Agreeing With An Emanuel? On End Of Life Issues… Perhaps

Never thought I would agree with what any of the Emanuel brothers— Rahm, Ari or Ezekiel– would write.  But I may have some common ground with brother Zeke (Ezekiel).  A professor at University of Pennsylvania, a trained oncologist and politically to the left of Trotsky, he was influential in formulating much of the Obamacare platform.  But his opinion in the NYTimes is worth considering.  He writes about the issue of physician-assisted suicide and associated issues. He attempts to dispel four myths associated with the topic.

First “pain”.  He points out that patients who desire euthanasia (in which a doctor administers a lethal drug) or physician-assisted suicide (in which the patient himself takes the lethal drug prescribed by the physician) tend not to be motivated by pain.  His claim is that the vast majority seek such an end not because of physical pain but psychological pain.  These individuals, he believes, should be offered “counselling and caring”, but not be considered for either of the above.  This sounds rather naive to me.  Depression associated with pain and the dying process cannot be treated with drugs or therapy.  It is often a natural reaction to the suffering that occurs at the end of life.  It is not a “disease” to be treated but a reality. Of course they should be utilized if possible.  I doubt very much they will alleviate the true suffering that is both physical and mental. So suffering will remain regardless of the cause.

Secondly, “mass appeal” which implies that assisted suicide will improve the end of life for everyone.  He points out that in Oregon in which only .2% of dying patients chose this means of dying and in the Netherlands fewer than 3% did.  His left leaning politics comes raging through when he states “well-off, well-educated people, typically suffering from cancer, who are used to controlling everything in their lives–the top .2%  And who are the people most lifely to be abused if assisted suicide is legalized?  The poor, poorly educated, dying patients who pose a burden on their relatives.”  Are you for real, Zeke?  How sanctimonious can you get.  Do you really think “rich” people will choose assisted-suicide just because they like to “control” everything?  Do your honestly believe poor people will be led to slaughter because they are a “burden” on their relatives.  Come on, dude.  You are stereotyping in the worst, most obnoxious way.

A “good death”.  He points to those rare situations in which the process fails.  Assisted-suicide is not perfect, nothing is, but this is a lame attack on the system itself.  The only statement he makes that makes sense is his last paragraph in which he emphasizes that we need to improve the care of the dying.  Palliative and hospice care should reduce the need for physician-assisted suicide.  But his arguments against it are rather weak. I would not dismiss the option for those who seek it.

Facilitating the inevitable when there is unremitting suffering (physical or mental) need not justify itself to anyone.

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