October 14, 2010

Please send me your comments!

Oregon Hospices Refuse to Participate in Physician Prescribed Suicide
Part Three of Three

By Wesley J. Smith

Editor's note. This first appeared yesterday on Wesley's blog at http://www.firstthings.com/blogs/secondhandsmoke/2010/10/13/oregon-hospices-refuse-to-participate-in-physician-prescribed-suicide/

A few weeks back, I mentioned a study published by the Hastings Center that hospices in Oregon are not participating in assisted suicide. The CBC [The Center for Bioethics and Culture] asked me to expound more fully on that issue, and the piece is out today.

I discuss the abuses in Oregon–which we have dealt with many times over the years here–and then get to the issue of hospice specifically. I reference the Hastings Center study's conclusion that "questions of legal compliance and moral complicity inhibits" hospice participation in assisted suicide. From my piece [http://www.cbc-network.org/2010/10/oregon-hospices-right-not-to-cooperate-with-assisted-suicide]:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I hope the actual reason is more fundamental, that hospice workers in Oregon understand that facilitating assisted suicide is directly contrary to the hospice philosophy. Indeed, rather than facilitating doctor-prescribed death, hospice professionals are supposed to prevent the suicides of their patients by intervening to provide services or treatments the patient might be lacking, so that they no longer want to die immediately…

This raises an important question: Why does hospice philosophy oppose assisted suicide? According to the late Dame Cecily Saunders--the creator of the modern hospice concept and one of the great medical humanitarians of the 20th Century--doctor-prescribed suicide denies the equal dignity of hospice patients. As she wrote in the 2002 book, The Case Against Assisted Suicide (chapter, "The Hospice Perspective"), hospice asserts on behalf of the dying patient his or her "common humanity and personal importance" to the moment of natural death.

The great American hospice physician, Ira Byock, is similarly opposed to assisted suicide, writing in the Journal of Palliative Care, "The hospice focus is on life and the alleviation of suffering," whereas "the goal of assisted suicide and euthanasia is death." Moreover, if a hospice cooperated in doctor-prescribed death, it would abandon that patient to his or her worst fears--that they will die in agony, that they are a burden, that their lives truly are no longer worth living.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
And this is a crucial point to remember:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Thus, when assisted suicide facilitators in Oregon brag that they have assisted the suicides of hospice patients, they are actually admitting that they interfered with the proper medical care of these patients. Indeed, boasting of helping hospice patients kill themselves is akin to patting themselves on the back for helping the patient die after denying them proper pain control--another crucial hospice medical service.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
I conclude:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This is the bottom line: Hemlock (if you will) and Hospice cannot occupy the same philosophical space. That is why I am very pleased that Oregon hospices are generally keeping assisted suicide at arm's length. Legal or not, doctor-prescribed death has no place in proper end-of-life care.
More than that, it has no business in the practice of medicine or in a humane and moral society.

Part One
Part Two