A recent (I don’t think it’s quite the latest) issue of the New England Journal of Medicine (NEJM) features a “case vignette” of a terminally ill man who requests an assisted suicide prescription from his doctor. Here’s part of that vignette:
John Wallace is a 72-year-old man with metastatic pancreatic cancer. At time of diagnosis, the cancer was metastatic to his regional lymph nodes and liver. He was treated with palliative chemotherapy, but the disease continued to progress. Recently he has become jaundiced, and he has very little appetite. He has been seeing a palliative care physician and a social worker on an ongoing basis. His abdominal pain is now well controlled with high-dose narcotics, but the narcotics have caused constipation. In addition to seeing the social worker, he has also been seeing a psychologist to help him to cope with his illness.
The response against assisted suicide is written by J. Donald Boudreau, M.D., Margaret A. Somerville, A.u.A. (pharm.), D.C.L. Here’s an excerpt – read right after vignette:
Permitting physician-assisted suicide creates a slippery slope that unavoidably leads to expanded access to assisted suicide interventions — and abuses. Advocates of euthanasia deny that slippery slopes exist, arguing that legal constraints and administrative safeguards are effective in preventing them. But the evidence is clearly to the contrary, as the High Court of Ireland recently affirmed. In upholding the constitutionality of the prohibition on assisted suicide, the justices wrote, “. . . the fact that the number of LAWER (`life-ending acts without explicit request’) cases remains strikingly high in jurisdictions which have liberalised their law on assisted suicide . . . speaks for itself as to the risks involved.”2 Vulnerable communities in our societies — persons who are old and frail and those who are disabled or terminally ill — perceive themselves to be threatened.3 Physicians must not be willfully blind to these serious dangers.
The response in favor of assisted suicide is written by Nikola Biller-Andorno, M.D., Ph.D. – her response can be found in the “option 2” page, which is identical to the page with the response against assisted suicide – same vignette, and the comments after the response are also the same ones.
Now for the really important part: This whole section of this NEJM issue is free and open to the public. You can leave a comment and vote in their poll. At the time I typed this, there were 157 comments. And the poll was running 72% against assisted suicide vs. 27% in favor.
This is an excellent forum in which to get your voice heard and to cast your vote. Click on this link to get started.
So, it boils down to a man in my age group is alleged to want to be aided to suicide because he’s constipated? And a doctor is arguing in favor of it? (Comment written/posted for moderation, while I ponder how much I want to wrestle/navigate the posting of comment on linked sites; few make it easy for my cognitive disability of severe CFS/ME.)
#2:I jumped the hurdles. Feh. Stephen, I wish you’d have warned it was moderated. I also post using my whole name and I’m not sure that was possible, however, what are the odds that my comment will be posted? I basically said what I said in my first comment here, also adding that I am severely disabled by CFS/ME and suggesting that the arguments regularly posted on this NDY website are what I support and that I am against
“assisted suicide”.
I’m sorry, Sanda. I didn’t realize the comments were moderated.
I do related to “exhausted”.
One more thought has been percolating for a couple of days, and I wrote down notes:
Myths since the 1940s and 1950s, when I started
going to the movies and watching them on tv (b.1940)
in films, have transformed the “image” and perception
of doctors, the military and others. (It was shock to me in recent years to learn that “circling the wagons to fight the Indians by pioneers going cross
country NEVER HAPPENED outside of movies – see wikipedia; the wagons were often circled at night so the cattle would not wander away during the night.)
Doctors go to the movies and believe the myths
about the job. (Doctors did not think of themselves
nor did the public prior to Hollywood mythmaking
as anything other than someone who would do what he/she, there were a few, to diagnose if possible
and let you know when they couldn’t do any more to help. They did not become “miracle workers” -oops,
that’s the Helen Keller teacher/student myth, until
movies. Same with the War Dept. which became the Dept. of Defense and has helped with movie making for several decades…)
Doctors are human. Proof: is the number 81,000 or more of deaths due to medical error in hospitals per year? Are there numerous studies showing doctors
spread disease in hospitals because they don’t wash their hands between patients (touching)?
Have doctors killed people quietly without
fanfare or notice for decades, “willfully”? Babies
murdered at birth because they were disabled and
judged by doctors as “better off” dispatched to the
great beyond? Adults who lives were ended by medical decision, quietly, while in hospital care.
So now, doctors want permission and praise
for doing it.
Radio interview, Terry Gross’ show, “Fresh
Air” (guest interviewer) a couple of days ago
about a “good nurse”. A journalist did a book about a nurse who killed people.
The surprise for me was that the hospital center
obstructed the police investigation and that no
person from the hospital was ever held responsible
for the obstruction and delay. The only person who
was prosecuted, and happily, jailed, was the man
who did the murders. He was called a “mercy killer”
but he never gave a thought to the people he was killing, sometimes doing it in cruel drug repeated
near death, then killing.
How often are hospitals and/or doctors held responsible for the deaths they cause?
PS (CFS is the “PS disease” – cognitively my process includes “after
thoughts”). Constipation is given as the immediate reason for the man’s wish for death. But constipation is treatable. Death is final. And that brings up the topic: when is it the “right time” to kill someone?
Finally (because I’m weary -), did you note the physician who used ableist language “physicians must not be blind to”….?
I didn’t notice the ableist language, Sanda, but I was pretty exhausted yesterday.
PS (CFS is the “PS disease” – cognitively my process includes “after
thoughts”). Constipation is given as the immediate reason for the man’s wish for death. But constipation is treatable. Death is final. And that brings up the topic: when is it the “right time” to kill someone?
Finally (because I’m weary -), did you note the physician who used ableist language “physicians must not be willfully blind to”….?
Ugh, so depressing. I was reading through some of the doctors comments and I am just sickened. I wish they could they could understand that when you tell one person with say MS that their life is worse than death it is sending a message to everyone with that condition. I hear doctors complain all the time that there patients do not trust them which blows my mind, they really can’t understand why?