Physician-assisted suicide raises ethical questions for doctors

Supreme Court
Neil M. Gorsuch's nomination to the Supreme Court has elevated the debate about the ethics of physician-assisted suicide.

The ethical questions surrounding physician-assisted suicide are back in the headlines with President Donald Trump’s choice of Neil M. Gorsuch, who is on record as deeply opposing assisted death, to the Supreme Court.

Gorsuch wrote a book, “The Future of Assisted Suicide and Euthanasia” in 2006, which made it clear he is in favor of keeping laws that ban assisted death and euthanasia, according to Medscape. "It is an argument premised on the idea that all human beings are intrinsically valuable and the intentional taking of human life by private persons is always wrong," Gorsuch wrote.

His nomination to the country’s highest court raised alarm among proponents of physician-assisted suicide, including the advocacy group Compassion & Choices, which said confirmation of Gorsuch would weaken the right of individuals to make their own personal healthcare decisions and vowed a legal and grassroots fight against his appointment.

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But a Gorsuch confirmation may not have much effect on the national debate over physician-assisted suicide because it is states that have decided the issue, Arthur Caplan, Ph.D., director of the division of medical ethics at New York University Langone Medical Center in New York City, told Medscape.

Since Oregon passed the Death With Dignity Act in 1997, four additional states—Washington, Vermont, California and most recently Colorado—have passed laws that allow physician-assisted death for terminally ill adults.

Yet Congress may, in fact, weigh in on the issue. On Monday, the House Oversight Committee will mark up a bill that would block the District of Columbia’s Death With Dignity Act from becoming law, according to dcist.com. If passed by the House and Senate and signed by the president, it would prevent the District from implementing the measure passed by the D.C. Council and signed by its mayor that allows physicians to prescribe life-ending drugs to terminally ill patients who have less than six months to live, the report said.

The question of aid-in-dying does raise ethical questions for doctors who argue they should ‘do no harm’ and not be involved with helping speed up a patient’s death. Doctors should not be forced to participate and state laws make that clear, Howard Grossman, M.D., an internist in New York and New Jersey whose practice focuses on HIV/AIDS and LGBT medicine, told Caplan in a separate Medscape interview. “But no, I do not believe that it violates the oath to do no harm. I believe we do harm to people when we force them to go through the dying process because somehow we think it is a beautiful thing. I believe it is the individual's choice,” Grossman said.

In Massachusetts, a terminally ill physician, Roger M. Kligler, M.D., has filed a lawsuit against the state seeking the right to die using self-administered medication, saying he should be free to determine how much suffering is too much during his final days. Compassion & Choices and a fellow physician, who wants the right to prescribe medications to help patients die without fear of prosecution, have joined in that lawsuit.

Vice President Mike Pence has weighed in on another controversial topic that has raised ethical questions: dying patients' right to access experimental drugs, according to Bloomberg. Pence, a supporter of the so-called right-to-try issue while governor of Indiana, is pushing for a nationwide law that would give terminally ill patients expanded access to experimental drugs that haven’t been approved yet but have made it through the first of three approval phases, the report said.

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