Friday, 10 July 2009

"No Kill" Nursing Homes

I just discovered that the senator for our region of Pennsylvania, Lisa Boscola, co-sponsored a senate bill 404 that will legalize physician assisted suicide if it is eventually passed. What this will mean is that if grandma is diagnosed with "terminal cancer" and wishes to end her life, she can ask the kind family doctor for a prescription cocktail that will end her life.The Hippocratic Oath which I took in 1985 makes me promise to not give anyone something that would end their life, nor counsel them on how to do it. Most western cultures have prohibited suicide and have laws against it. Both Christian and Jewish theologians have understood suicide to be a grave moral evil. Now in our enlightened age, we are going to change the rules and say it's ok to kill grandma or grandpa. Giving a patient a prescription to end their life is no different than me (a physician) going to K Mart and buying a shotgun and shells, sawing off the barrel for convenience and leaving it at the doorstep of my suffering patient so they can end their life.Does anybody have a problem with this?I am the medical director of two nursing homes and oversee the care of over 200 frail elderly patients. I spend my day attempting to alleviate the pain and suffering that is often experienced in the end stages of life. It is not usually easy, but often labor intensive and emotionally draining at times. However, I view it as my privilege to be entrusted to care for the most vulnerable of our society and would want no other job. But is if this bill becomes law, some will view it as cheaper and more convenient to encourage patients to end their life. The value of a older suffering person's life will drop faster than the stock market as it has in the European countries that have embraced PAS and EuthanasiaI am thinking of asking the administrators of my nursing homes to designate them as "No Kill Nursing Homes" just as they do with dog shelters, so the patients can be assured that they will be cared for and not put out of their misery. How can the hand that heals also be the hand that kills? How will patients trust me?The fact that most people I have spoken to in the medical profession have no idea that this bill was proposed back in March is frightening. This is not unintentional. Will we be the next Oregon or Washington state?In the next several months I am hoping to organize some effort to educate those around us to Physician Assisted Suicide and hopefully, by the time the bill is put up for a vote, or a public referendum, the public should be well-informed of this evil. The trick is to get to the public before the well-oiled and funded euthanasia lobbying machine gets to our legislators. Let your senators and representatives know how you feel about this.If you wish to let SenatorLisa Boscola (Lehigh Valley Region) know about your feelings towards this bill and her co-sponsorship of it, email her


MMajor Fan said...

Hi TJ. I've just discovered this blog.

TJ, I think you and other doctors have a huge chore ahead of you (and I know, time is a precious commodity). But I believe, and I'm not the first to say this, that especially when it comes to healthcare, doctors must break each issue into their components and communicate the problem to the public at large with each and every topic.

For example, we abhor the physician assisted suicide mentality, and that is morally instinctive for us. However, when speaking to a member of the public, they tend to have an image flash into their mind upon generic mention of this topic (a mentally stable but greatly suffering person who with sound mind wants to end his or her life due to a terrible fatal illness).

What doctors need to do is coach and teach the general public to see the slippery slope and problems beyond the singular image that flashes into their mind. For example, is it right for the bill, even if you believed in it, if it allows physician assisted suicide if the person is in pain but not every pain remedy has been tried? I mean, you know as doctors, how many people make great decisions when they are in agony? The general public can understand that scenario. So you can point out that even if such a bill were passed (God forbid), that who in their right mind would want a bill that doesn't first require the physician to demonstrate that he or she obtained every pain relieving treatment possible first.

Think about it legally. People cannot sign their own wills if they are under the influence of medication or otherwise. Yet, should a patient who is in terrible suffering sign their own death warrant if there is a way to remove them from the pain through pain treatment that has not yet been tried? So I cannot even fathom a physician assisted suicide bill, like it or hate it, that does not have a requirement that checks if all possible pain treatments have been given to or tried with the patient first, before the patient is forced by their pain in agony (thinking there is no relief from the pain) when perhaps the physician has not tried all possible. Perhaps we should demand a sign off from a non-physician assisting suicide doctor who specializes in pain relief first.

You see what I mean? Doctors, nurses and other concerned, ethical healthcare providers must attack the overall topic/philosophy of each bill, but also educate the public about each and every segment and aspect, as I give that example here. This is especially important as all the hidden pieces of the gigantic "healthcare plan" bill is rammed and crammed without examination. Each component must have light of day shined on it and then a physician/nurse statement and education of all the implications. Otherwise the general public just thinks of a stereotyped "for instance" as the knee jerk reaction (which is natural to think, "Hm, that sounds good and reasonable") without knowing the specifics of what is being proposed and all the incredibly scary implications, many of which I imagine have not at all been thought through by the authors, who suffer from the same ill informed "do good tunnel vision" problem!

Paulinus said...


I want to publicise this. please comment on and spread more widely this disgusting piece by Tony Delamothe in the BMJ:

Here's a taster:
"The debate on assisted dying has been hijacked by disabled people who want to live."

All the best


WV: being - I kid ye not!

Tiber Jumper said...

thanks MMF-I just found your comment now. Excellent thoughts!God bless

Anonymous said...

Great points to consider. I always believe that only God our Almighty has the right to say when it is time to go. Keep up the good postings and inspirations. By the way, these best gifts that you could give your better-half might interest you too. Thanks and have a nice and fulfilling day.