Why should anyone—the state, the medical profession, or anyone else—presume to tell someone else how much suffering they must endure while dying? Doctors should stand with their patients, not against them.
- Dr. Marcia Angell
This statement gets right to the heart of the matter, doesn’t it? People deserve more options at the end of their lives and doctors should be allowed to help their patients get the end-of-life care they want.
Dr. Angell is former editor of the New England Journal of Medicine and a senior lecturer at Harvard Medical School. Her quote is from a guest article published in the Health & Wellness section of the Boston Globe. Throughout her life, Dr. Angell has had extensive professional and personal experiences with difficult end-of-life care decisions. These experiences have shaped why she supports safe and legal assisted dying through Death with Dignity laws.
From time to time, she encounters medical colleagues who disagree with her positing, “a doctor’s role is only as a healer.” In the article, she addresses this concern:
When death is imminent and dying patients find their suffering unbearable, then the physician’s role should shift from healing to relieving suffering in accord with the patient’s wishes. This is not a matter of life versus death, but about the manner of dying, and it’s not primarily about doctors, but about patients.
Another common claim Dr. Angell has encountered is, “Good palliative care can relieve all suffering, so permitting assisted dying is unnecessary.” She counters with several facts:
Probably most dying patients, even when suffering greatly, would choose to live as long as possible. That courage and grace should be protected and honored, and we should put every effort into treating their symptoms. (Palliative care in Oregon is among the best in the country.) But not all suffering can be relieved. Most pain can, but other symptoms can be harder to deal with—symptoms such as weakness, loss of control of bodily functions, shortness of breath, and nausea—and the drugs to treat them often produce side effects that are as debilitating as the problems they treat. Even worse for many patients is the existential suffering. They know that their condition will grow worse day after day until their deaths, that their course is inexorably downhill, and they find it meaningless to soldier on.
This echoes how Dr. Kate Morris explained the Hippocratic Oath in one of her interviews in the documentary How to Die in Oregon:
“First do no harm” is going to be different for every patient. Harm for some patients is saying, “No, no, no. You’ve got to do this the way your body decides as opposed to the way you decide.”
Death with Dignity laws are about giving patients more options for their end-of-life care. As Dr. Angell explains, “No physician is required to participate in assisted dying; he or she may refuse for any reason whatsoever. This is a choice, not a requirement, for both patients and physicians.”
The entire process is voluntary for all involved—patients, physicians, and pharmacists. Truly, why would anyone feel it’s their place to deny a dying person as many options as possible? Whose life is it anyway?
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