(originally published as a Statement for the BBC)
For a print version, click here.
by William Toffler, MD
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There has been a profound shift in attitude in my state since the voters of Oregon narrowly embraced assisted suicide 11 years ago. A shift that, I believe, has been detrimental to our patients, degraded the quality of medical care, and compromised the integrity of my profession.
Since assisted suicide has become an option, I have had at least a dozen patients discuss this option with me in my practice. Most of the patients who have broached this issue weren't even terminal.
One of my first encounters with this kind of request came from a patient with a progressive form of multiple sclerosis. He was in a wheelchair yet lived a very active life. In fact, he was a general contractor and quite productive. While I was seeing him, I asked him about how it affected his life. He acknowledged that multiple sclerosis was a major challenge and told me that if he got too much worse, he might want to “just end it.” “ It sounds like you are telling me this because you might ultimately want assistance with your own assisted suicide- if things got a worse,” I said. He nodded affirmatively, and seemed relieved that I seemed to really understand.
I told him that I could readily understand his fear and his frustration and even his belief that assisted suicide might be a good option for him. At the same time, I told him that should he become sicker or weaker, I would work to give him the best care and support available. I told him that no matter how debilitated he might become, that, at least to me, his life was, and would always be, inherently valuable. As such, I would not recommend, nor could I participate in his assisted-suicide. He simply said, "Thank you." The truth is that we are not islands. How physicians respond to the patient’s request has a profound effect, not only on a patient's choices, but also on their view of themselves and their inherent worth.
Since assisted suicide has become an option, I have had at least a dozen patients discuss this option with me in my practice. Most of the patients who have broached this issue weren't even terminal.
One of my first encounters with this kind of request came from a patient with a progressive form of multiple sclerosis. He was in a wheelchair yet lived a very active life. In fact, he was a general contractor and quite productive. While I was seeing him, I asked him about how it affected his life. He acknowledged that multiple sclerosis was a major challenge and told me that if he got too much worse, he might want to “just end it.” “ It sounds like you are telling me this because you might ultimately want assistance with your own assisted suicide- if things got a worse,” I said. He nodded affirmatively, and seemed relieved that I seemed to really understand.
I told him that I could readily understand his fear and his frustration and even his belief that assisted suicide might be a good option for him. At the same time, I told him that should he become sicker or weaker, I would work to give him the best care and support available. I told him that no matter how debilitated he might become, that, at least to me, his life was, and would always be, inherently valuable. As such, I would not recommend, nor could I participate in his assisted-suicide. He simply said, "Thank you." The truth is that we are not islands. How physicians respond to the patient’s request has a profound effect, not only on a patient's choices, but also on their view of themselves and their inherent worth.
