Helping Patients End Their Lives Cannot Be Justified

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By Stanley L. Bukowski

The New York State Legislature is again considering legalizing physician-assisted suicide. Advocates claim it is a needed option for patients suffering at the end of life. But helping patients end their own lives is no answer.

Oregon provides our most extensive data on assisted suicide, back to 1998. The most frequent reasons cited are: less able to engage in enjoyable activities, loss of autonomy, loss of dignity, losing control of bodily functions and being a burden to others. Pain is a distant sixth. So it is not about pain. It is about personal losses.

Pain can be controlled. A prominent Buffalo anesthesiologist told me, “I can control anyone’s severe pain. But they have to accept they may die sooner from my treatment.” And that is ethically OK. To die sooner as an unintended secondary effect of necessary pain treatment, even treatment to the point of unconsciousness, is ethical.

What is not ethical is intentionally ending the patient’s life, even if the patient requests and ingests the dose.

Why? Because terminal illness and its suffering do not justify killing, even oneself. Intentional death then becomes a treatment, and the reasons and ways to use it expand. Look at Oregon’s House Bill 3337 (2015), Senate Bill 893 (2017) and House Bill 2232 (2019). In 2022, Oregon removed the residency requirement for assisted suicide. Vermont has also. There is indeed a slippery slope.

Yes, Canada is far down that slope. They kill 10,000 patients a year now. They need not be terminal. Almost all die by a doctor’s infusion: direct euthanasia. U.S. states are following, just more slowly.

The organization Compassion and Choices promotes assisted suicide but disclaims euthanasia. But it cannot stop euthanasia, once assisted suicide is legal. Its “safeguards,” such as terminal illness and self-ingestion, will be deemed “barriers” to “treatment.” As one assisted suicide advocate wrote in The Buffalo News, “Suffering is something to be defined by each patient.” So how long can society refuse the patient who is no-terminal or cannot self-ingest, but says his suffering warrants intentional death?

Self-defined suffering eventually becomes the only criterion. Any other criteria are deemed barriers and oppressive. And then, shown so frighteningly in Canada, those with illness-related disability, dependence and isolation, who exist on the margins of society due to inadequate medical and social supports, increasingly turn to intentional death out of grinding despair. Government and assisted suicide advocates state that the problem of supporting them is “solved.”

Western medicine has rejected intentional death for 2500 years. We need that guardrail. The trajectory of intentional death in assisted suicide states is far from settled. New York is wise to reject assisted suicide. It is bad medicine for patients, families and society.

Dr. Stanley L. Bukowski is an internist based in Alden.

Source: “Another Voice: Helping patients end their lives cannot be justified”

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