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camelStarting June 9, under a concept euphemistically known as “aid-in-dying,” terminally ill Californians can request prescriptions from physicians for medications that would allow them to end their lives. This is not to be confused with euthanasia, under which a third party administers the life ending medication or treatment. Under the California law, a doctor does not administer what he or she prescribes and is not required to issue such a prescription or refer a patient to another doctor who will.

In 1998, Oregon became the first state to allow doctors to prescribe lethal medications. The aid-in-dying practice has since become legal in three other states: Washington, Vermont and Montana. About a dozen other states, including Arizona, are presently considering adopting the same or similar laws.

The Los Angeles Times recently published the opinion of an Arizona doctor who will not abide by the lawful wishes of a patient no matter how well reasoned and informed because she believes the Hippocratic oath and her personal ethical (and religious?) position trumps the patient’s wishes no matter how well thought out.

The stated rationale of the Arizona doctor is that taking a legal dose is not the “right” way to die. Instead, she advocates hospice care and using morphine to induce a pain free coma while the patient dies “naturally.”

In this writer’s view, the Arizona doctor’s opinion illustrates the ultimate definition of a moron and hypocrisy (not to be confused with Hippocracy!) Let’s be clear here: I would not presume to question the doctor’s religious or ethical views, in spite of the fact that I strongly disagree with the use of religious or ethical precepts to trump the informed wishes of a dying patient to dictate his or her own exit plan (particularly under the safeguard procedures incorporated into the new California law).

The straw that breaks this camel’s back, however, is when the good Arizona doctor, no matter how well intended, attempts to distinguish between a quickly administered death and a slowly administered death. There simply is no rational distinction between the two. Make no bones about it, each involves professionally assisted death. For whatever naive reason, the Arizona doctor has somehow frivolously convinced herself that it is sounder and more ethical—and “better” for the patient and his or her loved ones who must sit and painfully maintain the vigil and assist their loved one on his or her final journey—to administer death more slowly.

I like the doctors in my life, both those who are there professionally and those who are there socially. To my observation, they are mostly hard working, dedicated servants who, in this economic climate, aren’t paid what they should be.

That said, however (and there are “bad” apples in every barrel), this Arizona doctor should stick to being a physician and not an ethicist or a logician. Doctor, heal thyself. Please!

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  • Jane S Taber

    This doctor needs to be put in a coma and die unnaturally.

    • 🙂

    • Jane, I think you will get notice of this further reply to you, but not Pepe’s reply above to me (and you too). I’m just bringing to your attention that Pepe offers a point of view contrary to yours and mine, to which you might want to respond.

  • Fred Taber

    Fortunately there are many more “fish”ycians in the sea who will issue prescriptions to aid a terminally ill patient!

    • Good to know. Patients and their families should be permitted to make informed decisions and “fish”ycians should not be impediments to implementing those decisions. Under the Hippocratic oath, I believe doctors are supposed to serve, not impose their personal views, and second guess their patients.

  • Jose Sigal

    Dear Ronaldo and Jane, altough I am super in favor of euthanasia, please have many Dr. Kevorkians so the law could really change. I also believe this particular doctor has her own conscience and has to deal with that in her own way right or wrong. People would always have the right to go to somebody else for this particular issue. She could be a great doctor In her own field. This is a hard issue to judge somebody for their conscience when it is them and not us who are pulling the trigger.

    • Pepe, I always respect your thoughtful input, but have you considered the following points:

      1. It is not necessarily very easy for a person who is terminal and in discomfort to start looking for a different doctor who is not familiar with the particular patient’s circumstances, particularly if the patient in question does not have family available to help the patient find and interact with another doctor

      2. Under this law, the doctor is not pulling any trigger, like Doctor Kevorkian, but is merely providing a prescription, which the patient then implements on his or her own.

      3. The Hippocratic oath, and fiduciary duty law as well, say that the doctor is obliged, legally and morally, to put the patient’s interests ahead of his or her own interests, or beliefs. At a minimum, shouldn’t the doctor have to give notice up front to all of his or her patients (kind of like the privacy policies the doctors, and other providers, are required by lo give, no more difficult) that he or she will not provide a death prescription so the patient becomes aware in time to find another doctor. More to the point, it is the doctor who perhaps should not be providing medical services if his or her personal conscience won’t allow the doctor to fully discharge his or her duties.

      4. That this doctor may be great in his or her field is irrelevant to the question at hand, No doctor, or other professional, has a right to be a moron where the wishes and welfare of the patient or client is at stake. See Paragraph 3 above.

      For me, I have no problem judging this doctor. Neither, apparently, does Jane, and she and I don’t often see eye to eye. 🙂 That said, I understand and respect your right to disagree with my way of looking at this.

  • Jose Sigal

    I still believe Ronaldo that getting another doctor would solve the issue. Most probably this same doctor could refer to somebody who thinks and feels differently. My only point is who am I to judge her in such a delicate matter? For you or me, it might be only prescribing, but for her it might be much more than that. I can not be so arrogant as to judge him even though I totally agree with euthanasia. If they made it legal to put people to sleep like the perros and gatos, could I judge a doctor for not doing it? Of course not. For this doctor, this might be crossing the line.

    • I understand your feelings completely. However, for the reasons I set out in our earlier exchange today, I believe there is no room for a doctor’s personal religious or moral beliefs to get in the way of the doctor’s Hippocratic and fiduciary responsibility to his or her patient. As early in the doctor patient relationship as possible, the doctor must disclose to the patient, in writing, the doctor’s position and must withdraw from the relationship unless the patient consents, also in writing, to the doctor’s position. These forms of disclosure and consent should be prepared by the regulatory authorities or by the AMA. This subject is too serious, for all, to leave it to untimely chance.