A “Death with Dignity” bill introduced in the state Legislature this session proposed allowing terminally ill, competent adults to get a lethal dose of medication from their doctor. Should we offer patients an early checkout?
April Troutman Donahue
Executive Director of the Hawaii Medical Association
Physician-assisted suicide is fundamentally inconsistent with a physician’s professional role as a healer. In this healing role, the physician preserves a patient’s health and life and strives to alleviate patient suffering.
In Hawaii, giving physicians the authority to assist in suicide will undermine, not strengthen, this time-honored role. We are concerned that such a law will have an adverse effect on patient care. Treatable conditions such as depression, nausea and pain will be ignored, and the application of the latest evidence-based medicine will be overlooked.
Patients near the end of life still need emotional support, comfort care, adequate pain control, respect for patient autonomy and the option for continued treatment. Physician-assisted suicide is an irreversible solution to what may be a temporary problem, given the possibility that tomorrow, medical science may discover a cure or remedy for the illness that is regarded as terminal today.
Proponents for physician-assisted suicide argue that patients, particularly elderly men or women who are deemed “terminally ill,” should have the legal right to expect this service from the medical profession. While we acknowledge their intention to end suffering, legalizing physician-assisted suicide could very well trivialize death as a billable procedure and redirect the evolution of dying-with-dignity and end-of-life care toward a financial, criminal and administrative issue. In this era of managed care, we fear that the right to die will morph into an obligation to die.
We believe that the emerging specialties of geriatric and palliative medicine are leading physicians toward a role that improves care for their patients. Research, education and training of physicians and caregivers about patients and their quality of life are what’s needed, not legislation to facilitate suicide. The focus of public-policy decisions should be on increasing access of quality healthcare for our citizens.
(Donahue wrote this with help from Gary Okimoto, M.D.)
State House Majority Leader, D-33RD
This issue is about end-of-life comfort for a lot of people who are terminally ill. It’s clear that people with a terminal illness want to have at least the option of knowing that they don’t have to pass in inextricable pain. Whether they ultimately decide to avail themselves of the option is their decision.
There have been some fears raised about a slippery slope, but the data shows that that hasn’t happened at all in Oregon where a death with dignity law was enacted in 1997. It’s a very regulated and reported process. There are forms, you have to get them certified by two physicians.
Since 1997, there have been 341 patients who have gone through with physician-assisted suicide in Oregon. In that same time period, 98,000 Oregonians died naturally of the same diseases that afflicted those who chose suicide, making the suicide rate just .003 percent.
Some doctors say their job is to save people’s lives, not take them. The Hippocratic Oath is a wonderful thing, and should be taken seriously. But at the end of the day, this isn’t about the doctor; this is about the patient. If a terminally ill patient sincerely wants this, and there are no psychological issues, then this is a decision for the patient, and doctors have an opportunity to help that patient have a safer and more comfortable experience. And keeping this option available through official channels means that health-care professionals will be able to maintain all the necessary safeguards and checks, rather than forcing patients to potentially seek out their own solutions.
I can understand the fears and uncertainties surrounding this subject. But when we have more than a decade’s worth of experience and data from Oregon showing that physician-assisted suicide is a net positive for society, those criticisms dissipate.
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