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PERSPECTIVES:
Doctor-Assisted Suicide
October 31, 1997    Episode no. 109
Read This Week's November 7, 2008
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BOB ABERNETHY: The underlying question, of course, is whether doctor-assisted suicide is right or wrong. Charlotte Ross is the executive director of the organization Death With Dignity. Father Kevin Wildes is a professor of ethics and associate director of the Kennedy Institute of Ethics at Georgetown University. Dr. Joanne Lynn is director of the Center to Improve Care of the Dying at George Washington University. Ms. Ross, why should this be legal?

CHARLOTTE ROSS (Executive Director, Death With Dignity): We must respond to the people across this country who see their loved ones die, die very difficult deaths. And we must do more and markedly improve the health care that we give -- or certainly the palliative care, the compassionate care we give the dying. We must look at those few that, despite our best efforts, are going to die very difficult deaths.

ABERNETHY: So your argument is one from compassion, right?

Ms. ROSS: Absolutely.

ABERNETHY: Father Wildes.

Father KEVIN WILDES, S.J. (Georgetown University): Well, I think to make the legal change is to raise a significant moral issue about the intentional taking of human life. I mean, essentially, we govern much of what we do in terms of moral thought, as with the presupposition that one should never take innocent human life directly. And this is a radical change in that, in that stance.

ABERNETHY: Not even when the person wants it taken?

Father WILDES: Well, this is the question, I think -- the fundamental moral question is, does the person have the authority to ask to end their own life? Does the person have moral authority? Traditionally, Christianity says they don't. I mean, that's out of a Catholic perspective, I would say no. What we do as a secular society is we have to debate that.

Dr. JOANNE LYNN (George Washington University): Really, the issue isn't just whether a person can do this, because a person can kill themselves on their own motion at any time. It's whether we can make it easy, neat, proper behind a white coat, and that it seems raises all manner of risks to terribly vulnerable populations we already don't take very good care of. And if we have large numbers of people who are going to be put at risk, and some very small number of people who might really claim this in some legitimate way, it seems we must really be responsible about the vulnerable populations we're placing at risk.

ABERNETHY: Be specific about that. What would be an example of the vulnerable person who might be encouraged to say, "Yes, I want to be helped to die?"

Dr. LYNN: We do a terrible job right now in long-term care of serious, chronic disease. The 88-year-old widow living alone who has a stroke and faces going to a Medicaid nursing home, who faces leaving the few friends she has, becoming utterly impoverished, being taken care of by people who often don't even speak her language, and she might well say, "Look, this is a fatal disease. I've got less than six months to live. Doc, give me some pills." What am I supposed to do then? Am I supposed to become society's Nazi and, you know, be willing to do her in? Or am I suppose to say, "No, if you were rich you could do it, but since you're poor, you can't."

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Ms. ROSS: Presumably, any physician in this country with heart, and any health care system, is going to see the vulnerable person, know what kinds of response to give and authority. But what do we say to the person who is calling out for relief from pain that can't be stopped, whose family is gathered around saying, "Help us. Help us. She is dying. He is dying. Let them go"?

Dr. LYNN: They need not be in such pain.

Father WILDES: They need strength.

Ms. ROSS: In a wonderful world they need not, but today with the best of help, we do have these people.

Dr. LYNN: Not the best of them.

Ms. ROSS: And the people watching this program know that.

ABERNETHY: So Father, what do you say about that?

Father WILDES: Well, I think that one question -- another moral dimension to this, it raises issues about what is the appropriate role of the physician in all of this? I mean, we have assumed, at least traditionally, that medicine -- that physicians were, if you will, to heal, not to harm. And the question is whether or not you think that bringing somebody's life to an end is a harm. Is directly causing the death of someone a harm? And how do we balance that?

ABERNETHY: You're a doctor, could you do that?

Dr. LYNN: Could I directly -- no. I can certainly sedate a person for whom that's the only way I can get them out of suffering. But, you know, in two or three thousand people I've taken care of, I've only had to do that about a dozen times. You know, if you do excellent palliative care, that's a really rare event, but excellent palliative care is reasonably expensive. And we have a care system that makes it very hard to get, especially for people with ambiguous prognoses. You know, it's one thing for the person who's dying in the next six hours or the next two days.

Father WILDES: Right.

Ms. LYNN: But the person who's really sick and is going to die of this disease, but might live three months, we've got nothing.

ABERNETHY: So how would you reply to that?

Ms. ROSS: Don't hold these people hostage until we fix the system we haven't been able to fix in 100 years. We do the best we can, and we've got to do better. But why must we hold the dying people hostage to this? If I'm lying in that bed, I want a doctor to tell me, "I can sedate you and leave you unconscious for several days, or I can help you now." And I know that doctors are called upon to do difficult -- sometimes they hurt us in order to help.

ABERNETHY: Folks, our time is up. I have a feeling that we'll be getting back to this issue from time to time.

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