Dr. Ron Pies writes an eloquent defense of why physician-assisted suicide should not be made a legal right in Massachusetts. He compares it to a doctor helping one of his patients jump from a bridge — something most doctors would never do.
But in making this analogy, I believe we’re removing all context and logic from the decision behind wanting to end your own life because of a terminal illness. For the patient, it’s not about the act of suicide or ending their lives — it’s about alleviating suffering from the disease and choosing one’s own way of dying with a little dignity. It’s about patient empowerment, human dignity and choice.
That’s why in the two states where it is legal for doctors to help patients with a terminal illness, it’s referred to as the Death with Dignity law.
Because the alternative takes much of the dignity out of dying in today’s modern medical system.
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What I find interesting is the fact that we will put animals to sleep to put them out of their suffering, yet we will watch loved ones suffer in agony or drugged until death finally takes them.
Where is the compassion in this? How can we be so humane and compassionate with our beloved animals, yet so cruel to people?
Are we afraid to let go? Afraid that at the last minute they will, by miracle, be healed?
Let people have the choice when they are terminally ill. Why prolong their suffering – it’s not easy to let people go, but it’s not fair to keep them here in their suffering either.
DEATH WITH DIGNITY is about compassion NOT RELIGION OR POLITICS. People say supporting DEATH WITH DIGNITY is sac-religious but if they or a loved one were/was in that boat they may feel differently!!! Drugging them into oblivion is better, what happens when the drugs no longer work and the MD can’t/won’t prescribe more??? We don’t let animals suffer like this but humans is a different story!
Being a nurse I saw people suffer for weeks, sometimes months – one pt. had diabetes then kidney failure, both legs and one arm were amputated then he slipped into a coma his fingertips and penis rotted off and his family was horrified and I thought this horrifies you, what about when he lost 3 limbs When his fingers and penis rotted off his body his family insisted he continued dialysis and wanted MD’s, nurses and EMT’s to take heroic measures to continue his life/ suffering!!! I thought you want a comatose torso to continue dialysis, we don’t let animals suffer like this, but with humans it’s OKAY what the hell people. The sick can’t work and the current system kicks them off insurance when they reach a certain amount, we’re taking a HUGE step backwards! Obamacare will address this HUGE problem. You can’t be pro-life and against subsidized programs like foodstamps. Just like w/ abortions the decision to end a life is intensely personal, and NO ONE, especially politicians should make that kind of decision, PERIOD. As medical personnel, we can’t project our feelings but we can educate them with the facts. I saw SUFFERING over and over (sometimes very young kids, one kid comes to mind he was 6 had brain cancer and I had to drop an NG tube, one tear rolled down his check, he could no longer speak, walk etc,); more often, though, it’s the elderly who have lived a LONG LIFE and we want it to end in pain and suffering … where the COMPASSION people? In other states we take the life of someone on Death Row because they caused pain and suffering people are doing that every day in Massachusetts these people aren’t in a prison w/ bare and locks but they are in prison, PRISON WITH NEEDLESS PAIN AND SUFFERING, HELLO WAKE UP!!!) That’s why I support DEATH WITH DIGNITY. Families are so blinded by grief they can’t make informed decisions!!! It passed in several states one of which it passed 14 years ago it needs to pass in Massachusetts or do we want to be known as the state with no compassion.
Despite the opposition organizations such as APHA (American Public Health Association), AWMA (American Womens Medical Association), amsa (American Medical Students Association) NASW (Social Workers of Massachusetts), NAPWA (National Association of People with Aids, ACLU (American Civil Liberties Union), American College of Legal Medicine, Death with Dignity National Center, First Unitarian Society of Newton,Autonomy: Advocating for People with Disabilities, Compassion & Choices National, Compassion & Choices of Greater Boston what about the little people or are they going to be lied to by religious leaders, politicians, and Groups that Oppose Death with DIGNITY.
I can’t speak for Dr. Pies, but I believe as a society, we cling to this false belief that death must be “natural” or else it’s somehow wrong. Yet we have no problem using our technology to prolong what “natural” means in life (especially to our life expectancy), setting ourselves up for a paradoxical disconnect in medicine.
Some doctors feel that is it is not within their purview to help someone end their life. What I say to those doctors is, that’s fine for you — but don’t put your personal beliefs onto me. If I want, let me end my life if I have a terminal illness at my discretion.
On the other end of the spectrum we have the miracle of medicine practicing their skills on very sick babies who, if left without the wonders of medical advancements and interference, would pass away because that is often what happens in nature. I’m not talking about mild cases – but severe cases.How is it fair to a parent for medicine to save a child who will not be able to do anything other than lay on the floor? There was a case, probably more than one, in Toronto of a family who had a baby that was, blind, deaf and dumb and should not have survived. Yet they saved this child anyway and then when the time came they gave this baby back to it’s parents to care for for the rest of it’s life – putting uncountable financial and emotional stress on them. This child would never be able to sit up, interact with anyone and never be able to be left alone.It comes down to QUALITY of life- whether you are entering this world or at the end of it.So is it right to prolong a dying newborn’s life just because they can? Is it right to deny a person a choice to end their life in the face of a terminal illness?There are views for and against.
Hi Doc, I essentially agree with your article. I have worked extensively with people at the end of their lives. I have had clients tell me that they feel hospice nurses are shoving their diagnoses down their throat and that they want to be alive while they can. I have had clients tell me they want their own way out by assisted or non-assisted means. I had a dear friend who was actually chastised for getting a last minute blood transfusion to buy a few more days with loved ones. Like she needed the guilt?I have also been worried that if assisted suicide was legal that people would feel pushed to die earlier to help the family save money, stress etc. That said, I think precautions can alleviate this threat.I have attended many many deaths and will say that almost all of these people have wanted to get every last minute of life they could. But for those who wish to avoid the whole pain management end of life care issues we should all have the right to choose and as it happens the good drugs are controlled by the docs and government. Lets help each-other out here but please build in precautions so people are not feeling forced to end their lives prematurely.
Perhaps read Dr Pies’ piece he posted at Thehealthcareblog almost 2 years ago and you can get a sense of how this physician thinks.http://thehealthcareblog.com/blog/2010/12/03/the-libertarian-mind/I am not sure if the link will work, but invested readers can go to http://www.thehealthcareblog.com and search it per “Ronald Pies & libertarian” and it will be the first post from the search (sorry, iPod typing has limits).I don’t think Dr Pies fully understands autonomy. You all read and decide for yourselves. Quality of life is not just defined by physicians.Sometimes, people make choices we do not fully understand nor appreciate, but, who are we to force our judgment on such others? I do not think a sizeable percentage of psychiatrists get that comment still today .
I appreciate the heartfelt comments thus far, as well as the powerful case for permitting physician-assisted suicide (PAS), provided by Dr. Grohol. (I will do my best to address your concerns later, John, and thanks for your spirited rejoinder!). For the information of others who may want to post, my usual policy is to reply directly only to those who provide their full names. However, I will try to address, in a general way, some of the concerns and objections raised in any responsible comment or question.
I realize that this is a very heated and emotional topic–one that touches so many of us in very personal ways–and I suspect that none of us has all “the answers”. I know I don’t! Perhaps the best we can do is raise the right questions.
Respectfully,
Ronald Pies MD
P.S. For a fuller understanding of my position, I’d like to recommend two related articles I have authored:
The one published in Medscape:
“Do We Need ‘Thanaticians’ for the Terminally Ill?”, available at: http://www.medscape.com/viewarticle/771274. [also see the appendix material citing problems with the Oregon PAS statute]
and a more philosophical piece:
http://www.hektoeninternational.org/End-of-life-care-and-contingent.html
Please note: my rejoinder to Dr. Grohol’s essay is now posted at:
http://psychcentral.com/blog/archives/2012/10/07/physician-assisted-suicide-why-medical-ethics-must-sometimes-trump-the-patients-choice/
I appreciate the opportunity to present my views.
Ronald Pies MD