
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, April 16, 1995                   TAG: 9504180034
SECTION: EDITORIAL                    PAGE: D-3   EDITION: METRO 
SOURCE: GERALD R. McDERMOTT AND WILLIAM A. FINTEL, M.D.
DATELINE:                                 LENGTH: Long

THERE'S A BETTER WAY TO DIE WITH DIGNITY

NOT LONG ago, a physician treated a woman who had come to the emergency room because of constipation. He soon discovered that the woman's real problem was terminal cancer, and that she couldn't wait to die. The doctor asked who was helping her at home, what medicines she had for her pain, and when the home health-care nurse had visited her last. No one, nothing, and never were her answers.

So the doctor told her about hospice: the nurse who visits regularly, the volunteer who sits with her while her husband goes to the store, and the medicines that are provided for her agony.

"Well, I guess that changes my plans," the woman replied, and went on to explain how she had planned to kill herself the following weekend. She is now in a hospice program, relieved to have found a way to die with dignity.

This is a side of the debate over physician-assisted suicide that often goes unheard. It is drowned out by publicity surrounding Dr. Jack Kevorkian, who gives the impression that his way is the only way to die with dignity.

The phenomenal success of modern medicine has made Kevorkian seem credible. We have technology that is able to prolong the death process to unbearable extents, and our doctors have been trained to save lives at any cost. As a result, families are rarely told, "Take your loved one home to die. There is nothing more that can be done."

It's no wonder that many a proud man and woman have vowed, "When my time comes, I'm not going to die on a tube." Many others have resolved never to be a burden on their families, either financially or emotionally.

Ironically, the wonders of modern medicine have done more to frighten us than reassure us. We're more afraid of dying than ever before. We haven't seen dying done well, and we're afraid of being subjected to some maniac doctor who never gives up, never gives in, and never gives morphine.

In these situations, Dr. Kevorkian can seem persuasive - but only if we have not considered the hospice alternative and the genuine moral dilemmas posed by physician-assisted suicide. Hospice provides a wonderful setting for patients to depart from their loved ones in relative comfort and with spiritual meaning.

The American public needs to listen to the thousands of religious leaders, doctors, hospice workers and patients who have found that the dying process doesn't need Kevorkian-style suicide to be meaningful and dignified.

Neither does it have to drain a family of its financial resources. When the dying process has begun, a patient has the right to stop expensive treatment and go home to be served by hospice, which usually costs the family very little.

The Kevor-kian plan (legal, physician-assisted suicide) poses genuine moral problems as well. It threatens to undermine the bonds of social obligation that societies have deemed critical for millennia. As secular ethicist Henry Sidgwick puts it, legalizing suicide can encourage us to neglect our social duties. A friend of ours lost her cancer-stricken father to suicide because he was afraid that he wouldn't be able to pay his hospital bills. This was an irrational fear because he had adequate insurance. My friend mourns the loss of many months, perhaps even years, she could have had with her father.

Most Americans believe they have an obligation to love their neighbors. Suicide prematurely deprives the family and community of a person who can love, and denies others the opportunity to minister to that person's needs.

The use of a physician involves another moral problem. It doesn't give us new power to kill (there are plenty of ways we can kill ourselves without using a physician), but it appears to confer social legitimacy on a practice that we (rightly) fear is morally questionable. We feel better about getting a doctor to kill us, not because we are sure that it is right, but because it shifts responsibility (blame?) to a neutral party. It also means that the physician, who has been trained to protect life, shares responsibility for destroying life.

Finally, the Western religious traditions (Jewish, Christian and Islamic) have generally condemned suicide (except in special cases, such as martyrdom) as a sin against God as Creator and Provider. As Dietrich Bonhoeffer explained, God gave us life as a gift to use for service to God and others, and he has reserved to himself the right to determine the end of life because he alone knows the goal to which it is his will to lead it. Our culture tells us that we are autonomous agents free to dispose of our lives if we so choose, but the religious traditions tell us we are responsible to God and others.

This is not an argument to condemn all those who have taken their own lives. Suicide is usually committed at a point of soul-wrenching despair, and we should not presume to judge the moral status of particular cases. But this is a plea to consider the hospice alternative and the moral problems posed by the likes of Jack Kevorkian before we start down the road to legalizing physician-assisted suicide.

Gerald R. McDermott teaches religion at Roanoke College. William A. Fintel, M.D., is an oncologist in Salem.

by CNB