Wednesday, June 02, 2004
A patient must make two oral requests for the drugs and one written request after a 15-day waiting period. Two doctors must determine that the patient has less than six months to live, a doctor must decide that the patient is capable of making independent decisions about health care and the doctor has to describe to the patient alternatives like hospice care.
The law also requires that the drugs be self-administered by the patient, rather than given by a doctor or family member, to avoid involuntary euthanasia. The death certificate, under the law, must state the cause of death as the underlying disease, not suicide.
That seems to be a prudently written law - on the surface. But the problem with assisted suicide is that it assumes the doctor-patient relationship exists in an emotional vacuum. That doctor's never get weary of hearing a patient complain about intractable health problems, and that patients are never influenced by their doctor's attitude (or the attitudes of family members.) Consider one doctor in England who found it all too tempting to first relieve his patient's suffering, and then to relieve his own.
Death is scary, no doubt about it. It's the ultimate loss of control. And that, in the end, is what really motivates those who seek physician-assisted suicide. It isn't so much to avoid physical pain, as to insure that they will ultimately be in control of those final days:
Barbara Coombs Lee, the president of Compassion in Dying Federation, said she saw the suicides not as "an impulse to self destruction," but as "an impulse to self preservation - preservation of the self I cherish."
That point of view clearly grates on Dr. Stevens. Although he said he did not want to "put people down or label people," he added, "the 'P' word is not 'pain.' The 'P' word is 'pride.' " He explained, "Rather than being death with dignity, it's death with vanity."
Which also calls to mind the British doctor:
The only valid possible explanation for it is that he simply enjoyed viewing the process of dying and enjoyed the feeling of control over life and death, literally over life and death.
One can argue that it makes the world of difference whether it's the patient who enjoys the control over life and death or the physician. But the problem is, that's a distinction that's too easily blurred in the symbiosis that is the doctor-patient relationship.
Oregonians must sense this on some level. The suicide option is rarely chosen. Which disturbs Dr. Marcia Angell, representative of the medical establishement to the national press:
But Dr. Marcia Angell, a former executive editor of The New England Journal of Medicine and a supporter of doctor-assisted suicide, said: "He can call it vanity. Somebody else might call it admirable independence."
If anything, Dr. Angell said, the Oregon law may be too restrictive and may not reach everyone who could benefit from it.
"I am concerned that so few people are requesting it," she said. "It seems to me that more would do it. The purpose of a law is to be used, not to sit there on the books."
The nerve of dying Oregonians. Why are they malingering and eating up valuable Medicare tax dollars when they could so easily put us all out of their misery?
Not coincidentally, Dr. Angell also advocates a single-payer healthcare system. Her attitude, unfortunately, is not uncommon among those who think the state knows best how to run things. And it isn't hard to imagine where that sort of attitude could eventually lead us in end-of-life care, especially in a wholly state-run system: from physician-assisted suicide to state-mandated euthanasia.
posted by Sydney on 6/02/2004 07:54:00 AM 0 comments