By Alex Schadenberg, Executive Director, Euthanasia Prevention Coalition
Editor’s note. Dr. Everett was responding to an earlier article by Scott Maxwell which supported assisted suicide.
The Orlando-Sentinel published a Guest Column on March 27 by Dr. George Everett, the governor and president of the American College of Physicians, Florida Chapter.
Florida is currently debating assisted suicide Bills (S864/H1231).
As a physician, the overwhelming majority of my colleagues and I do not wish to participate in PAS [Physician Assisted Suicide]. The American College of Physicians, the largest physician specialty organization in the world, and the American Medical Association, the largest physician organization in the United States, have both written extensively on the ethics surrounding euthanasia and assisted suicide and vigorously oppose physicians’ involvement in either activity.
Here are some of our reasons for opposition.
First, Hospice and Palliative Medicine, a relatively new specialty, is greatly underused and often sought at the very end of life rather than earlier when suffering can be allayed. Second, a slippery slope of misuse of PAS has already been shown to occur in countries where it is legal. For example, the Dutch have expanded euthanasia (most often delivered by physicians) from adults who have given consent, to now include children from ages 1-12 where parents have given consent.
Third, two of the four key ethical principles of medical care, beneficence (promote well-being) and non-maleficence (do no harm), are violated with PAS.
Fourth, loss of trust in the physician as a healer and comforter with the best interests of the patient at the forefront of the relationship, is compromised.
Technically, the use of medication to assist in suicide is suspect. Medical science has not produced a medication that can be orally self-administered which results in certain and painless death. The most consistently successful suicides are through methods that a physician would not be able to provide or suggest. Medication overdose, on the other hand, is the most common layman’s method of suicide attempt and is usually unsuccessful.
Furthermore, suicide is strongly associated with social and demographic factors. Men commit 80% of suicides. The highest rate of suicide is among Native Americans and non-Hispanic whites while the lowest rates are in Asians, Blacks and Hispanics. Imagine, for a minute, that PAS was delivered more often to some social or demographic groups compared to others. Suspicions about motives and accusations about discrimination would surely be asserted. Trust in the medical profession would suffer.
PAS and euthanasia are essentially unnecessary with tools currently available to relieve suffering as people near the end of life. As physicians, we much more frequently encounter patients and families who demand maximum therapy, often painful and futile, all the way to the end of life, than those who request hospice or palliative care that could minimize suffering. This observation is supported by studies funded from the National Institute of Health which found that more than 20% of all Medicare expenses go to people in the last year of life, with only a minimal proportion spent on hospice care.
Citizens of the state of Florida would be poorly served by physicians assisting in suicide but would be greatly benefited by education about the effectiveness of hospice and palliative care to limit suffering near the end of life.
This appeared on Mr. Schadenberg’s blog and is reposted with permission.