I very much appreciate Dr. Grohol’s taking the time to comment on my essay about physician-assisted suicide. I have great respect for his wisdom, judgment and fairness, and I recognize that reasonable people will disagree on this hotly-contested and complex issue.
I certainly don’t pretend to have reached any final “truth” in the matter of physician-assisted suicide (PAS). At the same time, I believe that Dr. Grohol’s conclusions (1) rest on several misapprehensions regarding my own position; the ethical responsibilities of physicians; and the relevant medical facts pertaining to terminally ill patients.
Dr. Grohol argues that the debate is really “…about patient empowerment, human dignity and choice.”
I fully agree with Dr. Grohol that the patient’s autonomy is of great importance; indeed, autonomy is considered one of the four cardinal principles of medical ethics, along with benevolence, nonmalfeasance and justice (2).
But sometimes, medical ethics must set limits on a patient’s autonomous requests, even in the context of an understandable choice on the patient’s part. Thus, a patient may feel completely justified and “empowered” in requesting that the dose of her pain medication be doubled, even though that would be extremely dangerous to her health.
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