Tuesday, 4 September 2012

Why Doctor-assisted Suicide is a Bad Idea

By John D. O’Brien, S.J.


What do you do when a loved one has a terminal disease, is in prolonged, acute pain, and needs a ventilator and feeding tubes to be kept alive? Have far do we go to prolong life with technology—is the law of sustaining life to only go so far and no further?

This is a perennial and complex question that vexes both private citizens and ethicists, both secular and religious. Thankfully, the Church offers clear teaching on the matter. We can distinguish between ordinary measures, providing food, water and special treatment—including ventilation if there is an expectation of healing and not just the prolonging of death—and extraordinary measures, which might be possible but disproportionate to the expected outcome, and can be opted against. The criteria are both reasonable and compassionate.

As Christians, we are not afraid of natural death, for it is the entry into new life. At the same time, we do not believe that suffering invalidates the inherent value of a human life. As our society increasingly loses its sense of this value, moves to adopt a more Dutch model of assisted suicide are making strides once again. Of note, the British Columbia Supreme Court as well as the Quebec National Assembly recently ruled in favour of legalizing physician-assisted suicide.

In a recent article in The Globe and Mail, a doctor made a passionate plea against going down this road. J. Donald Boudreau, who teaches medicine at McGill University, writes that current legislation and practices do meet the needs of dying patients, and that despite Madam Justice Lynn Smith’s assurance that adequate safeguards would prevent its abuse, doctors should not be conscripted to provide it.

“Our angst is not limited to cases of assisted-suicide,” he wrote. “It is rather that engaging in it alters the mission of medicine. It strikes at the very core of our beings as healers. It would leave an indelible imprint on dialogues with all patients. Our worry is anchored in the deep recognition of the vulnerability of sick persons and the power differential that exists in the doctor-patient relationship.”

Boudreau argues that doctors must not be given this role, for it will taint the rest of what they do, and that they are prone to erroneous judgment like anyone else. The Hippocratic Oath, which has guided the profession for 2400 years, he argues, is more than a quaint tradition, but embodies a broader governing ethic:“do not kill”. He notes that palliative care doctors are among the staunchest opponents of euthanasia, and points out that the Oath’s ethic has been the inspiration for the refusal for the vast majority of doctors to assist in capital punishment, such as providing lethal injections.

While Boudreau believes doctors must keep their vocation as healers untainted, he does suggest creating a new profession, which he calls “euthanatrics” to carry out society-sanctioned suicides—passing the buck, I suggest, on the issue out of fear.

Any discussion on assisted suicide ought to recall the words of Leo Alexander (1905–1985), a Jewish-American physician, who was a medical advisor during the Nuremberg Trials. Alexander wrote:

“The beginnings at first were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the acceptance of the attitude basic in the euthanasia movement, that there is such a thing as life not worthy to be lived. This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, the racially unwanted and finally all non-Germans. But it is important to realize that the infinitely small wedged-in lever from which this entire trend of mind received its impetus was the attitude toward the non-rehabilitable sick.”

It doesn’t take a dystopian scenario, such as that portrayed in the science-fiction film Soylent Green, to affirm that even the most sanitary and pain-free assisted suicide can lead to a general devaluation of human life. Some might argue that a secular society can’t be expected to hold to a more metaphysical or religious-inspired ethic. I say as Christians we must exercise our rights as constitutive members of society, and act as the leaven we are called to be.

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