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Two doctors, two death requests

This is a tale of two doctors, and two dying men.

One Washington, D.C., doctor received a phone call from a 33-year-old AIDS patient who had, according to the Washington Post, "talked of suicide for weeks." He asked for his doctor's help. So the doctor went that evening to his patient's home and showed the man's lover how to kill with morphine. Six hours later, the patient was dead.

About the same time, Dr. Carlos Gomez of the University of Virginia Medical Center received a similar request from a young man with acquired immune deficiency syndrome. But Gomez's response was 180 degrees opposite: He told his patient he always interprets a suicide request as a cry for help. He changed the patient's medical routine, started morphine, and gave the man the private phone numbers for both his beeper and his home.

Two cries for help; two responses: Which was the caring one? That's the question we face in the debate over "assisted suicide." Two lower courts have ruled that a lethal injection is a constitutional right. The American Medical Association, by contrast, has reaffirmed its opposition to physician-assisted suicide. The question seems headed for the Supreme Court. In the court of public opinion, the battle already rages.

Efforts to slow our rush to euthanasia are producing _ as this week's cover story of the New York Times Magazine put it _ "an odd coalition" of agnostics and believers, anti-abortion factions and abortion-rights advocates, "AIDS activists and Orthodox rabbis, the American Medical Association and Pope John Paul II."

Listen to these diverse voices. They include people such as Herbert Hendin, a psychiatrist and co-founder of the American Suicide Foundation, who traveled to the Netherlands (where assisted suicide is legal) and brought back horror stories: a depressed 50-year-old woman, otherwise healthy, who asked to be (and was) put to death two months after she lost a son to cancer; a sick man who requested death after his wife offered him the options of a nursing home or euthanasia. Hendin is particularly troubled by the effect of legalized killing on doctors: "The first assisted suicide may give them a moment's pause. The second is easier. It eventually turns into a kind of compulsion."

Or Yale Kamisar, a University of Michigan law school professor and ACLU member, who notes, "flabbergasted": "If assisted suicide went through, we'd be providing more safeguards for criminals picked up on the street than we would for the terminally ill."

Or Kathleen Foley, a pain specialist for New York's Memorial Sloan-Kettering Cancer Center, who notes, "It's a well-documented fact that those asking for assisted suicide almost always change their minds once we have their pain under control."

Or Linda Emanuel, who just left Harvard Medical School to become director of the AMA's Institute for Ethics: The suicide debate, she says, "is a defining moment in medicine. If doctors are allowed to kill patients, the doctor-patient relationship will never be the same again."

Or Daniel Callahan, an ethicist at the Hastings Center, who puts the self-glorifying stance of the Dr. Kevorkians in perspective: "The Nazi doctors felt they were doing something patriotic. People who assist suicides ought to have a problem; that they don't and cast themselves as heroic _ that's the problem."

Caring for the ill, as Dr. Gomez does, is so much more difficult, time-consuming and expensive than just killing them. If suicide is permissible, it will soon become morally, if not legally, mandatory. It already is in the Netherlands, notes Hendin; "It was almost as if you were a poor sport for not choosing it."

Mercy or murder? The stakes are high: What kind of people are we? And, what kind of people will we soon become?

Maggie Gallagher

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