Brittany Maynard's Lethal Prescription

Michael Egnor October 29, 2014 9:34 AM | Permalink

As you may know, Brittany Maynard is a 29-year-old woman diagnosed with a malignant incurable brain tumor. She has moved to Oregon, and plans to commit suicide this Saturday, November 1, under Oregon's physician-assisted suicide law. She plans to take an overdose of medication prescribed legally by a physician.

Ms. Maynard's plight is a terrible one, and we in the medical community should (and do) work very hard to ease her suffering, even if we cannot cure her disease. But physician-assisted suicide is the wrong thing to do, both for Ms. Maynard and for others who are suffering terminal illness.

Killing is not medical care. It is not a "treatment" for suffering, any more than killing is a "treatment" for depression (e.g., Robin Williams), or psoriasis or indebtedness. Killing isn't a treatment for any ailment or circumstance. It is the elimination of the person.

It is morally abhorrent that a state would sanction, and a physician would perform, physician-assisted suicide. It is a violation of the Hippocratic Oath, which explicitly forbids assisted suicide, and it devalues the life of the terminally ill person and implicitly devalues the lives of all terminally ill people.

Suicide is illegal for people who are not terminally ill, and we all agree it should be. If Ms. Maynard were perfectly well, and came to an emergency room wanting to take an overdose to end her life because she was unhappy in her marriage, she would be prevented from doing so, by force if necessary. She would receive mandatory psychiatric care until she was no longer suicidal.

Yet the State of Oregon has separate laws for terminally people -- laws that inherently devalue their lives. The enactment of physician-assisted suicide laws sets up a two-tier system. People who are not terminally ill are protected from suicide, by law. Terminally ill people may kill themselves with legal sanction, and even with medical help.

It is horrendous that some lives are protected under law, and some lives are extinguished under law and in cooperation with the medical profession.

It is no justification to insist that Ms. Maynard is merely exercising some hypothetical right to end her life. Such a right has never been recognized under any system of law. All states proscribe killing of innocents. If such "right" exists, it is difficult to see why physicians are empowered to protect suicidal 18-year-olds who have just had a high school romance go sour. Does the lack of a terminal illness deprive you -- or your teenage son or daughter-- of rights?

And it is naïve to believe that assisted suicide will always be a choice made only by the patient. Compassionate care for the terminally ill is vitally important, but it is expensive and difficult. Most health care costs are incurred in the last few months of life. As financial pressure builds, the pressure on the terminally ill to make the "right" end-of-life decision will be intense. I see such trends in medical practice even now. In time, the "right" to assisted suicide will become the obligation to assisted suicide.

Ms. Maynard's tragic situation is not ameliorated by her tragic decision. She needs love and care and prayers, not suicide. I pray that she does not end her life, because in doing so she devalues her life and she devalues the lives of all terminally ill people who need our care and protection, not our lethal prescriptions.

First, there is no reason whatever why she would "live her last days in excruciating agony and pain." If there is one thing modern medicine CAN do, it is eliminate pain in terminal illness.

And this has long been true. A favorite and very experienced doctor --- Dr. Jose Espinosa --- told me 30 years ago, "I have never seen intractable pain, BUt I have seen intractable doctors and nurses."

And there' nothing wrong with morphine sufficient to manage pain. Even if t predictably shortens life expectancy in the final days, it's pain management: which is different from an OD.

Second,what she proposes to do affects not only herself, but many, many other persons in a disastrous way. Legal "assisted" suicide deeply corrupts the medical, legal, and political professions. It turns medicine, law and government away from the desiderata of what is naturally good, and in favor of mere demand.

Anyone who wants to commit suicide on their own can do so, and 30 minutes' worth of mousing around on the Internet can tell you how.

But don't insist on "authorization" or "participation" from church or state or medico or politico. Surely in the name of autonomy, a would-be suicider can take care of business without insisting on corrupting everybody around them.

A self-respecting suicider (I am not recommending this) should be responsible for himself. This "legalized" "physician-assisted" crap just puts more death-dealing power in the hands of the State, to be used against persons far more vulnerable than this proud, attractive, articulate, but terminal and terminally self-serving lady.

With glioblastoma the tumor grows at a steady pace. The human cranuim is a fixed space - no room for extra tissue - so as the tumor grows it forces brain tissue out the only "hole" up there and that is the brainstem. The pressurized neural tissues cause havoc with loss of motor and sensory capability. Along with growing tissue is the inflammation caused by the body fighting the cancer - this causes more swelling so Heavy doses of corticosteroids are given. That makes the patient swell up - huge.

So along with the pain and agony so goes brain function until the patient can no longer reason yet there remains some cognitive ability. It may take a month from the time of the patients last whispered "I Love You" until death. During that time most institutions implement intensive efforts to preserve "life"

This is my definition of hell. For patients who know this process and must anticipate these stages the question of how you want to leave this world is not trivial.

And I pray to God that this coward never has to face such a challenge.

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