The Little Fool by Karen Swenholt. Image by Ian Riley Photography.
D. Joy Riley, M.D., M.A.
A couple of years ago, I was encouraged to meet a figurative artist (sculptress, in this case). So I drove many hours to meet Karen Swenholt, and the drive was worth it. One of her pieces is pictured above. It is a metaphor that resonates with many of us: the man feels rooted, bound to the earth, or his circumstances, etc., and yearns to be free. So he takes an instrument into his hand — a knife — to free himself from his hateful condition, not realizing that severing the tie will impact his life in countless ways.
Earlier this month, I attended a Tennessee Senate Committee hearing on a bill that would legalize physician-assisted suicide. Testimony for and against the bill was heard. Three things struck my ear as incongruent.
1) Attorney John Hay Hooker came to the committee, not to ask for justice, he said, but to ask for mercy, in his quest to allow physician-assisted suicide (P-AS). As a physician hearing this, I could not help but think about the implications for the field of medicine. Those who had spent long years training to help heal would be transformed into killers.
Taking this line of thinking further, I considered both restauranteurs and attorneys who, like physicians, are licensed by the state. Would Mr. Hooker wish the state’s august body of legislators, with the power of the pen, to turn restauranteurs into poisoners, or attorneys into executioners? Would that be “mercy” also?
2) Dr. Peter Raven, testifying for the bill, said he had written Oregon’s first prescription for physician-assisted suicide. He sees it as “care” for the patient. It was noted elsewhere in the proceeding that the state of Oregon has sent at least two people letters stating that their chemotherapy drugs will not be covered by the state’s medical plan, but listing as one covered “treatment” physician-assisted suicide. (See one account of this here.)
P-AS as a treatment is not a new treatment, frankly. It was against such doings that the Hippocratic Oath was written in the first place, for in it, the physician promised to “give no poison to anyone though asked to do so, nor suggest such a plan.” (Nigel M. de S. Cameron, The New Medicine: Life and Death After Hippocrates — New Edition, published 2001 by The Bioethics Press, Ltd., Chicago and London). But the original Hippocratic Oath has apparently been found too binding in several instances, and has been watered down significantly over the years. See a comparison of a translation of the original Hippocratic Oath with one written in 1964 here.
3) Senator Reginald Tate (D-Memphis) spoke regarding his introduction of the bill for consideration. He remembered fondly how John Jay Hooker had supported civil rights legislation, and felt this was payback for Mr. Hooker. He presented it in terms of water: no longer are persons of color relegated to specific water fountains. Indeed, we all drink from the same fountains, because it is “just water.” Presenting this bill was likewise “just water” in Senator Tate’s rhetoric. Calling physician-assisted suicide “care” is equivalent to telling a drowning person or a man about to be water-boarded, “It’s just water.” Turning physicians into accomplices to suicides is severing ourselves from our Hippocratic roots: who can stand if that happens?
Further reading:
The Tennessee Senate Health and Welfare Committee’s Hearing on Physician-Assisted Suicide Bill.
Audiey C. Kao and Kayhan P. Parsi, “Content Analyses of Oaths Administered at U.S. Medical Schools in 2000,” Academic Medicine September 2004, Volume 79(9):882-887.
Robert Orr, Norman Pang, Edmund Pellegrino, and Mark Siegler, “The Use of the Hippocratic Oath: A Review of 20th Century Practice and a Content Analysis of Oaths Administered in Medical Schools in the U. S. and Canada in 1993,” The Journal of Clinical Ethics 8(4):377-88.
