Saturday, January 31, 2015

Fear of imposed death by hospitals


In the Netherlands, where euthanasia is legal, reports circulate regularly about elderly people refusing to go to the hospital for fear that a physician will deem their life unworthy. The “right to die” quite easily becomes the “obligation to die” once physicians start becoming judge and executor.

James A. Avery, MD, The Daily Progress. 

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http://www.dailyprogress.com/starexponent/opinion/reader-s-views-physician-assisted-suicide-is-a-bad-idea/article_b7904700-a6fc-11e4-9979-f3c89d8d588b.html



READER'S VIEWS: Physician-assisted suicide is a bad idea

Posted: Thursday, January 29, 2015 12:00 am

READER'S VIEWS: Physician-assisted suicide is a bad idea James A. Avery, MD The Daily Progress

In the dark ages of medicine, physicians routinely ended the life of their patients. However, since the time of Hippocrates ­ 2500 years ago, physicians have promised their patients that they will not intentionally terminate a life.

When, as he wrote in the Decorum, “patients become overmastered by their disease,” physicians agreed to not hasten or prolong death. “Cure sometimes, treat often, comfort always” was the basic strategy. Of course, since that earlier time and, up to today, physicians have always been tempted to help desperate and despondent patients kill themselves. Time and time again, euthanasia and physician-assisted suicide causes were championed – only to be ultimately rejected by the medical profession and almost all cultures.

G. K. Chesterton once said, “Don't ever take a fence down until you know why it was put up.” Since the time of Hippocrates, medicine has made huge advances in our ability to control and manage pain. So, I ask, why has there been a recent effort to take down this fence?

Certainly, the recent highly publicized case of Brittany Maynard, a winsome and attractive 29 year-old newlywed, has renewed the old tiresome arguments. Diagnosed with a brain tumor, Brittany moved from California, where she was born and raised, to Oregon where right-to-die laws are legal. On November 1, 2014, physicians prescribed a massive dose of life-ending barbiturates so Brittany could kill herself before many of the symptoms she feared and imagined could develop. It’s a sad and tragic story but the conclusion that suicide was the compassionate solution was even sadder.

As a board-certified hospice physician, I have personally taken care of many young people with brain tumors. I have found that once the hospice team addresses their suffering in all dimensions – physical, emotional, social, and spiritual – and reassures them about the future, anxieties are reduced and a peaceful death is the norm.

There are many reasons why I oppose physician-assisted suicide but let me focus on one of them here: it will change the medical profession in a dramatic and negative way. I don’t believe it is commonly known by most people that physicians in almost all countries are forbidden from participating in capital punishment. And, when physicians are inducted into the military, they do not bear arms. There are fundamental reasons for this and these go to the heart and soul of medicine: physicians heal and comfort – they do not kill.

In the Netherlands, where euthanasia is legal, reports circulate regularly about elderly people refusing to go to the hospital for fear that a physician will deem their life unworthy. The “right to die” quite easily becomes the “obligation to die” once physicians start becoming judge and executor.

Patients want their physicians to care for them without pondering and considering whether “they are worth the effort”. Taking care of seriously ill and dying patients is hard work - just ask any physician who does hospice or palliative medicine. “Assisted suicide is the easy way out for doctors,” said Johns Hopkins physician, Paul McHugh, “physician-assisted suicide tears down the time-honored barrier protecting patients from physician mischief.” Patients want a caring physician who tries his best to cure, comfort always, reassure them when they are despondent, honor reasonable wishes, and labor for their good.

So … back to our original question: was poisoning Brittany the best response a physician can offer a sad, desperate, and frightened young girl? I, like almost all physicians for the last 2500 years, emphatically say “no.”

Thirty-seven years ago, I entered medical school with the goal of reducing human suffering; the years have taught me that the physician-assisted suicide is not the answer for compassionate end of life care. The answer, in my view, is skilled compassionate hospice care.

James A. Avery, MD is the CEO of Hospice of the Piedmont.

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