Medical Association public hearing about Physician Assisted Suicide

"...allowing physicians to participate in what amounts to assisted suicide may cause more harm than good. The provisions of the bill are fundamentally incompatible with the physician's role as healer, would be difficult or impossible to control and would pose serious societal risks."

This public hearing testimony provided by the Maine Medical Association explains a point of view in opposition to physician assisted suicide. Although this end of life issue is cloaked by emotion, the inclusion of others who will be asked to participate in this practice, is seldom considered.

Testimony of Gordon Smith Esq.

Testimony of the Maine Medical Association in Opposition to l..D. 1270, An Act Regarding Patient-directed Care at the End of Life to The Joint Standing Committee on Health and Human Services Cross Office Building, Room 209 May 15, 2015, 9:30 am 

Senator Brakey, Representative Gattine and members of the Committee, I am Gordon Smith, of East Winthrop, testifying today on behalf of the Maine Medical Association which l serve as Executive Vice President. 

The Association represents the interests of over 3700 Maine physicians, medical students and residents. The Maine Medical Association appreciates the good intentions of Senator Katz and the bill's cosponsors in presenting L.D. 1270 which would authorize a physician to prescribe a fatal dose of medication to a terminally ill patient under speci cally described circumstances and subject to several regulatory protections. If enacted, Maine would become one of a handful of states, including Vermont, Oregon, Washington and Montana, which allow such a practice. 

Maine voters rejected similar legislation in a ballot referendum in the year 2000. Given that other states have actual experience now since that time, it certainly is reasonable for the Legislature or the voters to take another look at this. And it is understandable that some patients in extreme duress such as those suffering from a terminal, painful debilitating illness may decide that death is preferable to life. 

However, allowing physicians to participate in what amounts to assisted suicide may cause more harm than good. 

The provisions of the bill are fundamentally incompatible with the physician's role as healer, would be difficult or impossible to control and would pose serious societal risks. The Code of Ethics of the American Medical Association, enforceable against Maine physicians as standards of practice by the medical licensing boards, in , Section 2.211 (attached to my testimony) prohibits a physician from taking the action called for in L.D. 1270. 

Passage of the proposal would put physicians in a conflicting position of honoring legal patient wishes or upholding their professional ethical code. 

Rather than working with patients to end their lives, physicians should aggressively respond to patient needs at the end of life. Among the options available are hospice care, palliative care, specialty consultations, pastoral support, family counseling, conscious sedation, and other modalities. 

Patients near the end of life must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy and good communication. You will hear from many opponents of some of the risks and dangers associated with this type of legislation. One significant one is that patients who may be without insurance coverage may chose suicide out of financial concerns...specifically not wishing to be a burden on their families. Such a decision should not have to be made in a just society with the resources that are available in our state and nation. A second risk is that despite the attempt in the bill to provide protections, the lives of our vulnerable elderly will be devaIued...the right to die may for them become the duty to die. And finally, physicians do not wish to play God. No one knows when a person's time on this earth is up, or when our "expiration" date arrives, as my late father Ezra used to say shortly before his good death at the VA Hospice last November at the age of 91. What a loss it would have been to our learned society if Stephen Hawking had taken advantage of this type of law had it been available in England when he was found to be terminally ill with ALS while still in college. He lives on today in his early 70's enjoying his children, grandchildren and still engaged in his research and writing. 

Thank you for the opportunity to testify and I would be happy to answer any questions you may have.

Belgian children are now the victims of the slippery slope predicted by the right to life advocates

Belgium lawmakers vote for children's right to die law. This is horrible because children are frequently the beneficiaries of spontaneous remissions. Of course, some children have difficult developmental difficulties from which they may never recover. Nevertheless, children should be the recipients of boundless hope. Anyone who puts out the option of death to a child for any reason has, truly, lost their own humanity. 

There's absolutely no reason, whatsoever, under any circumstances, to offer euthanasia as an end of life option for a child. Children are incapable of making these decisions for themselves; therefore no one should be authorized to make these life ending decisions on their behalf, regardless of the intention. Never. 

Although evidence of loss of brain function over an extended period of time can require the removal of life support, this decision should not be  interpreted as euthanasia. Euthanasia is the intentional intervention at the end of life to bring about an unnatural and premature death. Children deserve hope, not death.

As a professional registered nurse, I've seen families bond and medical providers rally to save the lives of children. It's unethical to put families and medical care givers in a position of advocating for the right to die for children. Moreover, it's morally unconscionable to permit euthanasia for children, because they have a strong capacity to recover from illness and injury. Children often outlive their terminal illness diagnosis. 

How many times do we read about children who are the victims of drowning being revived with no apparent harm? This is particularly evident when children are the victims of hypothermia. Moreover, children respond favorably to life saving interventions like transplants and immune therapies to treat malignancies.

Nevertheless, you must listen to this. 

I've heard parents tell me how having a mentally ill child is more difficult to deal with than terminal illness.

Do blog readers need to read the above again?  

Parents have told me, as a nurse, how a mentally ill child is more difficult to deal with than terminal illness.

Treating children with mental illnesses are expensive and recoveries are rare.  

Treating children with life threatening illness like cancer or metabolic diseases can be successfully accomplished. Remissions are common.

Children, especially those in Belgium, are now the victims of the slippery slope predicted by the zealous right-to-life advocates. There's dwindling hope for anyone with terminal illnesses to live longer lives, if people are considering euthanasia for children.  

A society that voluntarily authorizes children to euthanize will also put at risk the end of life care for everyone else.  

Belgium has now validated the ugly outcome of the "slippery slope" argument. This euthanasia decision by Belgium lawmakers is unethical and it puts all people with terminal illnesses at risk for having caregivers abandon hope for remissions or extended life options - especially those with mental illnesses.

As a nurse, I firmly believe the above to be the truth, the whole truth and nothing but the truth, so help me God. My opinion is validated from experience.