Hastings Center News
The “‘Ripple Effect” of Suicide: Hastings Center Cofounder Argues Against Physician Aid in Dying
Is it appropriate for physicians to help patients end their lives? In the current issue of Southern Medical Journal, Hastings Center cofounder Daniel Callahan and Lydia S. Dugdale, an associate professor at Yale School of Medicine, argue that this practice threatens the public good.
They challenge the reasoning that physician aid in dying is justified because patients ought to have the ultimate say concerning their medical treatment and, in specific cases, when they die. Callahan and Dugdale argue that that while the decision to end one’s life may be personal, it is not isolated. It affects other people – relatives and friends, but likely also a wider swath of society. They provide evidence of a “ripple effect” in which physician aid in dying may be correlated with increases in suicide in the general population (now 42,000 a year). They cite statistics in Oregon, where there has been a parallel increase in overall suicides since the late 1990s, when physician aid in dying was legalized. The authors suggest that the Werther effect may be in play: that suicides increase in response to publicized suicides, which can include physician-assisted suicides.
Further, Callahan and Dugdale write that the participation of physicians in helping patients who want to die further threatens the public good by legitimizing suicide. “Patients trust that physicians are ‘on their side’ and bound professionally to advocate for their health,” they write. “This role is compromised by conferring on physician the power to adjudicate whose life is worth living.”
Dugdale is the editor of Dying In The Twenty-First Century: Toward a New Ethical Framework for the Art of Dying Well (MIT Press). Callahan has written extensively about the ways in which the acceptance of physician aid in dying and euthanasia would harm the good of the community and go against the doctor-patient relationship. For more, read Callahan’s “When Self-Determination Runs Amok” in the Hastings Center Report.