On Doctors, Death, and the 'Right to Die'

Doctors work hard to improve the quality of patients' lives. But when that's not possible, do doctors have a role to play in helping patients commit suicide? Polls show the public - and doctors - have mixed feelings on the question.

“The goal of all life is death.”

—Sigmund Freud

When it came to the doctor’s ultimate duty, I remember one of my physician-dad’s bromides: “The role of medicine is to improve life, not to prolong it.”

Did that mean he was for physician-assisted suicide? I can’t say. We never really talked about it. But knowing my father, he might have thought that the current right-to-die movement in America could hit a slippery-slope. Dad, who was unable to walk for a while, thought that some disabled persons could easily become targets for assisted suicide taken to an extreme.

Presently, just 5 states (Oregon, Washington, Vermont, New Mexico, and Montana) permit healthcare professionals, under stringent rules, to assist terminally ill patients who wish to die. And as many as 15 other state legislatures nationwide are debating instituting a humane death option. According to a 1997 US Supreme Court ruling, state laws banning physician-assisted suicide are not unconstitutional, thus a state may decide for itself as to a doctor’s role in aiding death.

Toward the end (while in his late 80s), dad frequently talked about how unhappy he was with his life. He was sickly and lonely and thought himself a burden to his care-giving children (he wasn’t). “Every night before I go to bed, I pray I won’t wake up in the morning,” he regularly told me.

When I reminded him that he was a doctor who had the necessary medications and/or connections to end his life by his own hand, he would always say: “God wouldn’t want me to do that.” Thus, his objection to suicide seemed religious. As it turned out, dad did die peacefully in his sleep from a massive stroke (God listened).

While providing the means for a quick demise seems contrary to the long history of physicians, a recent Gallup Poll shows strong public support for doctor-assisted suicide. According to a May 2015 survey: “Nearly 7 in 10 Americans (68%) say doctors should be legally allowed to assist terminally ill patients in committing suicide, up 10% from last year. More broadly, support for euthanasia has risen nearly 20% in the last 2 years and stands at the highest level in more than a decade.” In addition, 56% of Americans now think physician-assisted suicide" is "morally acceptable."

The issue is right in the face of today’s practicing physicians. According to a Northwestern University report, more than 55% of doctors “have received a request for assisted suicide in some form or another.” And NBC News recently reported that “most U.S. doctors—54%—favor assisted suicide, backing the rights of patients with an incurable illness to seek a dignified death.”

Still, a great many doctors struggle with “death with dignity” matters, according to Tom R. McCormick, a senior lecturer emeritus in the Department of Medical History and Ethics at the University of Washington School of Medicine, who works with physicians on these issues. “For doctors, having the opportunity to help a patient die may resolve certain ethical issues but raises many others,” he says.

Doctors, who are already under enough pressure trying to keep patients alive, are welcome to offer their comments on physician-assisted suicide.

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Meanwhile, here a few quotes about the momentous issue of death:

1. “I want to be all used up when I die.”

—George Bernard Shaw

2. “Someone has to die in order that the rest of us should value life more.”

—Virginia Woolf

3. “Some people die at 25 and aren't buried until 75.”

—Benjamin Franklin

4. “Death is the wish of some, the relief of many, and the end of all.”

—Seneca

5. “No one can confidently say that he will still be living tomorrow.”

—Euripides

6. “Be ashamed to die until you have won some victory for humanity.”

—Horace Mann

7. “I have never killed a man, but I have read many obituaries with great pleasure.”

—Clarence Darrow

8. “Death ends a life, not a relationship.”

—Mitch Albom

9. “A thing is not necessarily true because a man dies for it.”

—Oscar Wilde

10. “While I thought that I was learning how to live, I have been learning how to die.”

—Leonardo Da Vinci

12. “Death is the cure for all diseases.”

—Thomas Browne