By Dr. Thomas J. Madejski
Most physicians are deeply troubled by the potential abandonment of patients when they are in their greatest need of our skill and compassion.
As president of the Medical Society of the State of New York (MSSNY), I know that the aid in dying proposal before the state Legislature is a very complicated, personal and controversial issue within our membership. There are passionate physicians on both sides making well-reasoned arguments. The Medical Society’s long-standing position against “aid in dying” is based upon the sacred principle that physicians are dedicated to healing and preserving life, not ending it. Nor does it appear MSSNY will change that position anytime soon based on a recent membership survey we conducted.
“Patients, with terminal illness, uncommonly approach their physicians for assistance in dying including assisted suicide and euthanasia. Their motivations are most often concerns of loss of autonomy, concerns of loss of dignity, and physical symptoms which are refractory and distressing. Despite shifts in favor of physician-assisted suicide as evidenced by its legality in an increasing number of states, physician-assisted suicide and euthanasia have not been part of the normative practice of modern medicine. Compelling arguments have not been made for medicine to change its footing and to incorporate the active shortening of life into the norms of medical practice. Although relief of suffering has always been a fundamental duty in medical practice, relief of suffering through shortening of life has not. Moreover, the social and societal implications of such a fundamental change cannot be fully contemplated. MSSNY supports all appropriate efforts to promote patient autonomy, promote patient dignity, and to relieve suffering associated with severe and advanced diseases. Physicians should not perform euthanasia or participate in assisted suicide.”
Assembly Bill 2383-A would permit a terminally ill patient to request medication from a physician to be self-administered for the purpose of hastening the patient’s death. Until such time as the law changes, aid in dying or assisted suicide by a physician is still illegal in New York state. The Court of Appeals’ Myers v. Schneiderman decision in September 2017 reaffirms this.
Although relief of suffering has always been a fundamental duty in medical practice, relief of suffering through shortening of life has not. Physicians are very concerned about the possibility of writing a prescription for a lethal dose of medication for a terminally ill patient. They have great apprehension that such a measure would negatively impact health care among racial and ethnic minorities and the physically disabled. Equally troubling are physician concerns that this measure would negatively impact the implicit trust between physicians and their patients.
First and foremost, I believe that we need to create an environment that eliminates the desire for a patient to contemplate ending their life due to fear of inadequate care at the end of their life. Equally troubling are physicians’ concerns that such a measure would have a negative impact on trust between the physician and patients.
MSSNY is committed to work with physicians and groups on both sides of this difficult question to continue to improve the access to and the quality of palliative care for all of our patients, particularly in their last days.
Dr. Thomas J. Madejski is president of the Medical Society of the State of New York.
Source: “Commentary: Shortening life to end suffering is troubling”, TimesUnion.com