From the Physician Editor-in-Chief
Euthanasia has long been a controversial topic. The Death With Dignity Act, now legal in 11 states, puts a new twist on the discussion. This act puts very precise conditions on who may be allowed to receive a lethal dose of medication from their attending physician. For example, a person must be expected to die in the next 6 months.
Should Doctors Be Expected to Save Lives and Kill Patients?
However, doctors are trained to save lives and ease patient suffering, not kill our patients. Should we be expected to do both? I understand that we are in a unique position, due to our medical knowledge, to be the only ones that should do this.
While I had strong opinions on the subject before this law was passed in my state (NJ), I didn’t give it much thought. Recently, I was asked for the first time by a patient to sign the papers and help them die.
It was easy to deny this patient’s request because they didn’t meet all the conditions. Since the day this patient asked, my thoughts have been greatly troubled about what I would do in similar situations in the future.
As a family doctor, a big part of my practice is preventing and catching diseases early. Despite this, some will develop terminal diseases. While I am a big advocate for palliative care, can I ever kill one of my patients?
I Couldn’t Live With the Decision to Help a Patient Die
After giving this much thought, the answer for me is clearly no. There are many reasons for this, including my strong religious beliefs. I try to keep my beliefs out of the exam room, but I simply could not live with making this decision. Additionally, there are many medications to make a patient comfortable short of killing them.
Another big barrier for me is where we draw the line. I see this easily becoming a very slippery slope in the future, easing the criteria for those who seek to die. The conditions are very strict, but they could easily be loosened with time.
I see a conflict in being a professional who saves lives and also being the one who helps lives end. Yes, there is a time when there is nothing left to do, and we should stop providing futile care. But, that is not the same as actively giving a medication to cause a patient’s death. These two things are drastically different in my mind. There is a time to let patients go; not to kill them.
I know I can never intentionally cause a patient’s death even if they request me to do so. However, I don’t think that this should be every doctor’s opinion. Yes, it may sometimes be more humane to end a patient’s suffering rather than let it linger on. In the future, if I encounter this situation, I plan to refer the patient to someone with more expertise in this area. If they decide to grant my patient’s wish, I don’t think there is anything wrong with that.
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