PAS has been in the news a lot lately. I blogged about Brittany Maynard, the 29-year-old California woman with terminal brain cancer who ended her life last November. I wrote about Ms. Maynard primarily because of the cancer diagnosis/prognosis issues involved.
“First, let me state that I believe that all cancer patients who want to end their own lives have the right to do so. Second, let me say that a “terminal” diagnosis is almost unbearable for the patient and his/her caregivers…”
Physician-assisted suicide is a hotly-debated issue in our society today. My challenge is that I can only consider the PAS issue through the eyes of a long-term cancer survivor of an “incurable” cancer. My cancer experiences color my PAS thinking.
If your cancer experience also colors your PAS thinking, scroll to the bottom of this page, post a comment or question and I will reply ASAP.
First, let me go on record as follows:
1) Across all posting on PBC, my opinion is consistent. Cancer patients and survivors must be in charge of, in control of ALL of their cancer care decision-making.
2) I believe in a higher power yet I consider my thinking as secular when it comes to cancer.
3) Conventional oncology and by extension your oncologist, is a human being first and a medical doctor second. As the Medscape article linked below points out, religious beliefs may guide your onc’s beliefs on PAS.
4) Palliative cancer care is NOT effective in all end-stage cancer situations.
5) For many cancer survivors, PAS is more about control that dying.
5) No prognosis is certain. I am not a 1 in 1000 fluke. There are thousands of examples of cancer patients living well beyond their terminal status.
This Medscape article raises some important PAS issues. The most important issues for all cancer patients, survivors and caregivers to understand is, odds are your oncologist is against PAS. This is important for you to remember.
The top reasons why physicians are against PAS are as follows:
“Why I’m Against Physician-Assisted Suicide”
1. God Is Against It (Religious Beliefs)
“The majority of physicians who were against PAS talked about God and religion. “Life is sacred, I will not play God…” While some respondents didn’t specifically mention God, they said, “my religious beliefs rule here.”
2. Support for Palliative Care
“Their assumption was that palliative care is available to all and effective in all or most situations. While that’s often true (or should be true), it may not always be the case.”
3. Maybe the Patient Has Treatable Depression
“One doctor commented that he supported PAS “pending a full assessment to rule out depression and other complicating conditions…
Studies showed that the fact that patients had access to the medication (suicide) if they needed it gave them a sense of control that actually enabled them to not want to take the dose, and they died from the disease itself.”
4. No Prognosis Is Certain
“A number of physicians asked, “Who is to say what is terminal and when death will come? I’ve seen situations in which everyone expected the patient to die very soon, and for unexplained reasons, the patient lived and the symptoms—while they did not disappear, they definitely subsided.”
“Why I’m in Favor of Physician-Assisted Suicide”
1. Medication Barely Helps Intolerable Torment and Prolonged Misery
“Physicians who had more direct or more frequent exposure to patients suffering from not-always-controllable pain, inability to breathe or move, reliance on years of dialysis, loss of all control, etc, talked about the patient’s profound misery and the concomitant suffering of the helpless family members. “
2. We Shouldn’t Force Patients to Have to Figure Out How to Kill Themselves
“In one interesting subdebate, some doctors commented that if patients want to kill themselves, they are certainly capable of going out and doing so…Other physicians seemed outraged that innocent, decent people should be forced to resort to more pain and torment by stopping food and treatment and waiting to die or that others should be forced to create violent means of death for themselves or create situations in which family members or other unsuspecting people will be the ones to find them dead.”
3. Why Shouldn’t We Treat People as Well as We Treat Animals?
“When dogs and cats are suffering from terminal disease or intractable pain, and there’s no way to fully alleviate the suffering, euthanasia is the common “treatment…” Of course, animals are not people (although some folks disagree), and therefore the same standards should not be applied to them.”