Wednesday, December 7, 2011

McDeathmobile: "Would You Like Fries with Morphine Overdose?"

image from Wikipedia.org
Viktor Frankl, a concentration camper survivor, once wrote, "Everything can be taken from a man or a woman but one thing: the last of human freedoms to choose one's attitude in any given set of circumstances, to choose one's own way."

That's not a particularly original thought, but it is expressed in a sophisticated way, and it's a valid method of making one's way through the world without being trapped in a constant fog of bitterness.

I often think of it when I think of the assisted suicide movement. In today's Daily Mail, a newspaper in Great Britain, there is a story about the expansion of assisted suicide in the Netherlands.
The Dutch government is considering plans to use mobile medical teams which would administer euthanasia to people in their homes.
The units, dubbed 'grim reapers on wheels' by critics, will be called in to kill patients when their own GPs refuse to administer lethal drugs.
The mobile teams of doctors and nurses would be sent out from a clinic following a referral from the patient’s doctor.
The story was balanced enough, even noting that physicians were euthanizing (killing, depending on your point of view) "dementia sufferers, including Alzheimer’s victims," hardly a population capable of making an informed consent.

If Frankl is correct, a rational person must agree that suicide is the ultimate means of "choosing one's own way." I have known several people who committed suicide, but I have never known their heart, nor even if they sought help, or even if the method they chose caused them pain. Still I cannot bring myself to support an organized effort by government or by private party (meaning groups like the Hemlock Society) to put in place a formal process wherein other human beings participate in the death.

The Netherlands, and Oregon (the state in the USA where the option has been legalized), require two professionals to acknowledge the person is making a correct decision. But human beings, including medical doctors, are fallible, and more often than not make choices -- even for others -- based upon their own emotional and intellectual outlook. While not so elegantly phrased as Frankl, the aphorism of "If you have a hammer, every problem becomes a nail" applies. Or to focus on one purveyor: if you approach the Hemlock Society for help in committing suicide, you cannot expect their representatives to counsel  you about other options to be considered first.

I began thinking about this today again not only because of the proposed changes in the Dutch law but also because of an opinion piece in The Providence, a Canadian newspaper. It has been circulating among disability activists, and it is from a physician who had a patient in common with another physician. The writer was asked to concur in a prescription for an assisted suicide for the patient who had undergone cancer treatment and become depressed because he could no longer hike as he had before treatment. 

The writer notes, "I told her that I did not concur and that addressing his depression would be better than simply giving him a lethal prescription. Unfortunately, two weeks later my patient was dead from an overdose prescribed by this doctor."

That's a doctor doing what's called "doctor shopping," which would land me in jail if I undertook such an enterprise to increase the amount of prescription pain relievers I am allowed. Perhaps it isn't criminal, but certainly an example of the I own a hammer, so you've gotta be a nail ideal and why a person might be influenced at a time when most vulnerable.
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