Thursday, September 10, 2009

Dropping the "Assisted" from Assisted Suicide


The New York Times, the venue wherein Peter Singer often finds a soapbox, has sometimes countered his utilitarian approach to life with several other pieces which present a more rational point of view.

Columnist Russ Douthat recently wrote "A More Perfect Death," a piece on the effort in Montana to have that state join Oregon and Washington in implementing physician-assisted suicide. An interesting reference in the article referred to thoughts from Dr. Ezekiel Emanuel.
Consider the words of a prominent oncologist, bioethicist and health care wonk, critiquing assisted suicide in 1997, just before a Supreme Court ruling on the issue. “Once legalized,” this writer warned in the pages of The Atlantic, “euthanasia would become routine. Over time doctors would become comfortable giving injections to end life and Americans would become comfortable having euthanasia as an option.” From there, it would be an easy slide to euthanizing the incompetent: “Comfort would make us want to extend the option to others who, in society’s view, are suffering and leading purposeless lives.”
The piece is especially interesting when read in conjunction with a longer piece in the New York Times Magazine about what may or may not have happened in a besieged New Orleans hospital during Hurricane Katrina.

That piece is relevant, I think, because once "physician-assisted suicide" becomes part of a doctor's toolkit, his responsibility as written down in the book of healing arts, the doctor might find himself in circumstances wherein he might rationalize that the "assisted" is assumed.

I think that happened in New Orleans. And I think it happened because the doctors were weak and fatigued, and gave in to an act they instinctively knew was improper.

And I believe the writer of the Katrina piece wanted readers to understand that the hospital's doctors were wrong. Criminal? Apparently not, at least so far as discovered by proceedings so far. But surely a moral and professional failure, which can be accepted with or without rancor.

People fail. Doctors are people.

Central to my reading was the discussion of triage in the Fink article. The doctors at the hospital corrupted that rational and ultimately empathetic practice.

Triage, as a moral choice, would have meant to sedate the "not expected to survive" group and then leave them behind for possible rescue later. That would be triage. What happened was homicide.

What I most regret is not that the central actor in this drama escaped criminal indictment. Instead I despair that her action has apparently has projected upon her some sort of expertise that allows her ideas to be taken seriously.
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