Proponents of PAS say that people, in face of an inevitable death, deserve the right to end their lives on their own terms, without pain and suffering. Opponents say that a physician taking a role in a patient's suicide violates a fundamental tenet of medicine by contradicting the doctor's role as a healer. Oregon was the first state to legalize PAS, with the passing of the Death with Dignity Act in 1997. Two other states, Washington and Vermont, followed suit. In 18 U.S. states, a majority of votes supported PAS. Interestingly, the researchers said, Oregon and Washington were not in that group.
More than 200 comments were posted, in which readers made arguments to support their beliefs. Many commentators on both sides of the divide agreed that palliative care, including hospice, are important for helping terminally ill patients manage their pain and suffering, both physical and psychological.
Family physician, ethics consultant and CMDA Board of Trustees Member Robert E. Orr, MD, CM : “The New England Journal of Medicine recently reported that in its international poll, two out of three physicians oppose the legalization of PAS. They also reported several years ago on a survey of U.S. physicians that gave similar results.1 The good news: (a) most physicians think PAS is a bad idea; (b) the NEJM is willing to report this in spite of their own editorial support of PAS. However, there is also bad news about such polls.
First, it is well documented that the way polling questions are worded can have a significant effect on the results obtained.2 Equally important, poll results may (or may not) reveal what people think about an issue, but they cannot tell us whether the issue in question is right or wrong.
It is possible to effectively speak against PAS using arguments based on principle, virtue or consequences.3 For the believer, there is a strong additional reason to oppose PAS: each person bears the image of God and we must not intentionally end a human life.
Another piece of good news from the poll results is that most people, whether for or against PAS, agree that excellent hospice/palliative care is the preferred response to end of life suffering.4
1Meier DE, et al. A national survey of physician-assisted and euthanasia in the United States. N Eng J Med 1998;338(17):1193-1201
2Hagelin J, et al. Surveys on attitudes towards legalisation of euthanasia: importance of question phrasing. J Med Ethics 2004;30:521-523
3Orr RD. What are the arguments against legalization of physician-assisted suicide and euthanasia? Today’s Christian Doctor 2011;42(2):30-2
4Orr RD. Pain management rather than assisted suicide. Pain Medicine 2001;2(2):131-137
CMDA Ethics Statement on Physician-Assisted Suicide
Resources on Physician-Assisted Suicide
What are the arguments against legalization of physician-assisted suicide and euthanasia? by Robert D. Orr, MD, CM