Arguments for suicide law perpetuate myths.Byline: DANIEL L. PHILLIPS For The Register-Guard LARRY SWISHER swisher Sexology A regional term for a really queer queer, not that there's anything wrong with that , in his Nov. 14 column on physician-assisted suicide Noun 1. physician-assisted suicide - assisted suicide where the assistant is a physician assisted suicide - suicide of a terminally ill person that involves an assistant who serves to make dying as painless and dignified as possible , and the subsequent Register-Guard editorial of Nov. 24, perpetuated several myths about Oregon's law, doing a grave disservice dis·ser·vice n. A harmful action; an injury. disservice Noun a harmful action Noun 1. to critically ill Oregonians. The first myth: Oregon's doctors must demonstrate proof of mental competency mental competency n. (See: competent) in candidates for physician-assisted suicide. The only proof the Oregon Health Division requires is a statement from the physicians involved who prescribe the lethal medication. There is no independent review of medical records; there is no mandated mental health evaluation. If a mental health evaluation is done and finds the patient not a candidate for physician-assisted suicide, there is no requirement that the negative evaluation be submitted. In other words Adv. 1. in other words - otherwise stated; "in other words, we are broke" put differently , those involved can keep seeking a second evaluation, and a third, and so on until they get two physicians to state the patient is a candidate, no matter how many physicians and mental health professionals believe the patient is not. This has in fact happened in at least two cases that we know about since Oregon's law went into effect. The second myth: Because the physician and patient mutually consent to assisted suicide assisted suicide: see euthanasia. , it follows that it should be permitted. This ignores the complex nature of the physician-patient relationship physician-patient relationship Medical malpractice A formal or inferred relationship between a physician and a Pt, which is established once the physician assumes or undertakes the medical care or treatment of a Pt; the establishment of a PPR is 'automatic' in . An analogous situation is that of consensual sexual activity between a psychiatrist and his or her patient. There is very little disagreement that such behavior is unethical, because the uneven nature of their relationship makes true consent impossible. Not only is the patient taken advantage of, but if we as a community were to grant approval to such behavior, it would fundamentally change the dynamic and expectations for all those who would seek psychiatric help in the future. Dr. Patricia Wesley's critique of the most widely known case of assisted suicide, in a 1993 issue of Law and Medicine, gives insight as to how the psyche of the physician and patient involved in assisted suicide can become intertwined in a way that causes similar damage to society and a fatal outcome fatal outcome, n a consequence that results in death. The course of a disease that results in the death of the patient. for the patient. The third myth: Attorney General John Ashcroft's decision will discourage states and the medical profession from trying to establish safeguards against abuse of physician-assisted suicide. Both Swisher and the editors of The Register-Guard seem to feel that Oregon has brought into the open a practice that occurs regularly, albeit illegally, in other states. If this were true, and I believe it is not, I would ask a question: What assurance can Swisher and the editors give us that the same professionals who feel free to break laws prohibiting assisted suicide will faithfully follow guidelines if the process is legalized? There is no evidence that other states, or the medical profession as a whole, feel that there is any role for physician-assisted suicide in the care of the seriously ill A patient is seriously ill when his or her illness is of such severity that there is cause for immediate concern but there is no imminent danger to life. See also very seriously ill. . The American Medical Association American Medical Association (AMA), professional physicians' organization (founded 1847). Its goals are to protect the interests of American physicians, advance public health, and support the growth of medical science. is on record as opposing physician-assisted suicide, 10 states have strengthened laws explicitly prohibiting physician-assisted suicide, and two states voted down laws similar to Oregon's. Apparently, the rest of the country feels the best way to protect patients from abuse of physician-assisted suicide is to prohibit it. The most dangerous assertion Swisher makes is that the Ashcroft decision will lead to actions against doctors whose treatment of pain hastens or causes death. Ashcroft sent a letter on Nov. 6 to the Oregon Medical Association that clearly contradicts this. The exact wording: "I want Oregon's doctors to know that under this decision, they will have no reason to fear that the prescription of controlled substances to control pain will lead to increased scrutiny by the (Drug Enforcement Administration The Drug Enforcement Administration (DEA) was established in 1973 by President richard m. nixon as part of the Justice Department, thus uniting a number of federal drug agencies that had often worked at cross-purposes. ), even when high doses of painkilling drugs are necessary and even when dosages needed to control pain may increase the risk of death." The Ashcroft letter puts the federal government on the record, for the first time, as saying that treatment of severe pain with controlled substances that results in the unintended death of the patient is not a violation of federal law. Reading that letter, which was sent to every Oregon physician, should allow physicians to continue in their proper role of relieving suffering, improving palliative care palliative care (paˑ·lē·ā·tiv kerˑ), n an approach to health care that is concerned primarily with attending to physical and emotional comfort rather , and understanding the concerns of the dying, and to turn away from deliberate, state-sanctioned ending of life. Daniel L. Phillips is a Eugene physician. |
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