Assisted Suicide Is Death Knell to Doctor Ethics

Article excerpt

The Supreme Court recently heard oral arguments in two cases that could generate a constitutional right to physician-assisted suicide. Several justices seemed skeptical about the wisdom of creating such a right, and we all should hope that the court will resist the temptation to authorize doctors to kill their patients. Otherwise, we soon will witness a new and barbaric culture of euthanasia and bureaucratized death.

Why shouldn't patients be free to have their doctors help in using lethal drugs to end their suffering? The answer lies in the special nature of the doctor-patient relationship. Anyone who has been seriously ill knows something about the tremendous power that physicians exert over their patients. Physicians have a virtual monopoly over the information patients use to make decisions about their own treatment, and they are experts at presenting the options in a way that almost guarantees which choice the patient will make. This is not necessarily inappropriate. We hire doctors, after all, because they know more than we do about treating our illnesses. But it does require us to assume that doctors have our interests at heart when they make their recommendations.

For thousands of years, the medical profession has recognized that patients will not place the necessary trust in doctors who behave like ordinary tradesmen. With the Hippocratic oath, every doctor promises neither to give a deadly drug to anybody if asked for it nor to make a suggestion to this effect. The oath is an offer to make a bargain with patients: "In return for your placing more trust in us than you do in ordinary tradesmen, we promise to behave in a less self-interested manner than other tradesmen." This is a good bargain for both parties: Physicians get more business because sick people will be less inclined to practice home remedies, and patients get better medical care when they are treated by experts.

The bargain implicit in the Hippocratic oath, however, is not self-enforcing. Traditionally, state legislatures have promoted the medical profession's monopoly by restricting unauthorized medical practice and by giving physicians exclusive control over powerful drugs. In return, state laws have required physicians to abide by key tenets of the Hippocratic oath, including the ban on assisted suicide and euthanasia. …