Editor’s Note: All opinion section content reflects the views of the individual author only and does not represent a stance taken by the Collegian or its editorial board.
Alongside embryonic stem cells and abortion, the practice of physician-assisted death is one of today’s most contested bioethical issues. Those opposed to aid in dying argue that the practice is out of line with fundamental medical principles, mainly those based upon the oft-quoted Hippocratic Oath. Such a claim, however, is erroneous as modern-day Hippocratic Oaths are not identical iterations of the ancient Greek declaration. I would actually go so far as to argue that physician-assisted death is supported by contemporary physicians’ pledges. With this in mind, I believe we should view “Death with Dignity” not as an issue at all, but rather as a new, necessary form of treatment that has grown out of a rapidly evolving medical landscape.
Physician-assisted death (PAD) refers to a patient’s conscious decision to end their life by way of lethal substances using the direct or indirect involvement of a physician. A situation where this practice might be employed is in the case of terminal cancer. If the affected patient knows they are going to die within X number of months and does not wish to undergo painful chemotherapy and/or palliative treatments until then, they can hasten death with the help of a licensed physician.
Few states—only six plus the District of Columbia—have legislation permitting physician-aided death. This is in large part due to persistent qualms about the supposedly immoral nature of helping someone die. A large part of these beliefs are influenced by religious dogma, especially in the Catholic Church, as well as pro-life political movements. But, particularly in the medical field, some argue that helping a patient reach life’s end diametrically opposes the primary tenets of the Hippocratic Oath: “primum non nocere,” or, “first, do no harm.”
There are two things wrong with this argument.
First, the above mentioned phrase is not actually from Hippocrates’ eponymous oath but is believed to have come from his work, “Of the Epidemics.” Granted, there is similar language found in the actual Hippocratic Oath: “I will use treatment to help the sick . . . but never with a view to injury and wrong-doing.” The only reason I point out this discrepancy is to show that the argument of “primum non nocere” is not technically a part of the physician’s pledge and thus should not be a major argument for anti-PAD oath-takers.
Secondly, many modern medical schools have their own versions of the Hippocratic Oath, drawing elements from the original text, while some do not require them at all. That’s not to say that some schools are more “ethical” than others, just that certain institutions view the practice of medicine in different ways—as they should, for the field is subject to change as major advancements or discoveries are made.
The genuine Hippocratic Oath, written circa 400 BCE, stresses admirable values, such as treating patients with the best of one’s skills, handing down medical knowledge to subsequent generations, and ensuring patient consent to treatment. But, some elements of the oath, such as those pertaining to religion or those forbidding abortions, fell by the wayside over the years. Some parts of the oath were adopted into modern versions, while others were omitted. These variations show not only a growing individualism in perception of medical practice, but epitomize the complexity and subjective nature of bioethics.
Interestingly, only 14 percent of modern day Hippocratic Oaths forbid euthanasia. If a doctor argues that they cannot perform PAD due to its conflict with a sworn pledge, it is statistically unlikely that their oath actually forbade the practice.
Even when discounting the semantics of Hippocratic Oaths, I firmly believe that we are the captains of our souls as well as our own bodies. If diagnosed with a terminal illness and given the option of: a) undergoing painful treatment until natural death, or b) ending things quickly in a relatively painless way, I am positive I would choose the latter. Wouldn’t you?
But, don’t just take my word for it. Six states and the District of Columbia have already legalized PAD, and it can be expected that number will increase in coming years. The growing level of acceptance can be seen on both ends of the patient-provider spectrum.
Patients have a number of reasons for supporting euthanasia: alleviation of negative side effects; regaining a sense of control over an otherwise ungovernable illness; and eliminating fears of the future, such as worsening quality of life and/or becoming a burden on loved ones.
Physicians too are able to see why support of PAD should be given. As medical practitioners, physicians aim to show every patient care and compassion, while also providing their best advice for course of treatment. To discount the compassionate nature of euthanasia—it’s literally giving a patient asked-for relief from pain—is to discount the shared message of all Hippocratic Oaths: to avoid wrongdoing towards the patient. If a sick person is suffering and a doctor has the ability to end that pain, why wouldn’t they?
We shouldn’t argue that PAD is wrong because it violates the Hippocratic Oath. Instead, we should debate why this practice is still inaccessible to so many who are suffering. Unfortunately, I’m out of paper space, so that’ll have to be a discussion for another day.
Note: I have chosen not to use the familiar term “physician-assisted suicide” due to its perpetuation of prejudice and negative sentiments towards individuals who choose to die with dignity.
Lauren Willson can be reached at letters@collegian and online at @LaurenKealani