Prescribing Death - Euthanasia Exposed
Proposals to legalize physician-assisted suicide have triggered intense legal, medical and social debate in the United States. For some Americans, the debate is fueled by their fear that medical technology may someday keep them alive past the time of natural death. However, this concern is unfounded for mentally competent adults who have a legal right to refuse or stop any medical treatment. It is also important to recognize that today’s health care climate lends itself more to undertreatment than overtreatment.
However, the present debate is not about refusing treatment or taking extraordinary measures. The issue is whether physicians should be allowed to intentionally kill their patients, either by providing the means of death or ending the patient's life by the doctor’s hands. There is a tremendous distinction between allowing someone to die naturally when medical technology cannot stop the dying process and causing someone to die through assisted suicide or euthanasia. The question is one of intent: Is the intention to cause the death of the patient?
The terms “physician-assisted suicide” and “euthanasia” are often used interchangeably. However, the distinctions are significant. The act of physician-assisted suicide involves a medical doctor who provides a patient the means to kill himself or herself, usually by an overdose of prescription medicine.
Meanwhile, euthanasia in the true sense of the word involves the intentional killing of a patient by the direct intervention of a physician or another party, ostensibly for the good of the patient or others. The most common form of euthanasia is legal injection. Euthanasia can be voluntary (at the patient’s request), nonvoluntary (without the knowledge or consent of the patient) or involuntary (against the patient's wishes).
The current policy debate in the United States involves physician-assisted suicide - not euthanasia. However, the only available data on the subject comes from a country where the two practices go hand-in-hand. In the Netherlands, physicians engage in both euthanasia and physician-assisted suicide, generally without fear of prosecution. Nonetheless, two Dutch studies document that the practice of euthanasia is 10 times more common than physician-assisted suicide. What is even more disturbing in the Dutch studies is that among all euthanasia deaths in 1990 and 1995, approximately one quarter involved patients who did not give their explicit consent to be killed.
Could the abuses witnessed in Holland be repeated in the U.S.? Escalating health care costs coupled with a growing elderly and disabled population set the stage for an American culture eager to embrace alternatives to expensive, long-term medical care. The so-called "right to die" may soon become the "duty to die" as our senior, disabled or depressed family members are pressured or coerced into ending their lives. The move toward managed care also threatens to promote euthanasia as more and more doctors are offered financial incentives to decrease the number of health care dollars spent per patient.
Another concern among opponents of physician-assisted suicide is that legalizing the practice will make patients vulnerable to coercion by family members who are motivated by fear or greed. Physician-assisted suicide also threatens the doctor-patient relationship by endangering the trust patients have in their physician.
The terminally and chronically ill do not need physician-assisted suicide. They need a physician to treat their depression, pain and other symptoms. Treatable depression is a critical factor among terminally ill individuals who wish to commit suicide. Studies have determined that more than 95 percent of individuals who have committed suicide suffered from depression or another psychiatric illness when they killed themselves.
Terminally ill patients do not need to suffer a painful death. Physicians who specialize in treating patients in pain report that today’s pain- and symptom-management techniques can provide substantial relief for up to 95 percent of the patients treated. In addition, these same techniques can lessen the effects of pain and other symptoms for all patients. Today’s pain-management techniques are so effective that, when applied correctly, experts say patients change their minds about seeking assisted suicide.
People living with terminal illness deserve more than the offer of a physician to facilitate their death. They merit true compassion. Focus on the Family encourages accessing expert palliative care — treating the symptoms and making the patient as comfortable as possible during the natural dying process. Palliative care differs from acute care in that it becomes appropriate when aggressive therapies are no longer beneficial to the patient and there is no longer an attempt to cure the disease.
We need to remove the barriers that prevent patients from receiving available treatments for pain and other symptoms — not alleviate the safeguards that protect patients from psychological or financial coercion to choose an untimely death. Our goal should not be to legalize physician-assisted suicide but rather to adequately provide available means of care so that patients and their families do not feel the need to consider an early death.
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