, Salem, MA

Election Forum

October 30, 2012

Column: A physician's perspective on Question 2


Furthermore, although proponents claim the bill offers a compassionate option, it is actually constructed in such a way to make the act of suicide incredibly isolating. The bill does not require any family members or next of kin be notified of a patient’s decision to kill herself. A spouse or relative struggling with the knowledge of a loved one’s diagnosis could be left further dealing with a suicide. But perhaps the most disturbing element in the proposed legislation is that no one (no witnesses, no medical personnel) need be present at the time of ingestion of this lethal dose of barbiturates. The lack of oversight opens the door to abuse of the sick, elderly, poor and disabled, not to mention myriad other concerns if the drugs get into the wrong hands.

The real fallacy of this bill is that it presents suicide as simply one option among many as patients navigate through the choices surrounding a terminal diagnosis. However, the idea that prescribing lethal medications for our sickest patients to kill themselves alone is just another option is certainly not the understanding of the vast majority of physicians who take an oath to “Do no harm.” Most of us realize that in enabling a patient’s suicide, we are corrupting the very foundation of medicine and changing the way physicians and patients understand each other’s roles. (The Massachusetts Medical Society and American Medical Association both oppose physician-assisted suicide.)

The practice of medicine involves meeting patients at their most vulnerable times — they often feel stripped of their dignity and come to us physically and spiritually naked, scared, and sometimes alone. As physicians, we recognize their trepidation, embarrassment and sadness, but acknowledge their humanness as they sit before us. We deal with their bodily fluids, foul smells, physical wasting, raw anguish, and yet we recognize the person in front of us. We meet them where they are and try to offer them some treatment or care that re-establishes their dignity — perhaps in an entirely new way. Palliative care, the branch of medicine that offers care to those with chronic or terminal illnesses, seeks to treat the whole person. It attempts to heal spiritual, mental and, where possible, physical processes that cause the patient suffering. Those within palliative care support the whole person and often guide them toward a peaceful end at the time of natural death. This bill does not require a palliative care referral to discuss options of care.

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