- - Wednesday, May 9, 2018


It is no surprise to me that, a whole year after the District of Columbia enacted a law to allow assisted suicide, just two out of approximately 11,000 licensed D.C. physicians are willing to participate. On top of that only one hospital has cleared doctors to participate. The law allows patients with a prognosis of six months or less to be prescribed by a doctor a fatal dose of drugs to end their life. This law is flawed and dangerous for many reasons that would give anyone pause, but especially someone who has dedicated their life to healing.

For millennia, a physician’s focus has been on sustaining life and healing patients who approach him or her for care. Assisted suicide laws distort that traditional focus, medicalizing actions which lead to death and have no place in the physician-patient relationship. How can trust between patients and their doctors survive when the healer is willing to play a direct and deliberate role in causing their patient’s demise?

Participating in suicide runs directly counter to our calling. Patients may choose not to pursue every one of the therapeutic options we offer, but our role and duty require that we, without prejudice to a person’s age, disability status or illness, provide our patients with each of the healing and comfort care measures at our disposal to the best of our abilities.

With this ill-advised public policy, the state has also created an ugly two-tier system, where the young, the able and the well get suicide prevention and people with treatable but deadly disabilities or chronic life-threatening illnesses get suicide “help.” We physicians cannot, in good faith, do the same. If we did, we would undercut the very thing that sustains us in our profession — sustaining the life and health of our patients.

It is tragic that legalizing assisted suicide sanctions discrimination against people with illnesses, disability or advanced years. Making death available to these groups relies on the assumption that dependency and the need to be cared for at the end-of-life is something too burdensome, perhaps even revolting, to those surrounding the patient who do not fall into those same groups. As the Oregon data show, feeling like a burden to others is one of the top reasons given for why people asked for lethal drugs in the first place.

To enshrine in the law, a concept that those who are dependent on the care of others should be enabled and even encouraged to seek assisted suicide is the worst form of “ableism” — it characterizes their needs as an unwelcome burden that can only be relieved by their death.

The D.C. assisted suicide law, like all other assisted suicide laws, contains spurious “safeguards,” which cannot adequately protect patients and cannot be controlled. With these laws, even the act of self-termination (suicide) is legally forbidden from being listed on a death certificate. That is not only a falsehood required of the physician, but it also makes tracking of the practice nearly impossible. The door is thereby left wide open for abuse. Anyone can see that the falsifying a death certificate is not really a protection for the patients but for th ose doctors who cannot be sued or subjected to criminal penalties when acting within this law.

Assisted suicide advocates will often say that these laws that allow this practice will be taken advantage of by only a few. But for these few, we must place a far greater number at risk of having their lives devalued, and deemed suitable for early termination. Assisted suicide is the ultimate “special interest bill.” People of advanced years, persons with disabilities, both physical and developmental, and people who experience depression all find themselves at a much higher risk of being placed, against their will, in that “second class” of people who do not receive the equal protection of suicide prevention and who are systematically and legally degraded.

One prominent national assisted suicide advocacy group blames a “cumbersome process” for dissuading doctors from participating. For each of the reasons mentioned here, and others, I am not convinced.

Assisting in suicide is an all-out assault on both patients and the profession of medicine. While proponents of this lethal practice point to real human suffering at the end of life, unfortunately, they offer a cure worse than the disease.

G. Kevin Donovan is a physician and director of the Pellegrino Center for Clinical Bioethics and professor at Georgetown University Medical Center.

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