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San Diego Union Tribune: Doctor assisted suicide sends wrong message

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San Diego Union Tribune

June 17, 2015

Commentary By James Santiago Grisolía M.D.


The patient lay confined to his bed, tied down by a failing heart and oxygen flowing constantly to the little prongs in his nose. He had lived a long, jolly life of faith and hard work. Here, on his last bed, he was luminous. His white hair, his translucent skin, his weakening laugh, all seemed lit from within. He died peacefully, amid family, when his time came. Not by suicide.


I’m a neurologist, and I know that death is hard and comes in all shapes and sizes. End-of-life care arouses strong emotions. But a small group of suicide advocates have increasingly dominated the California conversation on dying issues.


The Hemlock Society, re-branded as “Compassion and Choices,” has amassed a $22 million war chest, mostly from out-of-state figures like George Soros, for a three-pronged attack to pass physician-assisted suicide (PAS) in California: SB 128, a bill now moving to the state Assembly; a San Diego lawsuit saying physician-assisted suicide is already legal; and, if needed, a voter proposition. They believe the day for suicide has come.


Physician-assisted suicide means that you could find a doctor online, who would then examine you and a write a cheap prescription for an overdose of sleeping pills. You could take it the same day or anytime later when you felt ready. Sadly, your 12-year-old or anyone else could also find and take it.


SB 128 is flawed by a lack of safeguards. While claiming to limit PAS to patients with less than six months to live, this law provides complete legal immunity to the death doctor, with no mechanism for oversight or verification. PAS must be left off the death certificate and the only cases recorded will be those voluntarily reported by the doctor.


Oregon, Vermont, Washington and Canada have similar laws on physician-assisted suicide. We know stories of individuals getting PAS without a six-month prognosis, and we also know, at least in Oregon, that only a few doctors are doing the lion’s share of physician-assisted suicides. Instead of your family doctor sending you for an objective second opinion by a specialist, what really happens is that patients shop for a doctor who advocates PAS, who then gets a “second opinion” from another advocate who always agrees. In 2014, of the 105 cases reported in Oregon, only 2 percent got psychiatric evaluation for treatable depression. Without legal immunity, this would be malpractice.


SB 128 is both dangerous and unnecessary. Unnecessary because the Hemlock Society has been telling people how to commit suicide painlessly, without help, for decades. Dangerous because the doctor’s lethal prescription can have complications which go unreported under the shroud of secrecy covering physician-assisted suicide laws in other states. Our prison systems continue to botch executions, even with professional supervision. How can we send a sick, frightened patient home with a bottle of Nembutal, to die alone or with family, easily vomiting, choking or otherwise suffering?


In my experience, the family left behind suffers a range of emotions, including guilt and divisive anger. “You shouldn’t have let Mom go,” or “Did I do enough to let Mom know she really wasn’t a burden to us?” SB 128 fails to require family notification, much less any family therapy or reconciliation before the fatal swallow.


As our teens and young adults fight a rising tide of depression and suicide, what kind of message does it send to approve PAS? The state and doctors are telling you that suicide is legal and OK, it’s just a “choice.” Besides eroding the doctor-patient trust bond for all of us, legalizing physician-assisted suicide indirectly endangers our kids and other depressed, vulnerable people.


True “death with dignity” would make palliative/hospice care available for all Californians. The sensitive palliative care team involves family and friends, underscores the patient’s true human worth, and, when needed, can legally provide terminal sedation when suffering can’t be controlled.


Our representatives in the Assembly need your input now, to know how many Californians care on each side of this issue.


Grisolía, M.D., is a San Diego neurologist and is California director for the American Academy of Medical Ethics.


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