By Dr. David Kim
As a physician engaged in direct patient care, legislation (A.2383-A/S.3151-A.) that would legalize assisted suicide in New York is of grave concern to me, and I oppose it. So does the Medical Society of the State of New York (MSSNY), the state’s principal non-profit professional organization for physicians, residents and medical students of all specialties.
The MSSNY recently put out a statement saying: “MSSNY’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. Although relief of suffering has always been a fundamental duty in medical practice, relief of suffering through shortening of life has not. Most physicians are deeply troubled by the potential abandonment of a patient by their physician at their time of greatest need of their physician’s skill and caring.”
As a medical professional serving a significant number of people with disabilities, of advanced years, and in low-income situations in the city of New York, I believe that the power of medicine should never be used against vulnerable patients who look to physicians like me for affirmation, love, support and professional guidance in their times of greatest need. It is deeply disturbing to see patients at their most vulnerable point be encouraged, either directly or indirectly by the words of their physician, to consider ending their lives. My patients trust me to do what is in their best interest. With this proposed legislation, I would have the power to write a lethal script, that is, to help my patients kill themselves, disguised as medical “treatment.”
I would also have to lie on their death certificate—a key part of the medical record—and compromise my ethical responsibility to only document the truth. Procedural lying on the death certificate with no external accountability allowed on medical records (which are routinely scrutinized everywhere else to protect the patient, by the way) – scares many of my patients. It scares me too – how would our profession ever be able to maintain what little trust and relationship our patients have with us already?
Rather than upending the medical professional’s role of healing and allow physicians to functionally abandon their patients, we urge the legislature to remove barriers to accessing palliative and hospice care; improve the delivery of health care in hospitals, nursing facilities and at home; and encourage advance care planning. There needs to be a more thoughtful conversation on how to help patients live well until they die, not systemically and socially encourage their death and, ultimately, devalue people with chronic, life-threatening illness and/or disability. In Myers vs. Schneiderman, New York courts were exactly right to reference a standard Merriam-Webster dictionary to describe the process under deliberation as “suicide.”
Because practically, what this law will do is allow physicians to legally give medicines to a patient who will use them to kill himself or herself. And there are many of us in the medical community who are not willing to become partners in this legal and ethical conundrum, nor are we ready to wordsmith the obvious to make ourselves feel better about participating in our patient’s suicide.
We must, for the sake of the most vulnerable, think about the many at risk of deadly harm by a dangerous public policy. This isn’t about a harmless “additional choice.” For the current and future generations, it is truly a matter of life and death.
Dr. David Kim is co-director of the American Academy of Medical Ethics in New York. He resides in Manor Heights.
Source: “Legal assisted suicide dangerous, unethical (commentary),” SILive.com