A doctor's view of assisted suicide

By DR. ALAN STEINBERG- | Comments: 0 | Leave a comment

As a specialist in geriatrics and one who cares for patients and families for whom it is not a theoretical discussion, I have a unique perspective on the issue of physician-assisted suicide, and wish to add my voice to the discussion concerning legalization.

The appeal of the position supporting physician-assisted suicide is obvious. Who would not want to show what would be considered mercy and compassion to those in need of relief of their suffering?

The reality, however, is much more complex and cannot and should not be reduced to such a simple argument.

It is well established that the vast majority of individuals who lose the will to live are suffering from a treatable illness - that of clinical depression -- which, while not caused by their often horrific circumstances, has increased their pain. With treatment, most of those individuals are freed from much of their suffering and can live out their lives in comfort.

To assume that the majority of individuals who request assisted suicide are of sound mind by definition ignores the reality of the role depression and pain play in their anguish and, yes, their decisions.

In addition, I know of none of my colleagues who have been asked whether they would like to have foisted upon them a new and distinct role: that of suicide assistant, as opposed to caregiver, healer and alleviator of pain.

It would be foolish for a public which already distrusts the healthcare system to give this new and quite frankly awesome responsibility to physicians, most of whom may not want it. Would it also not potentially change, at least in the minds of some, the way their physician is viewed?

This, in and of itself, is worthy of lengthy discussion and debate.

The desire to alleviate suffering is laudable, but it must also be asked: Just who is suffering? Is it not also the spouse of the patient with Alzheimer's disease -- often, moreso than the patient themselves? Ask your physicians how often they have been asked to alleviate suffering, and ask them as well if they have ever questioned just whose suffering they are being asked to alleviate.

Physicians and other healthcare providers need to continue to be trained to identify the myriad forms which depression takes, and to be better able to treat it and manage pain, as well. Rare is the young doctor who chooses to go into geriatrics or palliative care; there are just too many disincentives at present, and these specialties are grossly underserved.

As a society, we need to better address these compelling public health issues intellectually, and not simply through an appeal to emotions alone. [[In-content Ad]]