Wednesday, October 15, 2014

Doctor assisted suicide.

Barbara Kay's column gets it mostly right - Suicide is none of Medicare’s business.  Doctor assisted suicide in the land of state monopoly medicine would present a huge ethical, moral and physical hazard.

I believe it would be an enormous conflict of interest for doctors and the medical system as a whole. I do not want our medical system looking to killing patients as an easier alternative to seeking a cure or easing their suffering. The American Medical Association gets it right. It’s position is (in part):
“... It is understandable, though tragic, that some patients in extreme duress--such as those suffering from a terminal, painful, debilitating illness--may come to decide that death is preferable to life. However, allowing physicians to participate in assisted suicide would cause more harm than good. Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks. ...”
The Canadian Medical Association, recently came up with the following weasel words (more or less): “it’s fine with us as long as doctors follow the law”. The CMA would seem to be playing down the ethical and moral hazards of doctor-assisted suicide as well as the deficiencies in our medical system.

Looking to death as a solution to medical problems is fraught with significant danger to the public, especially those already vulnerable (eg. the elderly). For example:
Treatable depression is already under-diagnosed and under-treated, especially in the elderly. With suicide as an option this situation will not improve. On the contrary, it will be exacerbated.

Palliative care experts report that the vast majority of terminally ill patients facing or fearing great pain withdraw their requests for assisted suicide once treated for depression and/or provided with proper palliative care. The problem here is that our health care system is already deficient in both depression diagnosis/treatment and palliative care. The availability of assisted suicide would lead to even lower availability of both. Clearly this would be hazardous to people who are ill and vulnerable (especially those already in, say, poverty and/or advanced age).

Many patients requesting doctor assisted-suicide are coerced by family members. There have been documented accounts of people committing suicide under pressure or duress from family members, friends or others present during their suicides. In 2010 it was reported that more than one quarter of assisted suicides in Oregon and Washington did so because they didn’t want to be a “burden” to their family. Does anyone suppose that none of those "burdens" were nudged towards suicide?
Elder abuse is widely recognized as a serious problem. Legalizing doctor-assisted suicide would make available the ultimate manifestation of that abuse.

Then there are the disabled.
Then there’s the slippery slope towards euthanasia, an even greater hazard. Many advocates for assisted suicide are really aiming for legalization of euthanasia.

No comments: