Our job as doctors is not to end a life

We have more than 65 years of experience practicing and teaching the art and science of medicine and have been following and contesting the relentless pursuit of legislation to legalize physician-assisted death in our state for many years.

Recently, Senate Bill 88, known as the aid-in-dying bill, was sent to our state’s Judiciary Committee in the Legislature, where it was defeated. Here are four reasons why that legislation concerned us.

1. Our ability as physicians to determine the timing of death in the setting of illness is imperfect, and our experience suggests that our patients do not typically question what we tell them to be the outcome of their illness. Many of us have cared for patients diagnosed with terminal illnesses who left inpatient hospice units to live many fulfilling years with their families. The case of Jeanette Hall of Oregon has been well-publicized. She considered assisted suicide when diagnosed with advanced colon cancer in Oregon in 2000. Eleven years later, after receiving chemotherapy and radiation, she wrote, “I am so happy to be alive! If my doctor had believed in assisted suicide, I would be dead ... Assisted suicide should not be legal.”

2. Safeguards do not work. If we look at the longstanding Dutch example, which allows access to both physician-assisted suicide and euthanasia, “60% of cases were not reported truthfully to public health authorities; 50% of cases not have the required consultations,” wrote Dr. Robert D. Orr in The Hospitalist. A paper published last year in JAMA Internal Medicine titled “Euthanasia and physicianassisted suicide in patients with multiple geriatric syndromes” described 53 people in the Netherlands who were put to death for non-life-threatening conditions including visual impairment, hearing loss, chronic fatigue, incontinence or recurrent falls.

3. Medical care has improved dramatically. With advances in expert diagnosis and palliative, psychiatric and hospice care both in the hospital and at home, we simply do not see patients who die in intractable pain or without dignity when given the appropriate medical and supportive care. In our entire careers caring for tens of thousands of patients, only one of us (Dr. Sofair) had a patient ask him to prescribe medications to help him take his own life. He was in his mid-60s, had metastatic lung cancer and was concerned over having pain that he could not tolerate. When Dr. Sofair sat with the patient and assured him that he would be with his patient through the process to help alleviate his pain, his request to end his life went away.

4. The qualifications of a responsible attending physician are not clearly specified in the legislation. Practitioners with limited experience in the bedside practice of medicine will be able to give patients access to life-ending medication.

In our opinion, legalizing physician-assisted death is simply the wrong first step in a perilous direction and will make patients suspicious of our intentions at the exact time they need us most. If this bill returns and is ever passed, will we then be obligated to legalize euthanasia to protect those who are so debilitated that they cannot take the medications offered under its guidance? Our work as physicians is to walk with our patients and their families, both when the patient is well and when they are ill, not to give them medications with the sole purpose of ending their lives.