Page 27 - Delaware Medical Journal - April 2018
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OPINION (CONTINUED)
has had a similar law in place for over 20 years. Notably, less than one in 20 who request aid-in-dying prescriptions ever use them, suggesting patient choice and control of one’s end is what’s important.
Jerry Brown, Governor of California and previously a Jesuit priest, encapsulated
the issue best for me when he signed the End of Life Act in 2015 stating, “I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded
Physician-Assisted Suicide
Misses the Mark on
Improving End-of-Life Care
Continued from page 109
If enacted, there would need to be training of participating physicians. What would be done if not enough physicians signed up? States like Washington have had to bring physicians into the state to do this work. decisions of a doctor-patient relationship was needed, one might be referred to the ‘specialist’ who handles PAS requests. Who would monitor the process, collect the data, and develop performance improvement programs? From where would the resources for this come? Could they not be put to better use improving end-of-life care as a whole? Who would address the distress of physicians?
The moral or ethical aspect of this discussion revolves around the goals of medicine, which are to preserve life and relieve suffering as outlined in Eric Cassel’s classic article in the New England Journal of Medicine (NEJM), The Nature of Suffering and The Goals of Medicine.
The American College of Physicians (ACP) statement opposing PAS concludes:
by this bill. And I wouldn’t deny that right to others.”
The concepts outlined in HB 160 are supported by thousands of Delawareans whose voices deserve to be heard. The time has come for our state lawmakers
to act on behalf of their constituents and pass the Delaware End of Life Options Act so that as we each face the inevitable end of our lives, we are offered autonomy and decision-making authority over how we die — and the peace of mind that goes along with it.
“Society’s goal should be to make dying less, not more, medical. PAS is neither questions raised at the end of life.... Control over the manner and timing of a person’s death has not been and should not be a goal of medicine.”
The medical profession should focus its efforts and advocacy where it can do the most good. Through high-quality care, effective communication, compassionate support, and adequate resources, physicians can help ensure all have access to that ‘good death’ the PAS proponents so ardently seek.
CONTRIBUTING AUTHOR
■ JOHN J. GOODILL, MD is board certified in Pulmonary and Palliative Medicine and has practiced in Northern Delaware for the past
30 years. He is the Director of Supportive and Palliative Care Education and Outreach at CCHS and works on the inpatient SPC Consult Service at CCHS. He is also Co-chair of the CCHS Ethics Committee and President of the Delaware Quality of Life Coalition. He is a member of MSD and serves on the Executive Board and Public Health Committee and as Chair of the Ethics Committee. He is a member of AMA,
ACP and AAHPM. His opinions here do not necessarily represent the opinions or policies of the aforementioned oranizations.
CONTRIBUTING AUTHOR
■ ROBERT J. VARIPAPA, SR., MD is a board- certified neurologist in private practice in Dover, Delaware. He is the Chairman of the Department of Medicine, Bayhealth, Kent Campus and Secretary and Board Member
of the Medical Society of Delaware. He is a member of the American Medical Association and the American Academy of Neurology.
His opinions stated here do not necessarily represent the opinions or policies of any of the aforementioned organizations.
REFERENCES
1. MSD Legislative/Regulatory resources page. Medical Society of Delaware Web Site. Available at: http://files.constantcontact. com/01c210be101/2720ff07-d654-4554- 83ac-8294b3b9894f.pdf. Accessed March 14, 2018.
2. Delaware General Assembly Bill Detail Page. Delaware General Assembly Web Site. Available at http://legis.delaware.gov/ BillDetail?legislationId=25707. Accessed March 14, 2018.
3. Gawande, A. Being Mortal: Medicine and What Matters in the End. 1st ed. Metropolitan Books; 2014.
4. Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life; Institute of Medicine, Committee on Approaching Death: Addressing Key End-of- Life Issues; 2014 [cited 2018 Mar 14]. DOI: https//doi.org/10.17226/18748.
5. Statement on Physician-Assisted Dying [Internet]. American Academy of Hospice and Palliative Medicine; 2016 [cited 2018 Mar 14]. Available from: http://aahpm.org/ positions/pad.
6. Delaware End-Of-Life Workgroup Final Report and Recommendations [Internet]. Delaware. gov. Delaware Health Care Commission; 2016 [cited 2018 Mar 14]. Available from: http://dhss.delaware.gov/dhss/dhcc/files/ endoflifefinalreportmay05.pdf
7. Cassels E. Nature of Suffering and the Goals of Medicine. N Engl J Med. 1982 Mar 18; 306: 639-645.
8. Sulmasy LS, Mueller PS. Ethics and the Legalization of Physician-Assisted Suicide: An American College of Physicians Position Paper. Ann Intern Med. 2017 Oct 17; http:// annals.org/aim/fullarticle/2654458.
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