Michael H. White, J.D.
Physician-assisted suicide should be a lawful medical procedure
for competent, terminally ill adults, because it is a compassionate
response to relieve the suffering of dying patients. Controversy
about this stems from fear that vulnerable populations may be
coerced into premature death, on the one hand, and from fear that
dying and helpless patients may be either abandoned or subjected
to unwanted and unnecessary medical treatments, on the other hand.
In a workable system, the option of physician-assisted suicide
would arise only after all treatment options are exhausted, the
best of hospice and palliative care has failed to relieve unbearable
suffering, and if a mentally competent patient continues to request
assistance in dying. Then, with outside opinion concurring, a
physician would be permitted to prescribe medication that the
patient could use to hasten death at a time of the patient's choice.
These safeguards would preclude abuse of the handicapped, the
incompetent, minorities, the elderly, or other vulnerable populations.
Patient and family anxiety about future suffering and death would
be reduced; care and comfort at the end of life would be improved.
The individual would be able to make this most private and basic
of decisions personally, without unwarranted and unnecessary intrusion
by the state or religious opposition.
A more rational law than the current ban on assisting a terminally
ill patient who requests help in dying will extend the length
of lives of those who are dying by preventing the suicide of those
who will benefit from relieved suffering.
Tracy E. Miller, J.D.
The two most common reasons that lead people to think about or
to commit suicide, whether they are terminally ill or not, are
untreated pain or depression. Given treatment for pain and depression,
most patients, even those with AIDS or cancer, choose to live
longer, not to kill themselves.
Unfortunately, all too often, physicians are not trained to offer
adequate treatment for pain or depression. As a result, many patients
feel that they have only two possible options: to commit suicide
or to suffer. But good medical care can give patients relief from
pain and control over their medical destiny without creating the
severe risks posed by assisted suicide.
Legalizing assisted suicide would be profoundly dangerous. The
risks would extend to all who are ill, but would be greatest for
patients who lack access to high quality medical care. The gravest
danger is not that physicians or family members will be abusive.
Other risks will be subtle and more common: elderly patients who
worry about being a burden; physicians who are not ill-intentioned
but hurried or insensitive; patients who feel that they have no
other options. What will it mean to patients if physicians recommend
suicide instead of treatment or care? A request for suicide is
often a plea for help. How many doctors know their patients well
enough to hear that plea?
As a society, we must commit ourselves to caring better for patients
at life's end. Authorizing doctors to assist suicide is a simple,
but far more dangerous, solution.