Additionally, by this “non-ruling,” the court has encouraged the contentious and age-old question to surface—should there be only one law of the land, or is an array of state laws the preferable model? The current trend of leaving it to the states will continue until the Supreme Court rules otherwise, and in so doing will have to supersede its previous action.
Explore This IssueMay 2018
The Physician Voice
Lest we repeat the error of our previous ways, physicians should work to insure control of many non-administrative issues such as dying and death, which should be within the dominion of the profession. Since a rendezvous with death is common to all of humankind, shouldn’t medical caregivers—the overseers of dying—be an important part of those discussions that standardize, regulate, and establish the ethics and the legal language applied to the process? I believe they should!
If, however, our leadership avoids the hard work and intellectual tenacity that philosophers, ethicists, sociologists, and legal scholars bring to the discussion table, we will be excluded from crucial social and legal debates. Poets, legal scholars, theologians, and philosophers have written extensively about death and dying, while the people who frequently witness death—physicians, nurses, hospice personnel, and others—rarely write about it. In a similar paradox, the medical profession has changed dramatically in recent times, and much that has transpired has been outside of our control. In my opinion, the failure of cohesive and effective physician leadership has in no small measure been responsible for this state of affairs.
Whatever the extent of the medical profession’s participation in the forthcoming discussion regarding PAS and euthanasia, it must be based on a practical brand of scholarship that possesses the underpinnings of humaneness and morality, while perpetuating an intense value for life. In deciding the future of this matter, the individual physician or lay person must not lose touch with what “feels” right and what “feels” wrong. These instincts are profound in insightful and substantive people, and they provide a moral compass that should generally be followed. From my own personal perspective, if an act or action feels wrong, then it usually turns out to be just that.
It has been said that wrong is always wrong, even though everyone is doing it, and right is always right, even if no one is doing it. While these statements are simplistic given the complexity of contemporary social and human behavior, the spirit of the statements can be borrowed and employed. After all, a physician’s behavior should be founded on a simple and unselfish premise—service to humankind. In keeping with that, is it “mission correct” to provide help in dying, whether by suicide or natural causes? In one form or another, physicians have been helping people die since times of antiquity; the notion of terminal sedation is hardly new. This latter action involves making someone comfortable with repeated small doses of a sedative that increases somnolence, decreases respiration, and invites such things as pneumonia that in turn accelerate the terminal approach to death. If one must classify this action, it probably lies somewhere between passive euthanasia and physician-assisted suicide. In previous writings, I have emphasized the importance of the trust between physician and patient, and this deed, as much as any other, exemplifies the sine qua non of trust!