ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Tuesday, September 17, 1996 TAG: 9609170068
SECTION: EDITORIAL PAGE: A-5 EDITION: METRO
SOURCE: FRANK H. BOEHM, M.D.
BECAUSE two United States Court of Appeals decisions have recently ruled laws forbidding physician-assisted suicide unconstitutional, the United States Supreme Court is expected to become the final arbiter of this important social, medical, ethical and religious issue.
Make no mistake about it - the outcome of deliberations by the high court on physician-assisted suicide will be as important as any we have witnessed in this country since the 1973 Roe vs. Wade decision. In this case, however, while abortion is predominantly a social issue, physician-assisted suicide is a medical one.
Although a recent Gallup poll revealed that 75 percent of Americans believe doctors should be allowed to end the lives of terminally ill patients at the patients' requests, I fear most Americans do not understand what could actually happen if physician-assisted suicide becomes the law of the land. The American Medical Association recently voted overwhelmingly to oppose physician-assisted suicide, and I wholeheartedly agree with this position.
Thousands of years of medical and moral tradition, claiming that suicide is immoral and wrong, and culminating with laws forbidding physician-assisted suicide, are in danger of being overturned because of a few compelling cases.
Legalizing physician-assisted suicide will change the way our society thinks about suicide. We will think of it as good rather than bad, moral rather than immoral, humane rather than inhumane, dignified rather than tragic, and legal rather than illegal. Legalizing physician-assisted suicide will also change how physicians view life, and will, because of cost-cutting demands of managed care, place doctors in a conflict-of-interest situation. Why bother with expensive, painful and often limited successful medical treatment when a legal, easy, less expensive option of suicide is available?
Supporters of physician-assisted suicide cite the Netherlands as an example of where legalizing physician-assisted suicide is working. It is not!
Herbert Hendin, Executive Director of the American Suicide Foundation, was quoted in The New York Times Magazine recently: ``The Netherlands has moved from assisted suicide to euthanasia, from euthanasia for people who are terminally ill to euthanasia for those who are chronically ill, from euthanasia for psychological distress and from voluntary euthanasia to involuntary euthanasia.''
The Netherlands' experience shows that thousands of physician-assisted suicides are undertaken because of family requests, not the patients'. Physician-assisted suicide cannot be adequately controlled and therefore should not become legal.
We must encourage doctors to assist patients in making the end of their lives easier and less painful. We have the tools, we just need the will. Studies show many physicians already help patients die peacefully and with dignity, yet we must teach all physicians it is permissible, even mandatory, to properly treat pain and discomfort. Once pain relief has been achieved, most patients requesting physician-assisted suicide relent.
Linda Emmanuel, the American Medical Association's vice president for ethical standards and director of its Institute for Ethics, was recently quoted: ``This is a defining moment in medicine. If doctors are allowed to kill patients, the doctor-patient relationship will never be the same again. If killing patients is an option, how can I expect you to trust me to do all I can to help you?''
Most important, how will killing patients affect the physician's view of his or her role in the care of patients? One of the United States Court of Appeals decisions assumed that because physicians ``have a strong bias in favor of preserving life, they will function as impartial professional third parties in making a decision.'' But after killing a few dozen patients, will these physicians continue having a strong bias in favor of preserving life?
Physician-assisted suicide is a complex, emotional medical problem. Those of us in the medical profession should be able to deal with the sick and dying with compassion and concern without stepping over the line by intentionally killing our patients. The Supreme Court has an opportunity to allow us to do this without giving us the immoral, improper and unethical tool of suicide.
Frank H. Boehm, M.D., is professor of obstetrics/gynecology and director of obstetrics at Vanderbilt Medical Center in Nashville, Tenn. He wrote this for The News of Boca Raton, Fla.
- Knight-Ridder/Tribune
LENGTH: Medium: 81 lines ILLUSTRATION: GRAPHIC: Richard Mulholland/LATimesby CNB