MEDIA ADVISORY: 11.02.12 Daniel Callahan and Marcia Angell on Death with Dignity Ballot Initiative
(Garrison, NY) New commentaries by Daniel Callahan, cofounder of The Hastings Center, and Marcia Angell, M.D., senior lecturer in social medicine at Harvard Medical School, give opposing views on the Massachusetts ballot initiative to legalize physician assistance in dying. The commentaries appear on Over 65, a Hastings Center’s blog for and about seniors seeking solutions for health care and security
Callahan opposes the Death with Dignity Act and Angell is its lead petitioner. Massachusetts residents will vote on the initiative on Election Day.
“Some 30 years or so ago I was far more sympathetic to euthanasia and physician assisted suicide (PAS) than I am now, and will use this occasion to say why I changed my mind, growing slowly disillusioned,” writes Callahan in “By Any Other Name: Physician-Assisted Suicide.” He points to the experience in the Netherlands, where an anonymous survey of physicians’ practices on euthanasia and PAS revealed that fewer than 50 percent of doctors had been reporting, as required by law, that they performed either act. And in some 1,000 instances, they had performed euthanasia without patient consent.
“The point of the comparison,” Callahan writes, “is that ever since Oregon and Washington legalized PAS, it has been claimed by the state and advocacy groups that there have been no abuses. Perhaps that is true, but we will not know for sure until there is an anonymous physician survey.”
Callahan also takes issue with the notion that dying with the aid of physician-prescribed drugs is dignified. “Physician assistance is sought, I believe, because it confers the legitimacy we usually ascribe to physician skills and competence,” he writes. “But I am not enthused about that form of legitimacy: doctors are far more skilled than the rest of us in knowing how they can directly kill us or give us drugs to do it for ourselves, and their authority should be severely limited to do so.”
In “Death with Dignity: A Response to Daniel Callahan,” Marcia Angell, former editor-in-chief of the New England Journal of Medicine, notes that good palliative care is sufficient for most dying patients, but not all, and that patients who are terminally ill and close to death should have the option to hasten their death.
“As someone whose father shot himself rather than continue to endure a protracted death from cancer of the prostate, I agree with Callahan that his death was no less dignified than if he had had the option of physician-assisted suicide and chosen that instead,” she writes. “It was also no less dignified than if he had chosen to die from his cancer. It seems to me that what is or is not “dignified” is entirely up to the patient who is experiencing the suffering.”
She cites two important points: that the law applies only to patients with fatal illnesses which will cause their death in a matter of months and that no doctor is required to comply with a request for assisted dying.
She concludes: “There is something bullying about telling dying patients who are in agony and asking for a quicker death that they must continue to soldier on. More than any other personal decision I can think of, this one belongs with the patient.”
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