Do you agree with Dr. Jack Kevorkian (euthanasia/assisted suicide)?

[losangeleno1]

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I'm prepping for an interview and I think the question of whether or not I agree with assisted suicide/euthanasia/Dr. Kevorkian's actions may be asked. Would you help a patient end their life? If so, under what circumstances?

I feel like what Dr. Kevorkian did could be justified in cases where a patient has a terminal illness, lack of treatment or pain management options, and of course, wants to end his/her life. I think patient autonomy trumps any other principle in these cases, and a doctor has a role to end suffering, if the patient wills it of course.

This topic is so controversial, and I don't want to say anything that will offend the interviewer

How would you go about answering this in a neutral way? Based on the assisted suicide laws of the state where the medical school is located?

I'm hoping for a good discussion about this

 

[NotASerialKiller]

Interviewers aren't going to ask a controversial ethical question and then reject you because of which side you're on. It's about how you defend your position, not the position you take. Answer honestly and think through your justification, while making sure that you don't vilify the other side. Shouldn't be that hard for any reasonable human being.

 

[Dagrimsta1]

"I'm not in the business of killing patients, but I will do whatever I can to provide the best quality of life. Not death."

 

[bonedoc5576]

The law precludes such action in all states except Oregon, Washington, Vermont, and Montana. Nevertheless, it has long perplexed me that what is considered a merciful act for an animal is considered (in most states) murder.
As physicians we are bound by the Hippocratic oath, primum non nocere, which many interpret as a prohibition against euthanasia. Nevertheless, it can be argued that the alleviation of suffering is consistent with the highest ideals of a physician.
Moreover, the perversion of primum non nocere to mean the preservation of life above all else has led, in my opinion, to the unjustifiable over-utilization of healthcare resources pertaining to end of life, to the out of control costs of healthcare in the U.S., and to the crisis in our national budget with respect to medicare.

 

[MetalloBetalactamase]

I wouldn't do anything illegal.

The law may fail to define ethical behavior.

That said, I am an advocate for bodily autonomy. Your body, your choice.

 

[DokterMom]

What are YOUR thoughts on the matter and why do you think/feel the way you do? What misgivings do you have?

That's what you need to be able to answer.

 

[Gibbward]

I was asked about physician assisted suicide. My interviewer even said up front that the answer doesn't matter, but the thought process was more important to him. Just answer as honestly and sincerely as you could. Have an opinion and do your best to stand by it.

 

[Psai]

"I'm not in the business of killing patients, but I will do whatever I can to provide the best quality of life. Not death."

Sometimes death is the best thing for a patient. It's really sad that our society can't see that. We can cause a lot of suffering with some of the things we do.

 

[aalamruad]

Sometimes death is the best thing for a patient. It's really sad that our society can't see that. We can cause a lot of suffering with some of the things we do.

Agreed, I don't even understand any counterarguments outside religious/spiritual contexts (which I still disagree with, but understand)

 

[dpmd]

I have definitely danced on the edge of legally permissible with patients i have made comfort care in the past. I would certainly prefer it be legally accepted to help expedite the process when family decides to terminally extubate their loved one because the ones that linger on the floor suffer and make the family suffer until the end. But the fact that it isn't hasn't stopped me from essentially doing so by giving versed and morphine prior to extubation and having very explicit titration instructions for my morphine drips that when followed (sadly that doesn't always happen) pretty much guarantees things won't last beyond a few hours. i think it is horrible that we show more kindness to a sick animal than a sick human in those situations.

 

[number9]

I don't even understand any counterarguments outside religious/spiritual contexts

So I actually thought I supported "death with dignity" acts until fairly recently, when a family member pointed out some arguments against them that I had never considered before and that definitely changed my opinion (at least to being more cautious if not outright against).

Basically, while I entirely support autonomy and someone's right to decide that they want to stop suffering and have some control over their death, I think the implementation/institutionalization of "death with dignity" acts enters slippery terrain. It's very difficult to come up with safeguards to ensure that these acts will only be used for people who are fully, autonomously, and in sound mind choosing to end their lives.

For example, I've heard (but not looked up myself, so take with a grain of salt) that some insurance companies have withdrawn support for end-of-life care in states that have "death with dignity" acts. This places a lot of pressure on someone who is dying to choose to end their life so as to not be a financial burden on their family. Additionally, what do you do about someone with progressive Alzheimer's disease or some other disease that may affect, even subtly, their cognitive abilities? I know that "death with dignity" acts often take these considerations into account, but where do you draw the line? Can an adult with Down Syndrome choose to end their own life? What about an adult with more severe cognitive disabilities? (It's interesting to note here that in some European countries, the answer to this question has been a progression towards active euthanasia, where the vast majority of people who are euthanized have mental illness or cognitive disabilities. In some European countries, babies born with disabilities are euthanized...so where do you draw the line?) How can you be sure that someone's disease isn't compromising their ability to make such a decision? I worry that it will be impossible to ensure people who aren't of sound mind don't slip through.

 

[Instatewaiter]

Sometimes death is the best thing for a patient. It's really sad that our society can't see that. We can cause a lot of suffering with some of the things we do.

Strongly agree. Realistically when we put someone on comfort care, we are doing little different than killing them with opiates. AHowever, by that time, many have lost their autonomy and dignity. Why not open these options up to people who are competent to actually make that decision, not leave it to the family?

 

[Psai]

Strongly agree. Realistically when we put someone on comfort care, we are doing little different than killing them with opiates. AHowever, by that time, many have lost their autonomy and dignity. Why not open these options up to people who are competent to actually make that decision, not leave it to the family?

Man and if the family just left their "loved one"in a nursing home to rot for the past few years...once the patient is hospitalized suddenly the guilt comes pouring out and it's somehow our job to make up for their deficiencies. Why should I intubate and do chest compressions on poor old demented muriel just because you couldn't visit her once in a while? Let her go and no we are not putting her on ecmo

 

[FCMike11]

Sometimes death is the best thing for a patient. It's really sad that our society can't see that. We can cause a lot of suffering with some of the things we do.

Word.

Sent from my Nexus 6P using SDN mobile

 

[BKNbkn]

Also, while the OP's question revolves about the Right to Die, it should also be known that euthanasia and physician-assisted suicide are not the same thing.

 

[femmegoblue]

If you are looking for some more insight to the world of Right to Die laws, check out How to Die in Oregon on Netflix. It's just a few families' experience with it, but for me it was eye opening going into interview season.

 

[E=mc^2]

Assisted Suicide should absolutely be legal. Like others on here have mentioned, it is insane that animals can be put down humanely but people can't. Its insane that we use lethal injection to purposely kill those on death row but can't put those suffering out of their misery.

Medicine isn't about keeping people alive the longest we possibly can. If it was, hospice care wouldn't exist. Medicine is about what is in the best interest of the patient. You may not agree with them wanting to die, but its not about you, its about the patient. Medicine should always be about the patient and their needs.

It is also important to note that assisted suicide should not be limited to those who are terminal within 6 months, much like current laws in the few states where assisted suicide is currently legal. There should be no time frame involved.

I state one case as an example in particular, locked in syndrome. Imagine a loss of all movement except for vertical gaze. Imagine being able to feel anything and having full consciousness but being completely paralyzed. Some patients in diseases like these can live for 20 + years, but what kind of life is that? It is inhumane to make them live that life if they don't want it.

Situations like that are why physician assisted suicide should absolutely be an option to treat patients. Not allowing is the equivalent to torture in some cases and the laws need to change.

 

[trobinsonmd]

I'm prepping for an interview and I think the question of whether or not I agree with assisted suicide/euthanasia/Dr. Kevorkian's actions may be asked. Would you help a patient end their life? If so, under what circumstances?

I feel like what Dr. Kevorkian did could be justified in cases where a patient has a terminal illness, lack of treatment or pain management options, and of course, wants to end his/her life. I think patient autonomy trumps any other principle in these cases, and a doctor has a role to end suffering, if the patient wills it of course.

This topic is so controversial, and I don't want to say anything that will offend the interviewer

How would you go about answering this in a neutral way? Based on the assisted suicide laws of the state where the medical school is located?

I'm hoping for a good discussion about this

Most ethics questions tend not to have a right or a wrong answer usually, but some have red flag answers. Just do not give a red flag answer and stay firmly attached to your stance and back it up... they will likely give you an opportunity to switch sides and make you doubt yourself... do not switch sides at this point as it makes you look indecisive

 

[RNtoMD87]

"I'm not in the business of killing patients, but I will do whatever I can to provide the best quality of life. Not death."

Sometimes death is probably the best quality of life.

 

[raiderette]

Our country does a lousy job of palliative care. There are other ways to die with dignity and end the pain. Research this area as either a complement or an alternative to physician-assisted suicide.

 

[Taddy Mason]

It's very difficult to come up with safeguards to ensure that these acts will only be used for people who are fully, autonomously, and in sound mind choosing to end their lives.

That’s why someone has to be deemed medically competent when making these decisions.

For example, I've heard (but not looked up myself, so take with a grain of salt) that some insurance companies have withdrawn support for end-of-life care in states that have "death with dignity" acts. This places a lot of pressure on someone who is dying to choose to end their life so as to not be a financial burden on their families.

There are life insurance policies that are void if someone opts for physician assisted suicide, which if anything would be more likely to create a greater financial burden for the family. A cursory Google search didn’t yield anything regarding health insurance, which financially wouldn’t make sense as people engaging in physician assisted suicide would likely save money for insurance companies versus those that opt for futile care.

Additionally, what do you do about someone with progressive Alzheimer's disease or some other disease that may affect, even subtly, their cognitive abilities? I know that "death with dignity" acts often take these considerations into account, but where do you draw the line?

Again, medical competency.

It's interesting to note here that in some European countries, the answer to this question has been a progression towards active euthanasia, where the vast majority of people who are euthanized have mental illness or cognitive disabilities. In some European countries, babies born with disabilities are euthanized...

Source?

Edit - ...and just realized this thread was necro bumped...

 

[mybluedog]

I'm not sure if anyone else mentioned this before. Here are somethings I did to be sure I'd be ready for these types of questions.

-make sure to know some points for both sides of the argument
-I sketched a brief table of the two sides for basic things (abortion, phys-assisted suicide, etc.)
-make sure you say that you understand and would respect the patient's wishes and place that as priority over your own opinions
-make sure you vaguely know the school's state's laws for those kinds of things