A group representing internal medicine doctors has reaffirmed its opposition to physician-assisted suicide, saying the practice “alters the physician’s role as healer and comforter” and “affects trust in the patient-physician relationship and the profession.”
In a paper published on Sept. 19 in the Annals of Internal Medicine, the American College of Physicians called for better promotion of palliative and hospice care, which opponents of physician-assisted suicide say are underutilized areas of medicine that could address concerns of patients facing difficult illnesses.
“The American College of Physicians acknowledges the range of views on, the depth of feelings about, and the complexity of the issue of physician-assisted suicide,” the group’s leader, Dr. Jack Ende, said in a press release. “But the focus at the end of life should be on efforts to prevent or ease suffering and on the often unaddressed needs of patients and families. As a society, we need to work to improve hospice and palliative care, including awareness and access.”
The American College of Physicians called for better promotion of palliative and hospice care, which opponents of physician-assisted suicide say are underutilized areas of medicine that could address concerns of patients facing difficult illnesses.
Palliative care focuses on symptom management, such as pain and nausea resulting either from a medical condition such as cancer or from side effects of the treatment itself. Hospice care, on the other hand, is related to palliative care but it is meant to address comfort concerns for patients with fewer than six months to live.
Patients asking for information about ending their lives with the assistance of drugs should be counseled by doctors, the A.C.P. said, suggesting that requests “for physician-assisted suicide are unlikely to persist when compassionate supportive care is provided.”
“Through effective communication, high-quality care, compassionate support, and the right resources for hospice and palliative care, physicians can help patients control many aspects of how they live out life’s last chapter,” Dr. Ende said.
The paper from the A.C.P., which claims more than 150,000 members spread throughout 145 countries, said too many Americans do not fully understand their medical options when confronting a terminal illness—including the option to forgo treatment altogether even if that means a patient will die.
“As noted in the paper, medical ethics and the law strongly support a patient’s right to refuse treatment, including life-sustaining treatment,” the organization said in a statement. “Vigorous management of pain and symptoms such as nausea at the end of life is ethical and, indeed appropriate, even when the risk of shortening life is foreseeable, if the intent is to relieve those symptoms.”
Discussion about physician-assisted suicide was once taboo, but the practice is gaining support across the country. A 2015 Gallup poll that tracks support for physician-assisted suicide found that 68 percent of Americans supported physician-assisted suicide, up from just 52 percent in 1997, when Oregon became the first U.S. state to legalize the practice. The Catholic Church is opposed to physician-assisted suicide and Catholic leaders have been involved in campaigns to fight legalizing the practice in several states, including in Massachusetts, where voters narrowly rejected the measure in 2012.
In addition to the A.C.P, the American Medical Association also opposes physician-assisted suicide. Its Code of Medical Ethics, which was updated in June 2016, states, “Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.”
Death With Dignity, an organization that promotes legalizing physician-assisted suicide, has recently claimed victories in legalizing the practice in California and Colorado, joining Oregon, Vermont, Washington and the District of Columbia. It plans to support campaigns in more than a dozen other states in the next few years.
I believe that I understand the immense difficulties faced by people who are seriously or terminally ill. My aunt was a widow whose husband died of lung cancer in his early fifties. She battled breast cancer and was successfully treated.. However, she then had brain cancer, and moved in with my parents. She had chemotherapy which was unsuccessful, so we quickly contacted a hospice program. My parents and me assisted the hospice nurses and staff in carrying for my aunt as best as we could. This involved us carefully administering medication, dressing and feeding her, and caring for her personal needs when she became incontinent. The hospice staff were very dedicated and compassionate. My aunt, although she hadn't regularly attended Mass for some years, did meet with our pastor and felt better when she went to the Sacrament of Reconciliation. She went into a coma on her birthday, March 19 (St Joseph's Day). For some time she had been receiving morphine for pain relief, as well as drinking liquid nutrition. As a Special Education teacher, one of my severely disabled students received nutrition by a feeding tube. My parents and me inquired of a priest at our parish as to whether it was morally required for my aunt to have a feeding tube to sustain her life. He consulted with a priest who was an "expert" in terms of end-of-life care. This priest said that because my aunt's condition was irreversible, that a feeding tube wasn't obligatory. She died peacefully several days later. My Dad decided that as an alternative to well-wishers sending flowers, that instead he would ask that people make contributions to the Sisters of St. Joseph of Philadelphia. As difficult as the experience was for both my family and especially my dear aunt, I feel that hospice care was the best, most compassionate choice for her. If I ever become terminally ill (I have for many years had a serious health condition) I would want care from hospice staff. As someone who has attempted suicide several times in years past because of depression due to being gay, I spoke to a compassionate priest, went to the Sacrament of Reconciliation (as I have been doing monthly for sometime), and feel that life, even when emotionally difficult, is worth living.