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What do doctors think about assisted suicide in regards to their patients ?
As a student in bioethics and as someone who would like to pursue medicine, I am always intrigued by the argument behind euthanasia and assisted suicide with patients. I am curious to know what the common consensus is among doctors.
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6 answers
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Brett’s Answer
Hi Danielle,
I see I am the first to respond to your question. I think that speaks to the controversy on this topic, and that there is no uniform consensus amongst physicians.
As physicians, we are trained to improve the health and well being of our patients. However, there comes a point where that is just not possible. In fact, our attempts to help the patient may prolong their pain and suffering. Quality of life has become an important factor in medical decision making, rather than solely prolonging life. Patients may choose to refuse medical treatment, such as CPR (DNR - do not resuscitate), or to only receive medications to make them feel better without treating the underlying disease (CMO - comfort measures only). There are physicians who specialize in palliative care who can be very helpful for these terminally ill patients. I'm no bioethics expert, but I believe these measures are all considered to be passive euthanasia.
Active euthanasia (assisted suicide) is very different, and has many other considerations. Is the patient truly terminally ill? How long is their life expectancy? What is our confidence on the answer to these questions? Are there family or friends with an ulterior motive influencing the patient? Is the patient competent to make this decision? If they are not, is it ok for someone else to make this decision?
I'm an anesthesiologist, so it would technically be very easy for me to take a patient's life in a comfortable manner - but I will never do it. In addition to it not being legal, there are a myriad of ethical issues. I have chosen to euthanize several pets, and I believe that it was the humane thing to do. And I have often wondered if we are more kind to our pets than humans when it comes to end of life issues. In order for assisted suicide to work, it would need to involve more than one specially trained physician, and this would need to be very carefully regulated, as this is a very slippery slope. All of these issues would need to be worked out before we start actively start taking lives.
It can be very easy to oversimplify many of these issues. When I met with estate attorney to make a will, she asked me a bunch of questions regarding what medical procedures I would want or not want if I could not make medical decisions for my own. I really couldn't answer these questions without context. Would I want to be intubated and ventilated? Probably, but not if I had an irreversible brain injury with little to no chance of having a meaningful recovery. Would I want a feeding tube , CPR, etc.? Once again, it depends. Bottom line, these are complicated questions, and I have just touched the tip of the iceberg with my response.
Hope that was helpful,
Brett Schlifstein, M.D.
Anesthesia Director
ECU Health Roanoke Chowan Hospital
I see I am the first to respond to your question. I think that speaks to the controversy on this topic, and that there is no uniform consensus amongst physicians.
As physicians, we are trained to improve the health and well being of our patients. However, there comes a point where that is just not possible. In fact, our attempts to help the patient may prolong their pain and suffering. Quality of life has become an important factor in medical decision making, rather than solely prolonging life. Patients may choose to refuse medical treatment, such as CPR (DNR - do not resuscitate), or to only receive medications to make them feel better without treating the underlying disease (CMO - comfort measures only). There are physicians who specialize in palliative care who can be very helpful for these terminally ill patients. I'm no bioethics expert, but I believe these measures are all considered to be passive euthanasia.
Active euthanasia (assisted suicide) is very different, and has many other considerations. Is the patient truly terminally ill? How long is their life expectancy? What is our confidence on the answer to these questions? Are there family or friends with an ulterior motive influencing the patient? Is the patient competent to make this decision? If they are not, is it ok for someone else to make this decision?
I'm an anesthesiologist, so it would technically be very easy for me to take a patient's life in a comfortable manner - but I will never do it. In addition to it not being legal, there are a myriad of ethical issues. I have chosen to euthanize several pets, and I believe that it was the humane thing to do. And I have often wondered if we are more kind to our pets than humans when it comes to end of life issues. In order for assisted suicide to work, it would need to involve more than one specially trained physician, and this would need to be very carefully regulated, as this is a very slippery slope. All of these issues would need to be worked out before we start actively start taking lives.
It can be very easy to oversimplify many of these issues. When I met with estate attorney to make a will, she asked me a bunch of questions regarding what medical procedures I would want or not want if I could not make medical decisions for my own. I really couldn't answer these questions without context. Would I want to be intubated and ventilated? Probably, but not if I had an irreversible brain injury with little to no chance of having a meaningful recovery. Would I want a feeding tube , CPR, etc.? Once again, it depends. Bottom line, these are complicated questions, and I have just touched the tip of the iceberg with my response.
Hope that was helpful,
Brett Schlifstein, M.D.
Anesthesia Director
ECU Health Roanoke Chowan Hospital
Updated
Maureen’s Answer
I work in a field of medicine, Neurology, where we sometimes have very little to offer to stop the progression of disease and certainly not to cure. This conversation sometimes comes up early in the discussion of a difficult diagnosis. I will use ALS as an example. My approach is never to make decisions for a patient, never to have my own opinions and biases become a barrier for my patients and also to ask more questions to drill down to the underlying reason why patients are asking.
When the conversation starts with this question, I find it is a starting point for exploring the patient's understanding, anxiety, expectations and usually leads to a Palliative care consultation as well. I think you will find the medical field of Palliative care very interesting, this is where bioethics is played out in almost every interaction. The goal of palliative care is not to decide on how to end life, but how to live out the rest of your days, making a positive choice about what you want and communicating it well to those around you brings patients a real sense of some control over a tough situation. Having your wishes clearly communicated and understood will help everyone in an end of life transition. I hope that perspective helps in addition to the other good answers above.
When the conversation starts with this question, I find it is a starting point for exploring the patient's understanding, anxiety, expectations and usually leads to a Palliative care consultation as well. I think you will find the medical field of Palliative care very interesting, this is where bioethics is played out in almost every interaction. The goal of palliative care is not to decide on how to end life, but how to live out the rest of your days, making a positive choice about what you want and communicating it well to those around you brings patients a real sense of some control over a tough situation. Having your wishes clearly communicated and understood will help everyone in an end of life transition. I hope that perspective helps in addition to the other good answers above.
Updated
Deb’s Answer
As part of a hospital team, I have seen this concept used, as well as a family member who used assisted suicide. The one thing I learned to give my patients early on as a hospital phlebotomist in my younger days - no-one else ever knows exactly what it feels like to live in someone else's body. In other words, their pain is their pain, and it’s not always for someone else to judge.
However, in life there are always more people to consider than just yourself. What does it feel like for a spouse to administer a lethal dose of morphine? Even when they understand clearly that their spouse has been suffering from decades of pain after being paralyzed in a car accident, and struggled near the end with constant infections, and a never-ending loop of antibiotics and the fallout from having the good bacteria killed too…it’s still painful to say goodbye and be the one ultimately causing death to occur.
I believe that, in good conscience, no spouse, physician, or healthcare team member can say they’re totally comfortable with the topic, but at the same time context is everything, and respect for others decisions. As the physician above pointed out, it is up to them to decide if a patient is competent, also considering their quality of life before issuing a lethal prescription (for which the physician can then be liable).
Indeed, if it was not complex and controversial, there would be no need for strict laws on the matter:
https://www.oregon.gov/oha/ph/providerpartnerresources/evaluationresearch/deathwithdignityact/pages/faqs.aspx
However, in life there are always more people to consider than just yourself. What does it feel like for a spouse to administer a lethal dose of morphine? Even when they understand clearly that their spouse has been suffering from decades of pain after being paralyzed in a car accident, and struggled near the end with constant infections, and a never-ending loop of antibiotics and the fallout from having the good bacteria killed too…it’s still painful to say goodbye and be the one ultimately causing death to occur.
I believe that, in good conscience, no spouse, physician, or healthcare team member can say they’re totally comfortable with the topic, but at the same time context is everything, and respect for others decisions. As the physician above pointed out, it is up to them to decide if a patient is competent, also considering their quality of life before issuing a lethal prescription (for which the physician can then be liable).
Indeed, if it was not complex and controversial, there would be no need for strict laws on the matter:
https://www.oregon.gov/oha/ph/providerpartnerresources/evaluationresearch/deathwithdignityact/pages/faqs.aspx
Updated
Parin’s Answer
That's a very unique question and probably varies person to person (physician to physician). Like all controversial topics, you won't find that an entire group of people agrees on this. I am grateful to have never been in a patient situation where this has come up. I have mixed feelings about it in that I can understand why some would prefer having control over their death, particularly when they have a medical condition that may alter their memories/behaviors/ability to care for themselves and live a life with any meaning. On the other hand, morally, I could not live within myself if I helped someone take their life, regardless of their reasons.
Updated
Patrick’s Answer
Danielle, it's important to understand that the subject of assisted suicide is an incredibly deep and ethically intricate issue in today's medical field. It's a point where empathy, professional duty, personal beliefs, and legal structures meet in very subtle and complex ways. Medical professionals tackle this delicate topic with a great deal of complexity, understanding that the discussion goes beyond simple moral judgments. It touches on the core aspects of human dignity, patient independence, and the role of healthcare in managing end-of-life experiences. The viewpoint of the medical community isn't uniform, but is a rich, evolving conversation that mirrors the deeply personal nature of suffering, terminal illness, and individual patient situations.
Doctors' views on assisted suicide are greatly shaped by the principle of patient autonomy—a fundamental pillar of modern medical ethics that stresses an individual's right to make informed choices about their own healthcare. Many doctors see this issue with a compassionate perspective, recognizing that for patients suffering from terminal illnesses with prolonged suffering, the option of a dignified, controlled end to life can be a form of medical care that eases severe physical and psychological pain. These medical professionals argue that truly patient-focused care must respect a patient's most private and personal decisions about their own life and death.
However, Danielle, the medical community is still greatly divided, with serious worries about possible ethical, professional, and psychological consequences of assisted suicide. Many doctors argue that the basic medical pledge to "do no harm" is fundamentally challenged by actively aiding a patient's death, even when that death might be seen as a merciful intervention. The potential for misuse, the risk of undermining efforts in palliative care, and worries about vulnerable groups being disproportionately affected are serious factors that make many medical professionals think twice when considering assisted suicide.
Regions that have legalized assisted suicide have created strict frameworks that try to balance patient autonomy with strong safeguards. These usually involve multiple medical evaluations, mandatory waiting periods, psychological assessments, and clear patient consent protocols. Doctors in these areas often report that these structured methods help alleviate many of the initial ethical worries, providing a carefully regulated mechanism that respects both individual patient choice and professional medical standards.
Specialists in palliative care offer particularly insightful perspectives, highlighting that the desire for assisted suicide often comes from inadequate pain management, psychological support, or fear of prolonged suffering. Many argue that improving end-of-life care, enhancing psychological support, and developing more advanced pain management strategies could greatly lessen the perceived need for assisted suicide. This approach represents a proactive medical response that aims to address the root causes of patient distress rather than focusing only on the potential for medical intervention in ending life.
The psychological effect on healthcare providers who take part in assisted suicide is another key consideration. Many doctors report experiencing significant emotional and professional challenges, grappling with complex feelings of empathy, doubt, and the heavy responsibility of being involved in end-of-life decisions. Medical institutions are increasingly recognizing the need for strong psychological support and ethical guidance for healthcare professionals navigating these emotionally intense situations.
The newer generations of medical professionals are increasingly tackling this issue with more openness and subtlety, seeing patient autonomy and comprehensive end-of-life care as interconnected ethical considerations. They tend to advocate for more comprehensive, patient-focused approaches that prioritize individual choice while maintaining strict ethical and medical standards. This evolving viewpoint suggests that the medical community's approach to assisted suicide will likely continue to develop, becoming more sophisticated and responsive to individual patient needs.
In conclusion, Danielle, please realize that the medical perspective on assisted suicide mirrors the profound complexity of human experience—a delicate balance between scientific expertise, ethical consideration, individual patient needs, and the basic human need for dignity and empathetic care. For those aspiring to be medical professionals and bioethics students, this issue represents a critical area of ongoing discussion, challenging traditional medical paradigms and requiring continuous, thoughtful engagement with the most private and profound questions of human existence.
Doctors' views on assisted suicide are greatly shaped by the principle of patient autonomy—a fundamental pillar of modern medical ethics that stresses an individual's right to make informed choices about their own healthcare. Many doctors see this issue with a compassionate perspective, recognizing that for patients suffering from terminal illnesses with prolonged suffering, the option of a dignified, controlled end to life can be a form of medical care that eases severe physical and psychological pain. These medical professionals argue that truly patient-focused care must respect a patient's most private and personal decisions about their own life and death.
However, Danielle, the medical community is still greatly divided, with serious worries about possible ethical, professional, and psychological consequences of assisted suicide. Many doctors argue that the basic medical pledge to "do no harm" is fundamentally challenged by actively aiding a patient's death, even when that death might be seen as a merciful intervention. The potential for misuse, the risk of undermining efforts in palliative care, and worries about vulnerable groups being disproportionately affected are serious factors that make many medical professionals think twice when considering assisted suicide.
Regions that have legalized assisted suicide have created strict frameworks that try to balance patient autonomy with strong safeguards. These usually involve multiple medical evaluations, mandatory waiting periods, psychological assessments, and clear patient consent protocols. Doctors in these areas often report that these structured methods help alleviate many of the initial ethical worries, providing a carefully regulated mechanism that respects both individual patient choice and professional medical standards.
Specialists in palliative care offer particularly insightful perspectives, highlighting that the desire for assisted suicide often comes from inadequate pain management, psychological support, or fear of prolonged suffering. Many argue that improving end-of-life care, enhancing psychological support, and developing more advanced pain management strategies could greatly lessen the perceived need for assisted suicide. This approach represents a proactive medical response that aims to address the root causes of patient distress rather than focusing only on the potential for medical intervention in ending life.
The psychological effect on healthcare providers who take part in assisted suicide is another key consideration. Many doctors report experiencing significant emotional and professional challenges, grappling with complex feelings of empathy, doubt, and the heavy responsibility of being involved in end-of-life decisions. Medical institutions are increasingly recognizing the need for strong psychological support and ethical guidance for healthcare professionals navigating these emotionally intense situations.
The newer generations of medical professionals are increasingly tackling this issue with more openness and subtlety, seeing patient autonomy and comprehensive end-of-life care as interconnected ethical considerations. They tend to advocate for more comprehensive, patient-focused approaches that prioritize individual choice while maintaining strict ethical and medical standards. This evolving viewpoint suggests that the medical community's approach to assisted suicide will likely continue to develop, becoming more sophisticated and responsive to individual patient needs.
In conclusion, Danielle, please realize that the medical perspective on assisted suicide mirrors the profound complexity of human experience—a delicate balance between scientific expertise, ethical consideration, individual patient needs, and the basic human need for dignity and empathetic care. For those aspiring to be medical professionals and bioethics students, this issue represents a critical area of ongoing discussion, challenging traditional medical paradigms and requiring continuous, thoughtful engagement with the most private and profound questions of human existence.
Updated
Patrick’s Answer
Danielle, while I'm not a doctor, I believe the issue of physician-assisted suicide is a complicated and ever-changing discussion in the realm of medical ethics. Studies reveal a wide range of views among healthcare professionals. My aunt and uncle, both medical professionals, have noted that opinions greatly differ depending on the specialty, location, religious beliefs, and personal experiences with patients facing terminal illnesses. However, recent surveys suggest a growing acceptance of this practice among doctors.
Doctors who support this practice argue that it respects patient autonomy, provides relief from suffering, and favors regulated methods over uncontrolled ones. On the other hand, those against it refer to the Hippocratic Oath, worries about patient vulnerability, possible loss of trust, and moral or religious objections. Different specialties within the medical field hold different views. For instance, palliative care specialists focus on providing comfort, while oncologists, who often deal with end-of-life scenarios, are generally more supportive.
Location and cultural factors significantly influence these views. European doctors are typically more accepting of this practice than their American counterparts, whose views can differ from state to state. Globally, professional organizations hold varying stances, but all stress the need for strict precautions and strong palliative care.
The field of medical education is increasingly emphasizing bioethics, understanding diverse patient views, and cultural competency. As we look ahead, the medical community is shifting towards a more patient-focused approach, with a growing acceptance of patient autonomy and the development of clearer guidelines.
For those entering the medical profession, it's crucial to comprehend different cultural views, legal structures, and to have strong communication skills. This is necessary to balance personal ethical boundaries with patient autonomy. The continuous evolution of this issue highlights the importance of giving compassionate, ethical care while respecting both the patient's wishes and the physician's moral conscience.
Doctors who support this practice argue that it respects patient autonomy, provides relief from suffering, and favors regulated methods over uncontrolled ones. On the other hand, those against it refer to the Hippocratic Oath, worries about patient vulnerability, possible loss of trust, and moral or religious objections. Different specialties within the medical field hold different views. For instance, palliative care specialists focus on providing comfort, while oncologists, who often deal with end-of-life scenarios, are generally more supportive.
Location and cultural factors significantly influence these views. European doctors are typically more accepting of this practice than their American counterparts, whose views can differ from state to state. Globally, professional organizations hold varying stances, but all stress the need for strict precautions and strong palliative care.
The field of medical education is increasingly emphasizing bioethics, understanding diverse patient views, and cultural competency. As we look ahead, the medical community is shifting towards a more patient-focused approach, with a growing acceptance of patient autonomy and the development of clearer guidelines.
For those entering the medical profession, it's crucial to comprehend different cultural views, legal structures, and to have strong communication skills. This is necessary to balance personal ethical boundaries with patient autonomy. The continuous evolution of this issue highlights the importance of giving compassionate, ethical care while respecting both the patient's wishes and the physician's moral conscience.