Monday, February 2, 2009

HPM Issues 2009:
#3 Dealing with Medically Hastened Death

(This is the third in a series of 5 posts (#5, #4) about issues in hospice & palliative medicine I think will be important in the next year. Feel free to disagree!)*

#3 Dealing with Medically Hastened Death
In a world where a women can give birth to 8 children, the abilities for science and medicine to control the beginnings and ends of life is unparalleled to any other time in history. As experts in the medical care of dying people, the public will look to us for guidance and measured discussion with regards to the political firestorm that is euthanasia and physician-assisted suicide/death. Physician-assisted suicide (PAS) is already legal in Oregon and now Washington state and potentially Wyoming.

If palliative care is patient centered how do we advocate for total care but stop short of full autonomy when it comes to the actual time of death. Is a neutral approach the best? Should we lead and help support or oppose legislation? Will this issue split our currently congenial and very supportive community along ideological lines? We educate and counsel so many families and patients about good end-of-life care on an individual level, so what is our responsibility to the greater public? These questions keep me up at night. And I am afraid I alone do not have the answer.

The AAHPM issued a new statement on Physician Assisted Death in 2007. It supports physicians in states where PAD is legal, while at the same time urges great restraint in wielding this power. Have you read the AAHPM's position statement? Any thoughts? If Compassion and Choices wanted to sponsor a speaker at a palliative care conference or place advertising in palliative care journal would would be the appropriate response?

Sometimes it is easier to just not think about these things, but it does not make them go away.

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