LETTERS: PHYSICIANS AND SUICIDE

To the editor:

In 1973, the U.S. Supreme Court carried the right to privacy to the extreme and gave us the Roe vs. Wade decision which has resulted in the legal killing of millions of unborn babies in the ensuing 23 years. Two recent federal court decisions have the potential to do for euthanasia what Roe vs. Wade did for abortion. On March 6, the 9th Circuit Court of Appeals in San Francisco struck down a Washington state law banning physician-assisted suicide. On April 2, the 2nd Circuit Court of Appeals in New York voided a similar law which had been passed by the New York Legislature.

In the Washington case, the court wrote: "The first distinction -- the line between commission and omission -- is a distinction without a difference now that patients are permitted not only to decline all medical treatment, but to instruct their doctors to terminate whatever treatment, artificial or otherwise, they are receiving." This is the crucial fallacy in the 9th Circuit argument. There is a huge moral difference between allowing a patient to refuse a futile treatment and actively causing his death. Life is a gift from God, and he alone should determine when life begins or ends. It is arrogant and presumptuous to assert that we pitiful humans have a right to exercise control over life (abortion) and death (euthanasia).

On the other hand, refusing or terminating treatments such as respirators or feeding tubes when there is no reasonable hope of recovery is merely a way of letting nature take its course. Pope John Paul II in his teachings has forcefully emphasized the critical distinction between the withholding of burdensome medical treatments and active euthanasia. He states that euthanasia "must be distinguished from the decision to forgo so-called 'aggressive treatment.' ... To forgo extraordinary or disproportionate means is not the equivalent of suicide or euthanasia; it rather expresses acceptance of the human condition in the face of death."

Once our society legalizes euthanasia in the form of physician-assisted suicide, we take the risk of sliding down the same slippery slope that Roe vs. Wade brought us to in the matter of abortion. After voluntary euthanasia, it is but a short step to a substituted-judgment decision to end the lives of terminally ill or handicapped persons who are either unable or unwilling to give their assent.

One of the assumptions of the suicide-rights movement is that suffering is an evil to be avoided at all costs. By suffering, I refer not just to physical pain, but rather to the loss of control, the dependency upon others which our society finds to abhorrent. Suffering, as opposed to physical pain, is a more deeply personal and spiritual matter. Christians derive strength from the example of Jesus Christ, whose suffering redeemed mankind. Our faith gives us the strength to endure earthly sufferings and to even turn them into a source of spiritual growth.

Many Americans fear that, when their time comes, they will be trapped in an intensive-care unit, their corpse kept alive by the excesses of modern medical technology. They also worry that their pain will be undermedicated. But the care of the dying is dramatically better now than five or 10 years ago and is continuing to improve. Our pain-controlling methods are now so advanced that by either using drugs, spot radiation therapy or selected nerve blocks performed by pain specialists, pain can almost always be effectively relieved.

Persons concerned that their lives will be needlessly prolonged when there is no hope of recovery should be encouraged to sign a living will in which their wishes regarding end-of-life care are outlined. Better yet, they should appoint a close relative or friend to be their durable power of attorney for health care. By so doing, they can assure that someone who shares their convictions will be available to help the medical team make treatment decisions in the event that they are incapacitated.

Care of the terminally ill has been aided tremendously by the growth of the hospice movement. A hospice is an organization consisting of both trained physicians, nurses and dedicated volunteers who tend to both the physical and emotional needs of the dying patient and family. They offer a much more rational solution to the problems faced by the terminally ill than does Dr. Kevorkian's suicide machine.

The task of the medical professional is to care even when he or she cannot cure. But killing a patient, regardless of the intended ends (relief of suffering) is never justified. We need look no further than the oath which most physicians took when they graduated from medical school, the venerable but quite relevant Hippocratic Oath:

"I will use treatment to help the sick, according to my ability and judgment, but I will never use it to injure or wrong them. I will not help a patient commit suicide, even though asked to do so, nor will I suggest such a plan. Similarly, I will not perform abortions. But in purity and holiness, I will guard the sanctity of life and my role as a healer. ..."

MICHAEL WULFERS, M.D.

Cape Girardeau