Page 27 - Delaware Medical Journal - July-August 2018

OPINION
statement about making sure other parts of end-of-life care are optimized are appropriate. I know people who feel passionately along both sides of the issue and I feel society’s attitude may be changing to favor the choice.
If physician aid in dying is made
legal, it must be a physician’s personal decision whether or not to prescribe. The current bill as written does a
good job writing in some safeguards as well as laying groundwork for administrative criteria for who may prescribe. In conclusion, I feel the MSD could take a neutral position on the ethics of physician aid in dying, as other professional organizations take, such as ACOG (American College of Obstetricians and Gynecologists).2 (1) ACOG practice bulletin 163, members- only link: www.acog.org/-/media/ Practice-Bulletins/Committee-on- Practice-Bulletins----Obstetrics/pb163. df?dmc=1&ts=20180412T1526088508 (2) ACOG committee opinion 617 www.acog.org/-/media/Committee- Opinions/Committee-on-Ethics/co617. df?dmc=1&ts=20180410T2014462342
32 I support the idea of a patient’s
right to end his life in the setting of intractable pain, despite hospice- delivered analgesia, by administration of life-ending measures.
33 I agree this is a complex issue, but if a patient that is suffering (think ALS) and doesn’t want to have a prolonged death, I feel it is appropriate to help ease their suffering and let them take
34 Withdrawal of life-sustaining treatment allows the disease to kill the patient. Deliberately administering
a lethal-dose prescription means the physician kills the patient, and that
is against everything our profession stands for. I completely support the position that we should focus on care and comfort and relief of suffering
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at the natural end of life, and I feel that measures that could contribute to comfort should not be withheld out of fear such measures could hasten death when death is deemed to be inevitable.
The MSD position is well written and consistent with ethical statements from national organizations such as the American College of Physicians. Aiding patients in taking their own lives is not consistent with the mission of physicians and would be a slippery slope that would negatively impact physician-patient relationships. In
the ICU, we routinely encounter families who feel that we are trying to kill their loved ones when we tell them that their loved one has reached a point where interventions might
be futile. I cannot image what those conversations will be like if some physicians actually start participating in killing their patients.
Hospice services in DE are adequate but outpatient palliative care services outside of hospice care are not adequate.
The MSD position does not seem
to respect patient autonomy. I am certainly aware of physicians, including in my family, who have used medication to hasten their own death at a point when they could see that life going forward was not a
way that they want to live. This is,
of course, a complex issue and one that requires skills beyond that of many medical providers, but it seems arrogant of me to remove the decision from the patient and put it into the hands of the physician.
Patients should be allowed to have some control over when and how they die. It is not for anybody else, including their physician, to decide any differently. Published data from Oregon, where physician-assisted
suicide has been legal for a long time, clearly indicate that there is minimal use of this option, while there is a quality of life and sense of well-being.
39 Hippocrates dealt with this issue thousands of years ago. In that day, patients were unsure if a doctor would poison them or seek to heal them. The oath put that issue to rest for those taking the oath at that time and since. I remain committed to the tradition of Hippocratic medicine.
40 Thank you for the work MSD has done on this issue over the years and for seeking input from the membership.
41 I believe that thoughtful, caring physicians can appropriately provide medications that hasten death as
a way of relieving suffering. The difference between palliative sedation that hastens death and other more direct interventions is only a matter of degree.
42 It is obviously a complicated issue, and I am in favor, in concept, of supporting physician-assisted suicide. My concerns are around the a Pathologist, I do not get involved with this.
43 Just take care of patients and stop heroic efforts to extend life when there is no hope or desire to continue. False hope and empty promises are the problem.
44 Delaware legislators are increasingly tampering with things they should not — cannabis, physician-assisted suicide, etc.
45 Regarding question 3 — I answered and palliative care programs.” By this I mean that the number of programs
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