By Anthony Pivarunas, MD
Traditional medical ethics, as stated in the Hippocratic Oath, as well as in most state laws, prohibit a physician’s involvement in assisted suicide. Public opinion in the U.S. is divided on this issue, even with the Supreme Court stating there is no constitutional right to physician-assisted suicide and that states may prohibit it.
The question is, how does society provide compassion and dignity to terminally ill patients at the end of their lives? This is not a new question; every generation and society has pondered it. New York examined this question before, and, in my opinion, answered it correctly.
Under the foresight of Gov. Mario M. Cuomo, a multidisciplinary Task Force on Life and the Law was assembled in 1985 to make public policy recommendations regarding life-sustaining treatments. In 1994, the task force published, “When Death Is Sought: Assisted Suicide and Euthanasia in the Medical Context.” This comprehensive report presents arguments both for and against assisted suicide; it is as cogent today as it was 23 years ago.
The report’s executive summary was farsighted. Among its highlights: No matter how carefully any guidelines are framed, assisted suicide will be practiced through the prism of social inequality and bias; the growing concern about health care costs increases the risks presented by legalizing assisted suicide; and if assisted suicide and euthanasia are legalized, it will blunt our perception of what it means for one individual to assist another to commit suicide or to take another person’s life.
The task force, comprised of members who held different opinions on the ethical acceptability of assisted suicide and active euthanasia, unanimously recommended that existing law should not change to permit either.
The task force also answered how to provide compassion and dignity to the terminally ill: “As a society, we can do far more to benefit these patients by improving pain relief and palliative care than by changing the law to make it easier to commit suicide or to obtain a lethal injection.”
A central foundation of the medical profession lies in the physician-patient relationship. Patients place their lives in our hands, and we pledge to act in their best interest. This is best embodied in the professional oaths we take.
This critical relationship will be fractured with the legalization of assisted suicide, and is incompatible with the physician’s role as healer.
Many patients will lose trust in physicians if these practices are permitted. Every generation believes it possesses a newfound wisdom, an enlightened status that the previous generation never achieved, so the constraints of the past no longer apply. If we allow it, this false hubris will cause us to make the same mistakes that past generations have made.
In 1994, Cuomo’s Task Force on Life and the Law concluded that a change in law would be “unwise and dangerous public policy.” My hope is that Gov. Andrew M. Cuomo will heed the wisdom of his father and preserve the present law.
Anthony Pivarunas, D.O., is an OB-GYN physician practicing at Catholic Health.