|
|
Let's take a patient with ALS who is on life support-- let's say, a ventilator
or a feeding tube-- who starts to talk about wanting to die. We have a model
for how these very tough decisions ought to be made: out in the open in a frank
discussion with our best minds to make sure that the patient is not depressed
and is getting the best treatment possible. We ultimately listen to the patient,
and act accordingly to stop treatment and let death come.
But, take an ALS patient who isn't on life supports, perhaps is suffering, an
even greater amount than the first patient, and who wants to end his or her life.
All of a sudden, that same discussion becomes a discussion about assisted suicide
and all the red flags go up.
We have an obligation to search in earnest with people for a reason to keep going,
for better ways to address their suffering, but ultimately to listen to them,
and then to find the least harmful way to respond to them. I think we have an
obligation to be responsive as best we can in these circumstances.
|
|
 |
I
want to respond in two ways:
Consideration of legalized assisted suicide would also apply to people who weren't
so fortunate, who are not receiving the best care possible, and who are suffering
needlessly. Though legalized PAS sounds like it would be very narrowly restricted,
in the real world, it would be far more broadly applied.
Second, patients who are suffering, in all circumstances, demand our comprehensive
attention and response, hopefully, within a team of caring providers, who will
give them with every opportunity to express their discomfort, and who will
honor the patient's right to refuse any unwanted treatment to prolonging life.
Tim and I agree, for instance, that patients who have an advanced terminal illness
and who consciously decide they no longer wish to eat or drink should be supported,
even though that decision in some circumstances could be understood as a suicide.
But there's a distinction to be made between that decision and physician-assisted
suicide. As hard as it is to care for people whose suffering persists despite
our best efforts, we have to acknowledge that there are some things that physicians
must not do. Killing patients by direct intention happens to be one of them.
|
|
