2/3rds oppose physician-assisted suicide in poll conducted by New England Journal of Medicine surveying its own members

By Dave Andrusko

Not-Dead-Yet2reThe headline on the story is encouraging enough—“Most Doctors Oppose Physician-Assisted Suicide, Poll Finds”—but that’s only the beginning. Here’s the opening paragraph of Steve Reinberg’s story for HealthDay.

He is writing about a poll conducted by the New England Journal of Medicine (NEJM) of the journal’s readers, mostly health-care providers.

“Whether doctors should help patients die continues to be a hotly debated topic within the medical community, a New England Journal of Medicine poll finds. The journal questioned readers about a hypothetical near-death case and received more than 2,000 valid responses. Roughly two-thirds worldwide — including 67 percent of replies from the United States — said they disapprove of physician-assisted suicide. Most readers of the journal are doctors.”

Okay, what else?

·   That 2/3rds “no” vote came even though the case was really designed to get agreement: a 72-year-old man with incurable metastatic prostate cancer. I’m guessing the authors were not happy with the results, for they wrote that “online voting . . . is prone to bias and is likely not to be scientifically valid.”

·   Likewise with Barbara Coombs Lee, president of the pro-euthanasia Compassion & Choices. Coombs said that while she doesn’t believe doctors should be forced to do something they have an objection to, “neither should patients be held hostage to the moral objection of a dissenting physician.”

·   Ditto for Marcia Angell, MD, a former editor of the NEJM and a proponent of physician-assisted suicide. She told Robert Lowes of Medscape Medical News, “[The survey] doesn’t tell me much,” said Dr. Angell, who is a senior lecturer on medical ethics at Harvard Medical School, in Boston. “These are the people who chose to respond. They’re not all practicing physicians.”

·   While it is regrettable that a majority of respondents from 18 states supported physician-assisted suicide, it is significant that respondents from the first two states to first legalize physician-assisted suicide– Oregon and Washington—did not.

·   Reinberg provides the needed context. He wrote, “The American Medical Association strongly objects to physician-assisted suicide. ‘Physician-assisted suicide is fundamentally inconsistent with the physician’s professional role,’ the association states. ‘Requests for physician-assisted suicide should be a signal to the physician that the patient’s needs are unmet and further evaluation to identify the elements contributing to the patient’s suffering is necessary.’”

·   Of the more than 200 comments the NEJM received, many referenced the traditional argument that this would be violating their Hippocratic duty to do no harm and warned of a “slippery slope.” One of the interesting responses Lowes chose to highlight really cut to the chase:

“I’m struck that my aboriginal patients never ask about euthanasia,” wrote a reader identifying herself as a Canadian internist in a remote area of the country. “I am realizing that our focus on individual autonomy is a culture-specific one, and occurs at the expense of other values such as connection to other people, valuing of the full human experience, and the ability to receive our life’s trajectory without always controlling it.

“To raise my hand to kill…never for me, and never (I hope) for my profession.”

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