As Dr. Jack Kevorkian was released Friday from a Michigan prison after serving eight years for second-degree murder in the assisted death of a man with Lou Gehrig’s disease, new polls suggest his cause retains strong support.
An Associated Press-Ipsos poll released this week showed that 53 percent of Americans believe Kevorkian never should have gone to jail for the assisted suicide campaign he championed in the 1990s; 40 percent supported Kevorkian’s imprisonment.
Just 30 percent of the 1,000 adults questioned agreed that doctors and nurses should do everything possible to save the life of a patient. More than two-thirds said there are circumstances where a patient should be allowed to die with help.
The survey had a margin of error of plus or minus 3 percentage points, and was conducted from interviews done between May 22 and May 24.
Religion had much to do with people’s answers, according to the AP. Only about one-third of those who attend religious services at least once a week said it should be legal for doctors to help terminally ill patients end their lives. In contrast, 70 percent of those who never attend religious services say doctor-assisted suicide should be legal.
A plurality, 48 percent, said the law should not bar doctors from helping terminally ill patients end their own lives by giving them a prescription for lethal drugs; 44 percent said it should be illegal.
Physician-assisted suicide is one of those things that sounds justifiable to the layperson until you get him to follow the logic into the unaviodable ethical swamp. Those who responded affirmatively to the survey should read this story of a coma survivor, especially the following passage:
and then be asked whether they wish to reconsider their answers.
This survey appears to include what my grandmother used to call iffy questions. An example is: if you were driving down the road in your car and you came upon a little baby on one side of the road, with her mom on the other side, and you had to run over one of them, which one would it be???. The point is, it’s the wrong set of questions.
The choice doctors face is NOT that of whether to helplessly watch while a terminally ill person dies in agony, OR to kill them with medications. Unfortunately, we also have the opposite problem, where some families demand medically futile interventions, in order to assuage the guilt and anger that they feel over how they treated momma all those years, or out of a genuine moral confusion that the existance of medical technology creates the obligation to use it. It’s amazing how idealistic people become when they are spending other people’s money, but if it involves selling off assets they suddenly discover the virtues of palliative and hospice care!
Reasonably good pain relief is usually obtainable with nerve blocks, radiation, or even just good old fashioned Morphine properly dosed. Unfortunately doctors have not always done a very good job of treating terminal pain, so we reap the whirlwind.
In the name of choice, this trend is here to stay. I think the best that Christian doctors will be able to do is to publicly identify themselves as Hippocratic physicians, who will not under any circumstances kill their patients. Some in the public will seek out a principled physician. Unfortunately, though, I don’t think it will be very long before the AMA reverses it’s current position against assisted suicide.
As Christians it is also an opportunity to speak out about the meaning and value of suffering. While it is reasonable to treat pain as well as we can, the avoidance/relief of suffering and pain is not the HIGHEST goal of medicine or a fulfilled life. One of the most basic human experiences is that of suffering, sometimes as a result of choosing a path for principle’s sake–everyone suffers in one way or another. If we tell people that nothing is worse than suffering, it will lead to a profound lessening of the meaning that people experience in life and the value of sacrifice for others.
This particular subject puts me at odds between my Christian beliefs and my personal experience. As my father lay in the hospital with untreatable kidney failure and pain that the maximum dosage of morphine could not overcome, us kids spent about 48 hrs straight attempting to move and hold him into positions where the pain of his slowly dieing kidneys approached bearable. The end was inevitable and yet for that time he was forced to endure what I would not wish upon my worst enemies. So after 2 days of hellish pain followed by several days of degrading failures of various bodily functions, I came to see the point of those who favor this option. Perhaps it is a sin for which I will have to atone at some point in the future, but it is still a belief to which I sadly hold.
Mike, that sounds like a terrible experience for your dad and your family. I don’t think it is a sin to desire to die, or to see death in some circumstances as the lesser of two evils.
I’m wondering how did the doctors determine what was the maximum dose of morphine in his case?
that’s getting beyond my knowledge there. All I know is we were told any more and it quite likely would send him into respiratory failure.
Mike, that’s something that I hear happening to families at frequent intervals. What you were told was true, high dose morphine CAN hasten death. Some physicians are not prepared to dose morphine to the point where respiratory depression and/or death becomes a risk.
However, it is not unethical to treat pain as aggressively as is necessary, even if that treatment hastens death. So, there is no maximum dosage of morphine and physicians with modern training in pain management know this and treat accordingly. It’s a time honored ethical principal called the double effect. As long as the PRIMARY intention of dosing the morphine is to relieve pain, the unintended SECONDARY effect of hastening death does not preclude treating the pain. Where this principle differs from what Kevorkian et al are proposing is that they want to use morphine and other drugs with the PRIMARY intention of causing death, not treating pain.
When I am treating a terminally ill patient, I write the orders for pain medications with great latitude for nursing staff and notate that the dosage is to relieve pain. That way the nurse can use her judgement and dose to the point of relief, or in very rare cases respiratory depression and death. In a few more instances, it is necessary to snow the patient in order to escape the terrible pain that they are in. As was the case with your dad, these patients are generally days to hours from death.
I’m really glad you shared your story here. It is extremely important that the experiences of patients and their families be heard in the debate, and I hope that your dad’s suffering might be redeemed to some degree by what you have shared here.
Almost every community has one or more hospice programs which need volunteer support and help in getting out the message to lay people AND physicians.
Again, I’m sorry for your loss.
This would be a hard one for me to decide. My wife has terminal cancer and we have talke the subject over. What she wants is to be kept comfortable and free of pain at the end. This is the way it is going to be.
Harvey,
I’m sorry to hear of your wife’s illness. I would strongly advise that she ask her doctor about hospice. The hospice program provides nurses, grief counselling, pain management and medications for patients who have less than 6 months of expected life. If a patient lives longer than that, the certification can be renewed.
The resources are available wherever the patient is being treated, at home, in a nursing home or in some cases within the hospital. Some hospices have a hospice house, where patients can go to be cared for, but that is not a requirement.
Capn Jack Sparrow,
I greatly appreciate your occasional comments on this blog, especially as regards physician practice. For instance, it was good to have clarified the ethical principle of the “double effect”.
I was visiting a close friend in the hospital who was only a few days from dieing from cancer. Yet, while I was there, he had to call his lawyer to call the doctor to threaten a lawsuit from his family to get enough painkillers. When the doctor finally called the hospital to tell the nurse to give what was, the nurse clearly took umbrage and dragged her feet to the point of his not getting the drugs until the time originally scheduled.
Just saw in the news where a man in a coma in Poland revived
suddenly.
It is clear abortion and its destruction of the value of human life is playing a large part in promoting the “Culture of Death” in many people’s minds.
Now days, there are long acting morphine derivitives that are in pill form. These last all day and can be very effective. Additionally, you can use super-concentrated morphine preperations in which a drop of medication under the tongue can give a full dose. Those drops are great because you can use them in a patient who otherwise cannot swallow-that saves the patient from painful injections.
Patients who are conscious can be hooked up to a PCA pump, which gives them a button to push when more meds are needed. Studies have shown that when a patient controls his own medication dose, he will actually use LESS pain medication and get better control.
tsk, tsk. This is not euthanasia, it’s just “Voluntary Transitioning.” Why shouldn’t these “resource hogs” take a neverending vacation? It’s not like they (or we) have a soul or anything.
Nothing to see here — move along…
I am really appreciating Capn Jack Sparrow’s perspective here. I have seen the same nurses that deaconjohn25 has seen but I have also seen–and worked with–nurses and other health care providers who compassionately and gently provide palliative care–good pain management which includes more than just medications: positioning, touch, hot or cold applications, and the like. I know hospice nurses who are Christ’s hands and heart for those near death.
Good palliative care with pain management is the right of EVERY patient, whether he or she is dying or not. Such care looks at each patient as a special child of God, deserving of the very best medical/nursing science can provide.
From a Christian perspective it is important to realize that we are transitioning from life to life. We should not hasten that transition, but we need to keep pain and discomfort to the minimum. Life is not out own, but a gift from God and we need to give it up and take it on God’s plan.
Cpn Jack is very knowlegable. Most doctors are trained in acute care and “curative ” medicine but not long term care, rehab, and terminal/pallative care. This is slowly changing. Many doctors fear law suits and families most of the time won’t consider hospice until too late or not at all. No ethical, hippocratic physician will consent to kill any patient or infant, but often don’t know about the wonderful tools to compassionately care for patients. Most pastors only know how to repeat empty platitudes if they show up. Terminal care can be a blessing for all involved–patient, doctors, nurses, family. Assisted voluntary suicide shorts this out and historically devolves into involuntary “suicide” and disposal of the useless and helpless. Kyrie eleison.
Twelve years ago, my aunt was in the final stages of lung cancer, in terrible pain. Finally, they started a morphine drip that basically knocked her out and two days later killed her. For some years, I worried that this was euthanasia, but someone then explained the principle of double effect (thank you, Capt. Jack Sparrow) and it all went into another light. She didn’t suffer, and those two days were a time for her family to gather, grow close, and spend time preparing for her death. A couple of years ago, hospice and morphine allowed a friend’s mother to come home and die in a lovely room with her family around in peace. It also gave time for a priest to come and reconcile her to the Catholic Church, which desire/intent she expressed before becoming comatose.
I read once that when euthanasia becomes acceptable, palliative care is basically thrown out the window and that is sad.
In re-reading my comment on the suffering my friend went through I realize that some could take it as an endorsement of euthanasia. My point was intended to be that it was not the disease in this case that made him suffer, but the callousness or incompetence of the doctor and nurse. As others have correctly pointed out, there are modern ways to handle pain and thus is not an excuse for euthenasia. But you can be sure when the MSM decides to promote it, as it has abortion and gay “marriage”, the media will be full of erroneous information or heart-rending stories to stampede public opinion.