I agree with Dr Allan Donkin on the subject of assisted suicide. I would be opposed to this for all of his stated reasons and am also opposed to the killing of terminally ill patients for any reason, in kindness or otherwise. Although one feels sure that noble motives exist in the minds of some who take an opposing view, it is too easy for physicians and nurses to become convinced that what they are doing is right simply because the profession is viewed in a light of kindness. We are all well meaning, aren’t we? There are a few in every population who may enjoy this power. We are all scarred in some way and that does not always reveal itself in medical school entry exams or in any other evaluation of that kind, I assume. We are a mix, let’s face it.
Further, not only would patients become embroiled in this fad of early death because it is open to them or expected, the very standing of the physician as reliably trying to support life in a trusted environment would be eternally damaged by the acceptance of the idea. It does not matter how many physicians feel they or colleagues have already justly done it occasionally with a tap of the nose or a wink as an act of all-knowing kindness or convenience. Presumably they live comfortably with that. Of course the proponents suggest that each practice may simply form a cadre of suicidists on the register to help the public feel that their doctor is not one of them. But he is one of them—the profession.
Patients who like the concept of assisted suicide would likely not think this way if we had not failed to fully address the need for better palliative care resources. In allowing this process the profession would smear itself as the Greek physicians did, leading Hippocrates and others to see that the two behaviors could not coexist with-out ultimate and all-pervading contamination of trust and honor. Do the proponents think that the College of Physicians and Surgeons and the legal system disallow sexual encounters with patients because we are generally against sex? It is clear that we need to feel reasonably confident that our spouses, children, and patients are safe when undergoing consultation and surgery. The subtleties of these situations, as Dr Donkin implies, are more profound than modish, superficial lifestyles may appreciate. The thin end of the wedge of progress has a thick end, and the destruction of our patients’ only hope in our integrity is attached to this.
Add to this my feeling that some momentum in this movement is generated by budget arguments. Well, swallow the cost. Let’s do what is right and put our effort and charity and integrity into good palliative care as an ethical profession. Improved mental health services would likely help a lot, too.
—Paul Champion, MBBS
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