Life Matters: Doctor-Assisted Death by Suicide

This is part one of four articles which we will highlight each week of October to help us reflect on the many life issues faced by our community. It is summarized, edited, and reprinted, here in the weekly Forum. The four articles are "Life Matters:" 1.) Doctor-Assisted Death by Suicide   2.) Responding to Unplanned Pregnancy   3.) Pornography and Our Call to Love;  4.) Call to Greatness.   For the full text of this article & other resources please see the web site of the United States Conference of Catholic Bishops:  www.usccb.org/about/pro-life-activities/respect-life-program/

Life Matters: Doctor-Assisted Death by Suicide

(For the St. Francis Forum, October 14, 2012)

In the original Hippocratic Oath, physicians swore to give no deadly drug, even if asked. Now, however, some doctors may participate in, and even promote, giving deadly drugs with the direct intent to end human life. There has been a profound shift in attitude in my state of Oregon since voters narrowly embraced assisted suicide—a shift that I believe has been detrimental to patients, degraded the quality of medical care, and compromised the integrity of my profession.

Since assisted suicide became an option, at least a dozen patients have discussed it with me. Most weren't even terminally ill. One told me that if his multiple sclerosis got too much worse, he might want to "just end it." I told him that I could readily understand his fear and his frustration and even his belief that assisted suicide might be a good option for him. But, I added, should he become sicker or weaker, I would work to give him the best care and support available, not assisted suicide.

How physicians respond to the patient's request for lethal drugs can have a profound effect on a patient's choices as well as on his view of himself and his inherent worth. When a patient says I want to die, it may simply mean I feel useless. When a patient says I don't want to be a burden, it may really be a question, Am I a burden? When a patient says I've lived a long life already, she may really be saying I'm tired. I'm afraid I can't keep going. And finally, when a patient says I might as well be dead, he may really be saying No one cares about me. Many studies show that assisted suicide requests are almost always for such psychological or social reasons.

There has never been a documented case of assisted suicide in Oregon because there was actual untreatable pain. The law does not require that the patient suffer. Claims of intractable pain, if true, would indicate inadequate medical care, not grounds for assisted suicide.

People with serious illnesses are now sometimes fearful of the motives of doctors and consultants. One cancer patient was concerned that her oncologist might be one of the "death doctors," particularly after she consulted a second oncologist who was more sanguine about her prognosis and treatment options. Such fears were never an issue before assisted suicide was legalized.

I regularly receive notices that Oregon's Medicaid plan will no longer pay for many important services and drugs for my patients, even including some pain medications. At the same time, assisted suicide is fully covered and sanctioned.

The assisted suicide laws in Oregon and Washington really don't provide protections for patients. Patients accessing assisted suicide are supposed to be of sound mind; yet fully 25% of patients given prescriptions for lethal overdoses were found to be depressed. In Oregon and Washington, fewer and fewer details of assisted suicide are documented with each passing year. There is no peer review. The law requires the physician supporting assisted suicide to falsely list the presumed underlying terminal illness as the cause of death.

As Catholics we celebrate and defend the sanctity of life in all of its natural stages. Each of us—regardless of age, race, physical or mental ability, or economic status—is inherently valuable. When every life is respected, when physicians, family members, and other caregivers respond generously to the needs of vulnerable persons in their care, we all benefit.

William L. Toffler, M.D., is a professor at Oregon Health Science University and is cofounder / national director of Physicians for Compassionate Care Education Foundation. Paul Schwankl condensed his article; the unabridged version is available at www.usccb.org/about/pro-life-activities/respect-life-program/2012/respect-life-program-2012-pamphlets.cfm.