One doc’s point of view

2 Book CoversYesterday, I wrote about the Canadian Supreme Court’s decision on physician assisted death. Dr. Bill Wright, the doc who has written two books featured in these pages on prison medicine, wrote me. He offered these thoughts and has allowed me to reprint them:

“I’m not afraid of death; I just don’t want to be there when it happens.” ― Woody Allen

Since I’m not literate enough in legalese to interpret the Canadian Supreme Court’s decision, I’ll present the medical side.

Doctors are philosophically split on the issue of physician-assisted suicide, just as they are on issues like abortion. It’s fine to have these differences as long as they don’t interfere with the job we signed up for — taking care of patients.

I take care of end-of-life patients every day. I have patients who cling to life despite incredible incapacity and physical pain. Others with incurable illness may not be that physically disabled yet, but they see the handwriting on the wall and don’t want to experience what they see as a horrible end to their lives.

As their physician it’s not my responsibility to make the decision about ending life for them. It is my responsibility to be their advocate, helping them to understand what the nature of their disease is and the treatment options available. One of the options, I believe, is to throw in the towel.

That doesn’t mean that it’s the best option, but right now in Colorado it’s not an option at all.

The law says I have to stand by the bedside of my patient with an abdomen swollen to obscene proportions from end-stage liver disease and simply watch until he eventually vomits enough blood to exsanguinate. There’s something wrong here.

Assuming my patient says he’s tired of this existence and wants to end it, telling him that he has to stick it out until the grim reaper decides to amble by one day in the indefinite future is cruel in the extreme.

Some argue that hospice care keeps such a patient comfortable, but lying in that pool of desolation taking narcotics is not what most of us would see as comfortable. We wouldn’t allow one of our pets to endure such misery, and yet we deny the same surcease to our fellow humans.

Since Brittany Maynard’s death, more states, including Colorado, are pursuing “death with dignity” statutes. It can’t come too soon for me.

Bill Wright, M.D.
2/8/15

My thanks to Dr. Wright. We probably should listen closely to physicians who will see us through to the other end, whatever that might be.

RGK

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