Physician-assisted suicide: Con
Provide better care at end of life, not physician-assisted suicide
The Judiciary Committee of the Legislature of the State of Connecticut is considering a bill that would legalize physician-assisted suicide in Connecticut. The bill has been termed "Act Concerning Compassionate Aid in Dying for Terminally Ill Patients." It is, in fact, neither compassionate, nor of aid, to those who are most vulnerable within our society.
At its heart, physician-assisted suicide is neither a legal issue nor a political issue. It is not even fundamentally a religious issue. It is a human issue. As such, it transcends political, legal and religious boundaries. Physician-assisted suicide violates the Hippocratic Oath, which states "I will not give a lethal drug to anyone if I am asked," as well as codes of ethics. The American Medical Association Code of Ethics states that:
"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. Instead of participating in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life. Patients should not be abandoned once it is determined that cure is impossible ..."
As a Catholic, I am concerned that this bill violates the central tenets of the Judeo-Christian tradition: the sanctity of life and the promotion of the dignity of the human person. As a bioethicist, I am concerned that this bill violates central tenets of ethics.
My work and research have evidenced that physician-assisted suicide does not accomplish the goals it purports to attain. In fact, it often undermines proper care for the terminally ill by short-circuiting the continuum of care that we owe our dying patients. This bill tries to put safeguards in place to avoid the "slippery slope" often associated with physician-assisted suicide; however, they are flawed and insufficient.
If physician-assisted suicide is not the answer, what is?
Proper care at the end of life involves addressing those factors that can lead to requests for aid in dying: loss of a sense of control, loss of a sense of meaning and purpose, a sense of being a burden on others, and in some cases, physical pain. We preserve patient autonomy and control through effective communication about their goals and values and the use of Advance Directives. We promote human dignity and a sense of meaning and purpose when we recognize that the dying are not expendable or a burden, and when we cherish them in their personhood and accompany them on their journey with true compassion.
Advances in pain management have made it possible to virtually eliminate physical pain as a factor in requests for aid in dying.
Palliative care, meanwhile, is significantly underutilized in the United States, and especially in Connecticut. However, the state's Palliative Care Advisory Committee provides some hope that we will be more effective in integrating palliative care into the full continuum of care in the future.
Connecticut is the birthplace of the hospice movement in the United States, yet we currently rank in the bottom 2 percent in the nation regarding timeliness of hospice referrals, which are supposed to occur when a patient has six months or less to live as judged by a physician. On average in Connecticut, patients are referred to hospice with less than two weeks to live. This does not allow for adequate time to address the physical, emotional, spiritual and psychological needs of patient and family.
We can and must do better.
I also write as a widower who accompanied his wife through chronic and terminal illness, and joined with her as she struggled to maintain her sense of worth, dignity, and autonomy. I was with her as she lay dying in my arms. More importantly, I was with her as she struggled to live.
The dying have much to teach the living about life, if we choose to listen. We promote compassionate care for the most vulnerable among us when we affirm their existence, listen to and acknowledge their fears, aggressively treat their pain and help them alleviate their spiritual and existential suffering, not by assisting them with suicide.
Dr. Matthew R. Kenney is the vice president for mission and ethics at Saint Francis Hospital and Medical Center in Hartford.