View Full Version : Kevorkian
04-14-1999, 07:10 PM
I'd like to see everyone's opinion on this
one. In my opinion, Jack is a little off.
I think that probably, his patients need
a little personal attention, medication review, more pain and psychological therapy. Although I feel that in certain extraordinary circumstances euthanasia is warranted, I get that creepy feeling in my gut that this guy's a weirdo and I'm glad they finally put him away where he can't
hurt anyone anymore. Now if this guy goes on a hunger strike, he'll be dead in a week. That will suit him fine. He'll be a national hero, maybe, someday. I bet that if his patients were treated properly, 95% would no longer feel the need to euthanize themselves.
Jack be nimble
Jack be quick
Jack convinced him
That he was too sick
04-14-1999, 08:00 PM
I'm wondering how you came to the conclusion that his patients were misinformed and not properly treated. These people had terrible illnesses. Their choice of life vs. death was on their minds at all times, for years. They made that choice after thinking about its consequences for a very very long time. If you dont like kavorkian, at least respect their choice.
how dare you say that you could change their minds if you gave them a little more psych help and more meds. Do you think that their decision to die was made on a whim? Do you think that these are people who just quit at the first sight of struggle? and that you can make it allright by just patting them on the shoulder a few more times and giving a little more morphine?
04-14-1999, 08:00 PM
I think you are definitely right -- the guy has a narcissistic thing going or something. It is one thing to say you are trying to help alleviate suffering. But he made a videotape of the event and sent it to 60 minutes for crying out loud. Then he chose to represent himself. I think he got what he wanted -- to be put away! I don't understand it, but I don't buy his lines about doing it to "help" people. I don't even think what he has done qualifies as "euthanasia".
04-14-1999, 08:10 PM
From what I understand, on the video of the death Kevorkian dared the prosecutors to stop him. Obviously Kevorkian is more interested in his little cat and mouse game than anything that remotely represents "helping" others...Now THAT'S ARROGANT.
04-14-1999, 08:22 PM
you're all falling into the trap of sensationalism. I agree that Kevorkian seems to enjoy the personal glory. But please dont lose view of the real issue that we should all be concerned with.
We cannot disregard this most important of all decisions that our patients may make. All we can do is make sure that they have considered everything, that they are well educated about all the consequences and actions. But if these patients come to the decision of ending their life, we must respect them.
Dont let your distaste for Kevorkian cloud the issue.
I think kevorkian has been wanting to go to jail so the issue can be brought up in front of the supreme court. This is why he kept pushing the limits.
04-14-1999, 08:46 PM
Very good point about the supreme court. I think that is exactly his intention.
04-14-1999, 10:14 PM
Since I wasn't there and didn't get to speak to the patients, their families, and their physicians, I can only base my opinion on what I have observed in the media. From what I have seen, I totally disapprove of Kevorkian's method of performing euthanasia. In certain cases, some patients experience such tremendous suffering that euthanasia should be an option.
Take for example someone with terminal bone cancer. It's a crippling disease because any little bump on the surface she's on can send tidal waves of pain throughout her body. Is it right to allow someone to suffer like this? After all, we put animals out of their misery all the time so shouldn't people be deserving of the same relief? What about someone with Lou Gehrig's disease? Hopefully I have the right disease here but it leaves you physically crippled and helpless well before you die. Is it right to trap someone in a violently twitching body while their mind is perfectly coherent and rational? Would you want to someday watch yourself urinating and defecating without control, your limbs flailing wildly everywhere, people staring at you like you're a freak? I doubt it. Is death the best choice? I don't know, but unless it's me who's suffering, it's not for me to decide. It's the patient's decision.
What I don't like about Kevorkian's methods is that he most likely should not be performing [for lack of a better term] the deed. If it's going to take place, then it should be by a physician who has known the patient for a long time, not someone who has spent a few hours with the patient and decided that euthanasia is okay. In some of Kevorkian's suicides, it is entirely possible that the patient's physician went to Kevorkian because he himself felt uncomfortable with performing the act. If this was the case, then what was done may have been appropriate. However, this does not seem to be the case with Kevorkian. To me, it seemed more like Kevorkian was running a drive-thru euthanasia joint. Anyone who was dying could come by for his services, regardless of whether or not he or she was suffering. It euthanasia is to be permitted, there must be numerous safeguards.
First, a minimum of 2 physicians, one of whom must be someone that is close to the patient, must agree that the patient is suffering tremendously or will in the immediate future and that death is the only humane altrenative. All psychological causes for the desire for suicide must be eliminated. There must be a short waiting period, anywhere from a week to several weeks but depending on the situation. People who become paralyzed often want to commit suicide but with time and therapy, they come to realize that life can still be complete. This opportunity of realization must also be provided to these patients. The patient's reasons for choosing suicide must be legitimate. It cannot be because she does not want to burden her family. Be suspicious if family members are overly aggressive in insisting on euthanasia. Make sure that they will not benefit from the patient's death. Most of all, make it an easing and comforting experience. Do not sensationalize it like Kevorkian. The end result may be attention given to the issue by the media but remember that a life has just been lost. While it may be good that someone was put out of his pain, don't forget that a patient has just died.
[This message has been edited by justwannabadoc (edited April 15, 1999).]
04-14-1999, 10:38 PM
These people all have one thing in common. They all suffer physical pain for extended periods of time. There is no reason that anyone should have to suffer pain like this. Proper pain management is not being utilized. Is a person who suffers with uncontrolled pain likely to be of the state of mind to make a proper decision about wether or not to end their life? Is it my wanting to end these people's suffering by administering to them good medicine and friendship rather than carbon monoxide what makes me arrogant? Can you understand that there is no need for extended physical pain in the terminally ill and that physicians have at their disposal the methods to releive their suffering? Your defeatest and negative attitude entice me to reach through your monitor and slap your face.
Calm down everyone. If this is how you handle a discussion on the subject, what will happen when you have to make the actual decisions?
I think Jack Kevorkian probably started off with his heart in the right place, watching helplessly as his patients suffered before his eyes. I had to watch my parents decide whether or not to turn off the life support machine on my younger brother and I respected their decision to allow him to peacefully die. I have also watched a patient bleed to death on an operating table because she had no clotting factors left in her blood and was bleeding faster than I could pump fluids into her body. The Anastesiologist in charge refused to give up until all hope was lost and he eventually told me to stop the machine. I walked with her to the I.C.U. and stood watching her for a time realizing that I would not see her alive again. She was a neat lady. The point I am trying to make is that somewhere along the line very often choices are made. However those choices are not supposed to involve the administration of lethal drugs. I am against the death penalty for the same reason that I am against Euthanasia, nobody has the right to take another persons life. As a physician you take an oath. If it is the Osteopathic oath part of it reads "I will be ever vigalent in aiding in the generalwelfare of the community, sustaining its laws and institutions, not engaging in those practices which will in any way bring shame or discredit upon myself or my profession. I WILL GIVE NO DRUGS FOR DEADLY PURPOSES TO ANY PERSON, THOUGH IT BE ASKEDOF ME." I do not mean to sound pompous or insensitive but I believe that our job as physicians is to heal. Some may argue that assisted suicide is a form of healing for those in extreme pain, but I ask you this, Who among you has not contemplated suicide at one time or another? What would have happened if there was somebody there who offered you the means? You probably would have come to your senses but perhaps not. The question remains to whom do we entrust the right to decide if a person can die or not? I respect the empathy we all feel for those who suffer, but that is why we are going into medicine, to help that suffering. I am just not sure that that help extends to assisting somebody die.
04-15-1999, 06:50 AM
The reality of the situation is that often times when dealing with a subject that society doesn't want to broach, a lot of theatrics are necessary to get people excited enough to start dealing with the issues. That is what Kevorkian's role is. He may appear to be grandstanding, but his heart is in the right place. It is necessary to educate the public about the pain and suffering of terminal illness. While euthanasia may not be the best solution for everyone, just as abortion is not, people should be able to make decisions for themselves and have more than one option.
04-15-1999, 07:07 AM
I'd like to throw this information into the discussion. Several of you have talked about Kevorkian's intentions and why he may have started doing this or his motivation.
In a medical ethics class we had a long discussion about Kevorkian and his ethics. What was told by the professor was that Kevorkian's original intentions were not really to help the people, but he was interested in harvesting organs. He wanted to come up with better ways to harvest cadaver organs and to get a better supply. Now, it has been a few years since I had this discussion, so a few of the details might be off, but I'm pretty sure his original intent was to somehow expand on the organ donation idea and not really help people with euthanasia. I'm sure now his intentions have evolved into a much different mode after he saw the infeasibilty of harvesting organs.
So based on this "original intention" I might agree with the original poster's comment of "I get that creepy feeling in my gut that this guy's a weirdo."
04-15-1999, 08:17 AM
How many of you know what Dr. Death's specialty was? I think if you don't then you might be missing a large part of the possible motives or lack there of, he might have. Post your guesses or answers and I will post the answer later in the day.
04-15-1999, 08:24 AM
TO Alexander DeLarge,
I completely agree with you in that no one should be made to suffer and that assisted suicide should be an absolute last resort. However, depite the incredible technology we have at our disposal, there are numerous cases in which the medications we have simply are ineffective at managing a patient's pain. This is not because the physicians are incompetent or are not trying hard enough. It's because the patient isn't responsive to those medications. Remember, every person's body is unique and thus has its own unique reaction to a medication. For example, Claritin is a great medication for most people with allergies. Unfortunately, it doesn't do a thing for me and neither does Allegra. My point is that what works for one person, whether it be an allergy medication or an analgesic, may not for another. Sure, there are plenty of other drugs out there that may work but in some cases, they don't work well enough to alleviate someone's suffering. What then? I don't know. But I find it difficult to standby and watch another individual suffer.
Now take the case where we are able to manage a patient's physical pain effectively, but the only way to do it is to keep them relatively sedated. Kind of like if you took more than 2 Benadryl's at one time (I've never done that since taking just 1 makes me sluggish to the point that I would never get behind the wheel of a car). Now, we have a patient that is physically pain-free but is so drugged up that his GCS score is like 6. This brings up the issue of quality of life. Is it right for someone to in order to escape excruciating physical pain to have to survive at just above a comatose level?
You bring up good points when you refer to the physician's oath and the fact that everyone contemplates suicide at some point in their lives. About your first point. I agree that our duty as physicians should be to heal our patients. However, we must realize that in some cases, it simply can't be done. What then? Are we still healers even though it's obvious we can't heal the patient?
Your other point that suicide has crossed everyone's mind at some point in time. If assisted suicide is to be permitted, some safeguards would include a waiting period, a thorough psychological assessment, and agreement by at least 2 physicians that this patient is suffering incredible pain that cannot be alleviated. These would hopefully significantly reduce if not eliminate the danger of granting someone suicide when not medcially warranted.
04-15-1999, 08:40 AM
Read these facts and then make your decision about the man:
When asked about his medical career, Kevorkian said:
"Well, it's never been going well. I had an erratic practice...I had so many controversial topics on my
resume, that people were just frightened to death of me. And it was hopeless to get a position." (10)
His professional experience has been primarily in the field of pathology (dealing with dead bodies and body parts). (11)
With the exception of his residency and his military service in the 1950s, he has had no clinical experience with live
He has no training or expertise in diagnosing or treating depression, and is completely lacking in any education or
experience in the fields of internal medicine, geriatrics, psychiatry and neurology. (13)
He has admitted that he is not qualified to practice medicine, even as a general practitioner. (14) Yet he has said that the
decision about who is worthy to use his death machine is based on his medical expertise. (15)
He graduated from the University of Michigan Medical School in 1952, did his internship at the Henry Ford Hospital,
(16) and his residency in pathology at the University of Michigan and at Pontiac General Hospital. (17)
He worked as a general pathologist at Pontiac General Hospital from 1960-1966. The circumstances of his leaving are
unclear. Although he said under oath that he'd never been asked to leave a hospital, he later said he had been fired from
Pontiac General. (18)
He then went to Wyandotte General Hospital where he worked for five months, (19) after which he set up a
computerized diagnostic clinic that failed in about a year. He blamed the failure on other doctors who wouldn't refer
anyone to his clinic. (20)
In the 1970s he bounced back and forth between Michigan and California. During this time he worked at four different
hospitals and took a 2 1/2 year break from the medical profession. (21)
Although he calls himself a "retired" pathologist, he has not held a full-time job for years. (22) His unemployment has
been more accurately described a "forced retirement." (23) He was even turned down for a job as a paramedic in 1989.
He does not have a license to practice medicine. His Michigan license was suspended in 1991 and his California license
was suspended in 1993. (25) According to the California Attorney General's office, Kevorkian is "fundamentally unfit to
See http://www.iaetf.org/fctkev.htm for more and citing of footnotes.
I realize this is an anti-euthanasia site, but it gives some food for thought.
04-15-1999, 08:43 AM
Thou shall not Kill.
It's a clear decision for me. Pain and suffering can hopefully be ameliorated, but it is not up to me to take someone's life. Providing information on how to do so is a lesser sin in my opinion, but the act itself is against what I know is right.
[This message has been edited by Matthews (edited April 16, 1999).]
04-15-1999, 08:49 AM
I checked on my earlier comments about organ donation being one of his initial motives and can now add that he was initially interested in using this with death row inmates and to harvest organs from them. His book written in 1991, "Prescription Medicide : The Goodness of Planned Death", discusses these early intentions.
04-15-1999, 08:59 AM
If the pain cannot be relieved to a reasonably bearable level, then what? Would you stand by and say "sorry, but I can't do anything more for your pain"? Also, suppose you came across a dog that had been hit by a car. You know there's no way that it can be saved. If you could, would you end its misery or wait for animal control to come and do it?
BTW: Please be assured that I want to know what you think. Just wanted to say this due to the increasing tension on this site.
04-15-1999, 09:57 AM
Helping someone die is sometimes the best thing that you could do for them (I'm talking terminally ill ONLY).
I watched my father die of cancer wh/ I was 16 - and at the end - the overdose of Morphine was the best thing that could be done to alleviate his Peine.
As far as Kavorkian - an argument was made by the prosecution that some of his patients didn't have to die - That they didn't have terminal diseases. If this proves to be true, it can not be tolerated. I think it is unacceptable for a health professional to go and kill people who otherwise might be helped (counseling, psy/Peine-therapy etc).
Nick. I am sorry that you had to go through that at such a young age, or at any age for that matter. It is a very well known fact that doctor assisted "deaths" occur all the time, Increasing morphine doses being just one method. The rihgt and wrong is very unclear. The oath practitioners take definitly say it is wrong, however individual situations may say it is right, it obviously was in your fathers case. If things were so cut and dry we would not even be discussing this rihgt now. My question regards the actual decision. Who gets to decide? I agree that Jack K is an unfit person to make that decision but where does this stop if we make mercy killings legal? Perhaps it is best left to individual situations with those who best know, ie the person suffering making the decision. How do I decide if somebody has suffered enough to be allowed a prescription for suicide? I would like to disagree with DCDO and say that I don't see anybody out of control here. This is a topic most worthy of discussion and people should be able to put an idea on the board not as a finished product but as an attempt to wrestle with such a difficult topic. I hope when the time to make such a decision comes for me, that I will have other people around, such as you all, to bounce my thoughts with
04-15-1999, 10:50 AM
I dont know where some are getting the idea that Kevorkian was the person that decided for these people.
I wouldnt sound so combative if you didnt have your head up dark places. what kind of a pharmacist are you? you of all people should know that there are many diseases where even morphine does not cut into the pain. I'm curious what you recommend for use in those situations. Maybe you know something that i dont. Please indulge us. In fact, write it up. I'm sure JAMA or the NEJM would love to publish a remedy for such pain management nightmares. In fact, the whole world would rejoice. You would have found the end to all suffering.
04-15-1999, 10:52 AM
I think others have made the points I was trying to make more eloquently then I could. While the issue Dr. Kevorkian is trying to bring into the limelight is definately a legitemate one, I beleive he has alterior motives to his practice of euthansia.
PS Pathology was his specialty
[This message has been edited by matt s (edited April 15, 1999).]
04-15-1999, 09:09 PM
There are a couple facts that I think can be brought to light. The patient he killed suffered from Lou Gerhig's Disease. An article in Newsweek was just published recently (sorry) and a doctor at a hospital in Germany has polished a technique that allows a patient to modulate brainwaves to spell a message out on a computer. These advances occur practically daily. I would hate to see a loved one go just before such a time. Bone cancer? Well, not everything can be helped! Another thing. Let's not forget that he didn't assist a suicide. He injected! That is murder by definition. Supplying the means is a shady thing but doing it??? No physician should ever need to participate in that. Jack is a very strange boy...
04-16-1999, 06:55 AM
Correct me if I'm wrong but when you have advanced Lou Gehrig's disease, doesn't your body violently twitch such that you basically have absolutely no control over your body? If this is so, that must be an incredibly difficult thing to live with. I agree that no family member wants to see a loved one go before "the time." But what you're forgetting is that " the time" for the patient may much much earlier than "the time" for the family. take for example someone who has a CVA that leaves him permanently on comatose. No DNR was ever written up but close friends know that he would want to be removed from life support. Family members who never discussed this issue with him don't want to see him go and want him on life support indefinately. My point again is that we as family members should not decide when it is appropriate to go. It is up to the patient.
I wanted to clarify that you do feel that in some cases such as bone cancer, euthanasia may be warranted? Now suppose the patient is unable to self-administer the lethal agent because he simply can't move. Kind of hard to imagine but in a tiny portion of cases, it is the case. Or take Lou Gehrig's disease. Kind of hard to take even a pill if you have no control over your movements. Who then performs the deed? Some say family members should but that is an incredible burden to put on the shoulders of a son, daughter, wife, you get the point. It think it is not only unfair but cruel to make a family member do it when they are already grieving. How do you feel about physicians who OD a patient on morphine for the purpose of ending his suffering? Happens quite frequently. Here, the doc is performing the deed. Is it evil?
04-16-1999, 09:04 AM
Firstly, I do not equate a dog's life with a human life.
Secondly, as a physician, if I am unable to relieve someone's pain I will refer them to someone who may be able to or I will tell them to seek medical advice elsewhere if they feel that I am not doing enough. One thing is certain though, I will never EVER inject someone with a lethal dose of anything. That decision and that action are the responsibilities of others (family).
[This message has been edited by Matthews (edited April 16, 1999).]
04-16-1999, 10:46 AM
I agree about the Lou Gherig's statement. It is a sad state and the ability to communicate such a horrendous decision must be impaired. However Lou Gherig's does not fly in from nowhere, without warning, and cripple you. Such a decision could be made in advance. Comatose. That's another good point. Our current knowledge leads us to predict successfully (in most cases) who could come out and who is a "vegetable". Any condition leading to this state could be treated before with a living will but, what if that was not done? For someone in a comatose state as such they in all probability won't wake, we lack ANY indication as to what that state is like. What they feel, what they don't, or even if they are cognisant. Pulling the plug seems human but what makes it different than letting them continue on a respirator? I do feel that the sooner the patient passes the sooner the family can finish grieving (forgive me for this statement, I realize we never really stop grieving. It becomes easier to live with) and the sooner life can continue for them. Morphine O.D.'s are generally self-administered by the patient in most cases (i.e. the patient is physically able) but otherwise we're back to the drawingboard of this debate. What is most important is that to remember I feel is that we recognize the split on this dilemma and knowing there is no clear answer, we keep an open mind and respect each other's choices when we have to act. We must stand together until a clear choice is available (if it ever is....)
04-16-1999, 12:04 PM
I didn't mean that you should equate a god's life with that of a human. BTW, you never said what you would do if you came across the situation. My point is that if most people feel that it is humane to end the life of an animal that is suffering and beyond saving, why is it wrong to do the same for people? True, a human life may be more "valuable" than a dog's but that isn't even the issue. The issue is that if the termination of a life for purposes of ending suffering is OK, why can't it apply to people? Remember, I am only speaking of terminal illnesses that cause tremendous pain for an individual and for which there is no relief.
I respect your refusal to never administer the lethal dose yourself. You should not do it if it is against your beliefs. However, you have to at least acknowledge that there are some instances where there is absolutely no way to relieve someone's pain. In such a case, would you if you knew of a colleague who helped people die (and it's legal and all safeguards are in place) refer your patient to him or her if your patient came to you for help?
You say that it should be the responsibility of others (i.e. family) to decide and act. The decision should be made solely by the patient but I do not think that burden of the act should be placed on the family. I have already discussed this issue but to quickly summarize, it is cruel to put family members through more grief by saying to them, "one of you has to do it."
04-16-1999, 12:16 PM
About Lou Gehrig's. Yes, it takes a while before one becomes incapacitated but it also takes a while (I think) before one dies as well. I agree that the decision can and should be made well in advance. Do you think it would be appropriate for the patient to say "I want my life terminated when I reach the point where I lost total control over my body"? Obviously the statement wouldn't be that simple but I hope you get my point.
I'm not sure what your point about being a coma is. My point when I brought it up was jsut that the patient is the one who should decide when to go or not, not family members. Please clarify if you want. I totally agree that people should have living wills and their wishes expressed somewhere.
In terms of Morphine OD's, are you saying that it's okay if the physician provides the extra dose as long as he or she doesn't do it? Or are you saying that it's not as bad. I disagree in that I think that physicians or nurses more often inject the lethal dose versus the patient. Obviously, this can't be proved since no one is going to come out and say what happened in their situation. Nevertheless, it's difficult to say concretely what should or shouldn't be done because each case is unique. At least discussions such as that will stimulate some ideas and get us closer to an answer.
04-16-1999, 12:27 PM
I agree with justwannabadoc - I'm sure that anybody who's been trough this kind of situation understands.
Remember all: the patient comes 1st and if all you can do to help him/her is to alleviate his/here Peine then you have to consider doing it.
The family is the one that ultimately decides (that was true in my case) - but the health practitioner is the one who does it.
04-16-1999, 12:51 PM
By the way, I think that it's ok for the "family" to decide - a lot of terminally ill patients are out of it, toward the end - and are therefore unable to make the decision for themselves.
The reason, I believe, most patients don't decide for themselves while they still can make decisions, is bc/ most patients do NOT want to dye and DO NOT want to even consider that alternative - I cannot blame them, after all the 1st think a doc tells you wh/ you find out you have cancer is how optimistic you should be and how much you MUST believe you gone a make it.
Psychology and state of mind plays a big role in recovery folks (depression is a factor that has been proven to make things worse), so I have a hard time imagining a patient having to decide wh/ or how he/she should die - wh/ they are in the middle of fighting a disease (cancer being only an example I'm all too familiar with).
04-16-1999, 09:08 PM
It sounds like you know how you would handle the situation Jonathan (justwannabadoc). I hope technology will soon grant us more tools by which we can end suffering in terminal diseases. Talk to you again soon.
04-16-1999, 10:14 PM
I think allowing the family to decide would be dangerous. They could have alterior motives for wanting the patient to die. Not likely but possible, so I would be hesitant. Then again, we currently let family members to pull the plug so I don't know what the answer is about letting someone other than the patient decide.
If everything goes according to current plans, I probably will never be in a position where it would be appropriate to take action (won't be a PCP or some other area where I would know a terminally ill patient well enough to do anything). I certainly don't envy any physician who faces such a situation though. Have we chatted or e-mailed each other before?
I think it is so funny to listen to you guys say what you would do. Unless you are a resident in your middle to upper level you don't have enough knowledge to even grasp what you guys are even talking about. Yes you do have opinions which I do respect but how many of you guys have past medical training. If you do disregard my comment. If you don't you have not even begun to have the feelings of responsibility that goes along with these decision. I am a nurse that will be starting school this fall. I do not care anything for Kevorkian. I think it is sad that he has to push the system and risk his freedom to address this issue with the supreme courts. I believe that patients should have this option. I do not know if I would be able to do it or not.
04-17-1999, 07:19 AM
I haven't worked in a hospital setting with terminally ill patients but I have had such patients working as an EMT. Even in those short encounters, I can see that many of them are in excruciating pain. It may or may not be different than taking care of them in a hospital setting. I agree with you that it is an incredibly complex situation and we probably won't have a complete grasp of it until we care for a few terminally ill patients. But I don't think it hurts anyone to discuss it now. I've enjoyed it and I hope others have as well.
04-17-1999, 04:19 PM
for a good article on Kevorkian read the April issue of Reader's Digest. It reveals a side to him that many people may be unaware of. For instance, he thinks that the experiments performed by the Nazis on human subjects were important because they can never be repeated. He favors experimentation on inmates, the mentally handicapped, terminally ill patients, etc. He has also tried to offer for transplation the kidneys of a quadriplegic he killed. He is a sick man. The article says that a large number of his patients were NOT terminal, and some had no signs of disease at all. In one of his videos, according to the article, the woman he was "helping" appeared disoriented and unfit to make a decision such as this.
Having a law requiring the agreement of two doctors for a legal p.a. suicide would not work. It would be a hotbed for payoffs, etc. All a doctor would have to do is get another doctor with similar values (or lack there of)to sign off with him and he could do as he pleased. Family members would be able to legally terminate the life of a family member without that person's consent. Even if one of the doctors had to be the family physician it still wouldn't work, as most (I'm assuming) family docs would not sign off on that. I wouldn't.
This is an issue with no easy answers. My Christian background causes me to object strongly to physician-assisted suicide. The danger is there for it to lead to great societal problems (the slippery slope argument). On the other hand, in cases where there truly is no effective pain relief, I don't believe God would want that person to suffer. This is a hard issue, one on which I have found no definitive answers. I am still against it, but I certainly see the opposing arguments. Just realize, people on both sides of the issue, that not all things are black and white. Try to see the other person's viewpoint. It will greatly facilitate friendly discussion of topics such as this one!
Don't misunderstand me, I have enjoyed the discussion. One day as a doctor you will be faced with many different issue. One should try to explore different ethical and emotional situations that may arise as a physician. I think it is appropriate to talk about the issues but people started saying they would or would never do so and so. There is no way to know what one would do because one has not developed to that point. On a different subject here is an issue to look at. At a hospital a patient was seen in the ER with a stab wound to the belly. He was seen by the doctor, stitched up, and sent home. (It was thought to be a superficial wound) The patient later returned to the hospital coding and died. (The wound was internal and the patient bled out into his belly) It was a flat mistake made by the doctor. This mistake killed someone. Rather than thinking of how much you would sue the doctor for if you were the family just think if you were the doctor. Someone with a problem that easily could have been fixed came to you in plenty of time to correct it. You have been training for many years. This patient was 15yrs old and was not terminally ill. She died because you missed something. I bring this up to let you guys think about it. Because I am a nurse and I don't have the responsibilities that the physician has (yet)I have a bad habit of saying the doctor was stupid for making that mistake. The reality is that we are all human and mistakes can be made. One day (I hope not) this could be me or you. The real question that I ask my self is how could I live with or deal with such a devastating mistake. This is just some food for thought. I am going to start an ethics discussion in the medical board.
04-18-1999, 07:05 AM
Unfortunately, doctors are expected to be perfect all the time. If they're not, wham, lawsuit. Obviously doesn't happen all the time but too frequently in my mind. Physicians should certainly be held accountable if they are grossly negligent. However, as Spat said, we are only human and we will make mistakes, hopefully just minor ones. If you make an honest mistake that results in some injury or even death to a patient, morality and ethics dictate that you should admit to it. But is this really practical? In a perfect society, yes. But we live in a highly litigious (spelling?) society and admitting to a mistake could ruin your career. So what should you or what do you think you would do?
While I think there MAY be a few situations in which euthanasia is justified,
I'm beginning to change my mind about a few things. Last week we had a very
interesting lecture from an oncologist. One of his topics was pain mgmt. As
it turns out, in the past the primary obstacle to proper analgesia was the DEA.
Apparently, until recently they have been on a witch hunt and many docs have been
afraid of giving sufficient morphine for fear of retribution. According to him,
most if not all cancer pain can be relieved if properly administered. The key is
PROPERLY escalating the dose, so that pain is relieved without the patient feeling
doped up. As a case in point, he described a patient who was terminally ill and
hospitalized during her final days. This woman was taking enough morphine to kill
several people but was completely lucid and comfortable. Anyway the hospital got a
visit from the DEA who demanded to know what the hell was going on. They went to
see the patient who was sitting up in bed, playing cards with a friend. After
talking with her they decided that the doc knew what he was doing after all and
left him alone. The point is, before allowing a patient to be in pain, please
make sure you've exausted all your options and know what you're doing. According to
our faculty, many physicians still don't understand how to properly manage pain.
Hopefully in the future this will change.