Today’s Boston Globe has two letters by doctors who are opposed to legalization of assisted suicide – and are responding to a glowing endorsement of assisted suicide by Marcia Angell, MD, in an op-ed published in the paper on September 29. The letters to the Globe are at this link, but can’t be accessed directly without a paid subscription for online access. Fortunately, someone emailed them to us and they’re reproduced below:
As a physician who has been taking care of dying patients in Massachusetts for years, I found Dr. Marcia Angell’s Sept. 29 op-ed “A method for dying with dignity” chilling. Physicians who oppose Question 2 are not concerned about their “self-image,” but rather for the welfare of their patients.
In my experience suicide is a tragedy whether it occurs years, months, or days before natural death. I have been asked for a lethal medication a number of times. Behind the request lies terrible fear. By drawing these fears out and addressing them, we help patients pass through the crisis that leads them to turn to suicide.
Suicide is not a purely autonomous act; it has deep, long-lasting effects on loved ones and society. Even when an individual loses the sense of the value of one’s life, those around the individual do not.
The referendum has no provision for notification of family members, and no requirement that anyone be present when the lethal dose is taken. The patient is left alone with the poison, all in the name of autonomy. To embrace suicide as a medical treatment is to cut at the heart of what unites us as a Commonwealth.
Dr. Jane A. Driver
Boston
The writer is in the division of aging at Brigham and Women’s Hospital and is assistant professor of medicine at Harvard Medical School.
Dr. Marcia Angell (“A method for dying with dignity,” Op-ed, Sept. 29) wrote that the Massachusetts Medical Society opposed physician-assisted suicide because it is inconsistent with physicians’ “self-image” as healers. However, the rejection of the so-called Death with Dignity Act by the majority of physicians is based on much broader medical considerations.
Twenty to 40 percent of medical diagnoses prove wrong when confronted with the ultimate criterion of truth, the autopsy. This means that the license to cause deaths on the grounds of medical diagnoses can lead to tragic mistakes.
The act would allow prescriptions for lethal drugs to be given to patients with a life expectancy of no more than six months. This too is a potential source of serious blunders because physicians’ ability to predict how soon a patient would die is notoriously unreliable.
In addition, the Dutch experience has shown that the acceptance of death as a medical solution is suppressing the performance of doctors and nurses in critical situations when life is threatened but can still be saved.
Dr. Richard Fenigsen
Waltham
On September 30th, another physician weighed in on assisted suicide at PsychCentral. In an essay titled ‘Merciful Assistance or Physician-Assisted Killing?,’ Ronald Pies, MD had a skeptical take on assisted suicide as well:
Imagine that your father, age 85, has been diagnosed with a terminal illness and given only three months to live.
Fortunately, he is still well enough to walk, and finds himself one night near a tall bridge. Having contemplated the suffering he believes will attend his final days, he decides to end his life by jumping off the bridge. However, he is too weak to hoist himself up atop the protective railing.
Suddenly, he sees his very own physician, Dr. Jones, walking by. He begs Dr. Jones to help him climb atop the railing, adding, “Don’t worry, Doc, it will be my decision to jump.” The doctor is taken aback, but quickly determines that his patient is not psychotic or severely depressed, and is capable of making a rational decision regarding suicide. The doctor tries to persuade your dad that pain and suffering can usually be well-controlled during the final days, but the patient is insistent: he wants to end his life.
Would you agree that Dr. Jones is fulfilling his obligations as a physician by assisting your father in jumping off the bridge?
If not, would you support the doctor’s providing your father with a lethal dose of medication?
That’s just the beginning of the essay – please read the rest of it here.
There is an ongoing story in NYC right now: Grace Sung Eun Lee, 28, has been in the news for a few days, radio soundbites on news stations and NPR “All Things Considered” show on Oct. 4 had bioethicist Art Caplan addressing her “case”.
But “All Things Considered” did not invite NDY’s Diane Coleman or Stephen Drake to contribute their accumulated knowledge of their own and many of us on the topic of alleged “Right to Die” as it was labelled. Ms. Lee has had brain and also lung cancer since last year and asked to be removed from her feeding tube.
There was never any question, from the point of view of the host on NPR that her parents, who sought a court order to not remove the feeding tube, were being unreasonable. After all, the host said, the doctors think it’s wise and the patient requested it. A cursory view of the listings about the story via google search, indicate she is in North Shore hospital palliative care center. It implies a conflict of cancepts to me “palliative care” vs removing feeding tube. The court said “hold” on removing feeding tube. Where it is moment by moment is not clear to me.
The big question remains: why are the following questions NOT asked in either the short nor the long segments about Ms. Lee:
1. Who helped Ms. Lee decide on removing the feeding tube? (I can’t remember the “official” name of the hospital staff person who talks about turning off equipment/removing tube,etc., as seen in earlier NDY blog entries by survivors of the process of being asked if they’d like the feeding tube, etc. removed/turned off.)
2. What does it feel like to starve to death after the feeding tube is removed? There is, on NDY, a link to the Daily Mail (UK) article, in a story, some months ago, about a young woman who did a blog about how it felt, living at home, starving herself to death in order to die (with step-mother assisting as cheer leader), Christina – and how painful it was and how long it was taking.
Did anyone tell Ms. Lee what it’s like when you are awake and conscious and starving to death (and the matter of liquid was never mentioned)?
I googled Grace Sung Eun Lee’s name for an update to the story. There’s a good story in the L.A. Times, Oct.7, 2012 that she “won” in court, the OK to turn off ventilator, then she changed her mind, signed her father as “medical guardian” and said she wanted to leave the nursing home “right away”. The guardianship was to be decided in court. Ms. Lee, 28, was a financial analyst before her illness.