call for PAD arises from the concept of a life not worth living (not just from pain), the legalization of PAD will lead subtly but definitely to the concept of a life not worthy to be lived. This concept will seriously jeopardize the rights of many persons in society whom some consider unsavory.
The term physician-assisted death is not specific. I will take it to refer to two things: physician-assisted suicide, in which a physician provides the means, or access to the means, by which a patient can end his life, and voluntary active euthanasia (a term used by the American Geriatrics Society), in which the physician or some other agent, but not the patient, administers the means of death. As I use the term physician-assisted death, I will be referring to both of its forms. The position I will argue tonight is that both forms of PAD are killing, and should remain illegal.
Let me be equally clear about what I do not oppose. I will argue that terminally ill persons should be allowed to die, and that treatments that a terminally ill patient deems useless or excessively burdensome should be withdrawn or withheld in order to avoid unnecessary prolongation of the dying process. When extending life has become impossible, the appropriate course of action is not blindly to attempt to postpone death by using every last technological tool available to us, to squeeze in every possible moment of biological life. For example, I would not argue that the state should have required that William Bartling, a patient with severe end-stage lung disease, must continue being treated with a mechanical ventilator when he had requested that it be
discontinued. Although I am not entirely comfortable with all aspects of the decisions made in the well known cases of Karen Ann Quinlan and Nancy Beth Cruzan, the patients in persistent vegetative states whose families petitioned to have their mechanical ventilator and enteral tube feeding discontinued, respectively, I would argue that after providing sufficient safeguards, the state should not prevent these treatments from being discontinued when the wishes of the patient or of a...
References: 1. van der Maas, P.J., van Delden, J.J.M., Pijnenborg, L., Looman, C.WN., Euthanasia and other medical decisions concerning the end of life, Lancet, Vol. 338, 1991, pp. 669-674.
2. Teno, J., Lynn, J., Voluntary active euthanasia: The individual case and public policy, Jour. Amer. Geriatr Soc, Vol. 39, 1991, pp. 827-130.
3. McCormick, R.A,. Physician-assisted suicide: Flight from compassion, The Christian Century, Dec. 4, 1991, pp. 1132- 1134.
4. Pellegrino, E.D., Doctors must not kill, 1. Clin. Ethics, Vol. 3, 1992, pp. 95-102.
5. Pellegrmno, E.D., Compassion needs reason too, JAMA, Vol. 270, 1993, pp. 874-875.
6. Lusthaus, E.W., Involuntary euthanasia and current attempts to define persons with mental retardation as less than human, Mental Retardation, Vol. 23, 1985, pp.
7. Percy, W., An unpublished letter to the Times. In: Samway, P., ed., Signposts in a strange land, Farrar, Strauss, & Giroux, 1991.
8. Gomez, C.F., Regulating death: Euthanasia and the case of the Netherlands. New York: Free Press, 1991.
9. McCrystal, C., Ann Humphry 's final exit, Vanity Fair, Vol. 55, 1992, pp. 80ff.
10. Anglican Study Group, On dying well, 1975, Quoted in McCormick, R.A., Physician-assisted suicide: Flight from compassion, The Christian Century, Dec. 4, 1991, pp. 1132- 1134.
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