Medically assisted death: Don’t alter definition of medical care
COURTESY PIXABAY
James Hochberg is a Honolulu lawyer who believes that we should stand in strong opposition when it comes to legalizing physician-assisted suicide.
The Hawaii Legislature is hearing bills to legalize physician-assisted suicide to radically change the practice of medicine. We should stand in strong opposition. Without an accepted medical protocol for suicide, doctors are guessing on the proposed protocol for medical suicide. In the places that have legalized physician assisted suicide, the suicide medicine often comes with dangers of unintended survival of the patient with new health issues, or organ failure, coma and the like.
>> Medically assisted death: A compassionate option
In 1896, the Hawaii Territorial Legislature enacted the statutory definition of the practice of medicine to be the treatment of disease in humans. That concept has been the definition of the practice of medicine since Hippocrates of Kos offered it in the late 5th century BC. For the last roughly 2,500 years, that understanding has led to the trust between medical professionals and their patients that continues to today. The Hawaii definition has only been changed a couple of times since 1896, and all of those changes increased the type of treatment permitted, and permitted those new treatments only for maintaining health and treating disease.
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Now, proponents of doctor assisted suicide want to change the definition to include intentionally ending the life of a patient instead of treating the symptoms, which is inconsistent with the concept of maintaining health and treating disease.
In 2017, the main proponents filed a lawsuit asking the Hawaii court to legalize physician-assisted suicide. Contrary to their arguments since 2011, this practice is not legal in Hawaii. They argue that the law must permit a doctor to facilitate a dignified and peaceful death when the patient desires to end their life; however, for ages, people all over the planet have been taking their own lives for any number of personal reasons.
Five bills on assisted-death are before this Legislature. Only Senate Bill 1129 has received a hearing so far and is advancing:
>> SB 1129: Would establish a death with dignity act in which a terminally ill adult resident may obtain a prescription for medication to end life. Licensed physicians would be allowed to prescribe a lethal dose of medication to terminally ill, competent adults diagnosed with six or fewer months to live.
>> HB 201: Would let a terminally ill adult with the capacity to make an informed healthcare decision to request a prescription for aid in dying medication from physician.
>> HB 550: Would authorize terminally ill adults seeking to end their life to request lethal doses of medication from medical and osteopathic physicians.
>> HB 150: Establishes a persons ability to choose the End of Life Option when afflicted with a terminal illness.
>> SB 357: Authorizes a terminally ill adult with the capacity to make an informed health care decision to request a prescription for aid in dying medication from their physician.
The second argument in the lawsuit is that no legal difference exists between medical directives (instructions a patient may give a doctor defining the treatment the patient wants and does not want) and a doctor giving dangerous and controlled medicine intended to be used for suicide. No common understanding of the practice of medicine includes physician-assisted suicide, yet the proponents unbelievably argue in the lawsuit that physician-assisted suicide is, in fact, another way to treat disease in humans.
Here’s how it works: The physician writes a prescription for anti-nausea pills and 100 capsules of seconol, a sedative drug. After giving the patient the prescription, that is the end of the doctor’s assistance in the suicide process. Without help, the patient must empty the 100 capsules to accumulate nine grams of pure, bitter-tasting seconol. To mask the bitterness of the suicide medicine, it is mixed with something to make it somewhat easier to swallow.
Before the patient actually consumes the suicide mixture, she must ingest the anti-nausea medication, to avoid rejection of the suicide mixture which would result in failed suicide. The doctor is not present to help with any complications: suffocation or multiple organ failure. On the other hand, in places in Europe when the doctor is present for the suicide, he fixes a failed suicide by lethal injection.
“Physician–assisted” suicide is very little assistance from the physician. It quite easily is not a peaceful and dignified death. Recognize that intentionally taking the life of the patient to alleviate health symptoms is not the treatment of disease so not the practice of medicine understood for 2,500 years. Don’t radically alter the practice of medicine to include the intentional elimination of the patient.
James Hochberg is a Honolulu lawyer and an Alliance Defending Freedom allied attorney.
17 responses to “Medically assisted death: Don’t alter definition of medical care”
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Death is a part of life. We are sovereign beings not party to a government or corporation. In our path we shall travel unimpeded by license or any harassment as guaranteed by Kanawai Mamalahoe; the first law of the Kingdom and enshrined in the fakeState constitution. Impede ones right to travel and Hewa no make. A lawful government may pretend to regulate business but only tyranny tries to dictate what is peace when injuring my own. Without lawful compromise terror and fear breed the unthinkable. The fakeState has no say (as long as peace is maintained) what i put or don’t put in my veins, who i sleep with or practice procreation or how i birth or how i die.
This extremely heartbreaking situation, i.e. in the case of a hopelessly, terminally ill patient, should be addressed. It is not an easy topic to breach and requires clarity on definitions, authorizations, administration, and discussions on morality. However, Jack Kevorkian showed that the severity of certain individuals’ illnesses & related suffering, requires this type of assistance. Not a “cut-and-dried” issue from any angle.
Kevorkian showed nothing except his own agenda. Fear mongering is what promotes this legislation as palliative care properly administered addresses the issue of pain and suffering.
Quote in the dumb article;..dangers of unintended survival of the patient with new health issues, or organ failure, coma and the like.’
Are they gone totally nuts? Anybody with only a remnant of a brain knows how to use enough heroin to send the body into the beyond!
quote “… totally change the definition of medical care” Are the writers gone insane? nothing but panic suggesting impudence , HAIRRAISING NONSENSE ARGUMENTS. ANYBODY WHO KNOWS ABOUT ANESTHESIA knows you go to sleep without nausea !
Jim, mahalo for your words. Imua.
Try harder…weak arguments. Legislator of 1896? Don’t even want to think what the government makeup of Hawaii looked like shortly after the imprisonment of the queen. Even in the US at that time blacks and women had no voting rights. 2500 years ago? Were doctors back then even at the point of using leaches to cure ailments?
But I did learn something. Sounds like the process of death assistance could be improved. Hope the legislators write that into the bill before it PASSES and becomes a much belated needed law.
If you take the “profit” away from medical facilities that keep pain riddled terminally ill patients artificially alive, this subject would be talked about more humane.
“The Hawaii definition has only been changed a couple of times since 1896, and all of those changes increased the type of treatment permitted, and permitted those new treatments only for maintaining health and treating disease.”
so abortion teats a disease?
Let’s not forget –
https://en.wikipedia.org/wiki/Terri_Schiavo_case
Mr. Hochberg, there’s no such drug as “seconol.” You must be referring to Seconal, the tradename for secobarbital, a barbiturate drug that in decades past was widely used as a hypnotic (sleep-inducing drug). The barbiturate class of hypnotic drugs has been virtually eliminated by more modern “sleeping pills” in the benzodiazepine class of drugs such as temazepam (Restoril) and triazolam (Halcion), or by even more modern non-benzodiazepine, non-barbiturate drugs such as zolpiden (Ambien) and eszopiclone (Lunesta). All of these non-barbiturate drugs have much better safety profiles than the barbiturate class of hypnotics. This is why in modern times orally-administered barbiturate drugs such as secobarbital are extremely difficult to find, and even harder to purchase, legitimately or otherwise.
You are correct, Mr. Hochberg, that attempted suicide using the physician-prescribed drugs you describe is fraught with potential for failure. A failed or aborted attempt can leave the person with massive brain damage, a state much worse than death. The costs of caring for such a person are enormous, both for families and for our communities.
This is precisely why humane, ethical euthanasia of persons who choose to die rather than endure extreme suffering or disability must be the responsibility of licensed health care providers. Euthanasia protocols employing intravenous administration of drugs by trained professionals are highly effective. Safeguards can be imposed by law to assure that human euthanasia by health care professionals is performed only after review by an impartial panel of professionals who are bound to inquire thoroughly for potential ulterior motives (“Let’s kill tutu so we can get her house and money,” etc.) or for behavioral health issues that potentially could be remediated with appropriate medical therapies. Just look to the successful implementation of ethical human euthanasia in Oregon: the “catastrophes” predicted by naysayers have failed to occur.
For Heaven’s sake, Mr. Hochberg, our society allows and even encourages humane euthanasia for our beloved non-human “family” members when they have incurable suffering. Veterinarians administer a sedative drug to relax and calm the suffering pet, then administer a lethal intravenous injection that quickly and assuredly renders the pet unconscious and stops its breathing and heartbeat. The procedure is much more difficult and emotionally painful for the pet’s human survivors than it is for the pet. Dozens of animals are humanely euthanized in our state, every day.
We as a society have the compassionate good conscience to offer our pets release from intractable suffering. Is it morally justified to deny our human family members the same compassion? I, for one, think not.
Mahalo, justin_thyme.
Hawaii should keep it simple and start with incremental steps regarding this subject. If someone requires a morphine drip and is such intense agony and pain from clearly documented terminal cancer or whatever, they have a the option after discussion with the patient and family members to up to a lethal dose. Don’t make it easy for the patient amd family to accomplish this but it can be a last available legal option. And the patient really has to be at a point when they are so close to death such as they are in hospice care that this option is made available. I don’t agree with Hawaii legalizing a Kervokian style suicide machine that you can press a button to end their life. If someone is still mobile enough to walk and talk and want to end their life for whatever reason, then they can take a plane to Oregon and NOT Hawaii where they can use a suicide machine or whatever.
James Hochberg, your argument is based on an appeal to tradition, a logical fallacy. Time alone isn’t justification for continuing a practice that is, by all accounts, inhumane. Just because things have been done a certain way for ages doesn’t mean it’s right or good. If history and precedence were the final arbiter for our decisions, then we’d be doomed to repeating the same mistakes over and over again. The proposed bill to legalize physician-assisted suicide frees the many from the tyranny of a few, like you, who believe they have the right to decide how everyone else should die when terminally ill and suffering. The proposed bill doesn’t take any rights away from you. You can decide for yourself whether or not to seek assistance toward the end of your life. What this bill does do is frees us from your power to decide how the rest of us will face our end. Unless you’re somehow morally, ethically, and spiritually superior to the rest of us, please, step aside and give us the power to die with dignity when our time comes. Aloha.
Very well said, kimo. Hochberg and his ilk pretend to be “libertarians,” but in reality they’re consummate authoritarians who wish to impose their own sets of values on all the rest of us.
Death and the choices surrounding it are intensely personal and almost invariably context-dependent. Society must move forward and reject rigid rules and customs that deprive individuals of their autonomy, whether exercised personally or by their trusted designees.
don’t pass that assisted suicide law there will be a lot of malpractice suits by there siblings because they will claim that there family member was not in there right mind when they said to the doctor to give them something to end there life.
levitt, Yamane, and soldner ambulance chasers to the rescue.