SUICIDE...
Physician-assisted SUICIDE



DEATH.... with LOVE, bravery, pride, wisdom, dignity, compassion, relief... and freedom


The author, who is a physician, has initiated these personal notes and thoughts and comments about "P.A.S."


Selected from the on-going INTERNET BOOK, "The Doctor's Terrific Tablets"
( http://www.terrific-tabs.com )
by
John N. Todd III, M. D. (link)

The web-link to this essay is: http://www.terrific-tabs.com/print_suicide.htm
To send a "live" link to a friend, copy and paste this web-link in an email message.

See related "tablet":
EUTHANASIA for HUMANS, turtles, horses, and dogs (link)
AND:
MORTALNESS... We're all born to die (link)
AND:
Author's Death Note

"Doctored" -- 12/01; 3/02; 4/02; 5/02; 6/02; 9/02; 10/02; 11/02; 4/03; 6/03; 9/03; 11/03; 7/04; 10/04; 11/04; 1/05; 4/05; 5/05; 6/05; 10/05; 11/05; 2/27/07; 12/7/07


CLICK HERE to go to the "FRONT PAGE" of "The Doctor's Terrific Tablets"
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This is a personal commentary by the author of this website.... a physician who has diagnosed and treated and "managed" many dying patients....
a physician who has observed and "interacted with" the family and loved-ones of many absolutely miserable and helpless terminally-ill patients....
a physician who has watched many fellow-humans, suffering and lingering, then succumbing to the inevitable result of an incurable, uncorrectable, ghastly illness....
a physician who is very much in favor of "physician-assisted-suicide", in which a quick and easy assisted-suicidal-departure from this life is chosen and requested and controlled by a cognizant patient.... in consultation with trusted physicians.... and with the support of loving family members.


But FIRST..... It is extremely important to understand the difference between
physician-assisted-suicide and physician-induced-euthanasia,
(as "popularized" by Dr. Kevorkian).

Physician-induced-euthanasia ["euthanasia" means, literally, "good death"] is a procedure in which a patient, in cooperation with his physicians, decides that he or she wants to end his existence in this life, because of an unbearable and uncorrectable medical ailment. With "euthanasia", the patient requests and allows the physician to inject a medication which induces a painless and rapid demise. This "procedure" of planned euthanasia.... a consorting of patient and physician.... was "utilized" by Dr. Kevorkian; and has been widely discussed, pro and con, in the news. More will be said about "euthanasia", below.

Physician-assisted-suicide differs from "euthanasia" in one primary way. In physician-assisted-suicide, a medical doctor prescribes for the patient an ordinary "sleeping-pill" (such as a barbiturate). The doctor prescribes a large number of these "sleeping-pills" -- a number which would be lethal if taken all at one time. Instructions are given on the prescription bottle, that if the sleeping-pills are taken in excessive amounts, serious side-effects would result.... even death. All of this is explained in detail, to a cognizant patient, and to his loving family. If the patient decides that he (or she) has suffered enough, and that there is no logical and realistic hope for return to a functional existence, the patient may decide that he will ingest a "cocktail" solution of all the "sleeping-pills".... thereby leading to a fast and gentle and painless departure from this world.

(In my opinion, this method of self-induced demise constitutes a brave and loving and intelligent and honorable way to escape intense and hopeless agony.)

Everyone should remember.... SUICIDE CANNOT BE PREVENTED by any LAW, or by any GOVERNMENTAL MANDATE. The primary "benefit" of physician-asssisted-suicide is that the means of suicide becomes simple, humane, and painless. Physician-assisted-suicide is a civilized method of allowing an understanding patient to end his own earthly existence -- without his having to consider blowing-out-his-brains with a pistol-shot, or executing himself with a shotgun poked into his abdomen.



Statement by the author: "This commentary expresses an opinion reflecting only my personal thoughts and feelings. I have no interest in attempting to convince anyone to consider or utilize physician-assisted-suicide."



I am a physician.
I am a human-being.
I am a Protestant Christian.
I have never "played God" (as is sometimes said of "doctors").
I have never "assisted" a patient in suicide.

I (like most physicians) have witnessed suffering and death and dying, in my patients.... many, many times.... during my 32 years in the practice of Internal Medicine and Cardiology.

I have seen and treated ghastly and agonizing and painful illnesses in many of my treasured patients -- who were doomed to inevitable and impending death.

I have treated many post-stroke patients.... partially paralyzed, usually unable to speak intelligibly.... frequently unable to stand and walk; sometimes drooling, and unable to swallow.... ALL embarrassed by their appearance and their functional impairment; and ALL terribly chagrined because of being a "burden" and an expense to their loved-ones.

I have seen many, many patients in dreadful pain.... lying in misery -- reeking with the aroma of fatal-illness and impending demise.... aggravated by gastric tubes, bladder catheters, tracheostomies, pump-ventilators.... and all the other torturous human-inventions that simply prolong suffering.

I have seen innumerable patients in a post-surgical phase.... many times after a pointless and fruitless and expensive surgical procedure.... patients and their families waiting and waiting.... for the relief and peace that only death can bring.

I have looked into the tomb, personally.... and have faced imminent death (yes, with a treatable illness) -- and I have felt the suffocating misery of severe oxygen-deficit, and the gasping and labored respirations concomitant with pulmonary embolism.... and I have personally felt the profound weakness and helpless incapacitation of severe blood-loss.

As a patient in the hospital, myself, I have personally hand-written a
death-note (link) to my family, and to my physicians -- with specific instructions not to "falsely" prolong my illness (my life) -- if additional uncorrectable decline supervened. I have eagerly hoped for, and awaited death.... rather than being frivolously "treated", and allowed to suffer the indignities of "life" (existence) without function, and without hope.

I was taught, early in my medical training, that "life is qualitative, not quantitative".... and I have explained that philosophical "truth" to many patients and friends.... and to my family.

I have guided the families of many dying patients, as these loving families (themselves) suffered horribly -- while they watched their dear-ones dwindle and waste-away, and suffer in the throes and anguish of terminal illness.

I am aware of many caring physicians who (in conjunction with, and encouragement by loving families) have withheld or reduced useless terminal therapies in their cherished patients.... remembering that the function of a physician is to "prolong life.... but not to prolong suffering". 

(I have heard the term "passive euthanasia", in reference to this concept of not prolonging the agony of a terminally ill loved-one.... that is, when close members of a family, along with the cooperation of an understanding physician, refuse to authorize the use of worthless therapeutic measures, which can only extend pain and suffering for a few hours, or a few days.)

Also, parenthetically, I have read recently (July 2003) in an article in the New England Journal of Medicine.... of how some patients, who are terminally-ill, decide for themselves to utilize a method of "suicide", which has been labelled "death by voluntary dehydration". The name of this "procedure" adequately describes the process itself. A patient voluntarily refuses tube-feedings, and intravenous infusions.... and then refuses to ingest food and liquids. Death usually supervenes within 10 to 14 days. The writers who described this "suicidal" dying-process, in the article in the NEJM, state that the terminal suffering due to progressive dehydration is not as severe as some might have supposed. Indeed, it was stated in the article, that after a few days, the process becomes quite peaceful, as the patient fades in awareness and consciousness.

(I allowed my own 82 year-old, cancer-infested father to impose this "death by dehydration" upon himself. He refused intravenous infusions, and naso-gastric feedings. He said to me, "I want to get out of this [life] as quick and easy as possible.")




Caring physicians do not "play God".... nor do they attempt to decide who should live -- and who should die. The FACT is as follows (for those who haven't yet "figured-it-out"): disease and injuries and degenerative maladies -- and death -- are UNIVERSAL. Our Creator-God has ordained that every living creature will die.... at a time, I believe, that is pre-determined and specified by God. To me, as a very knowledgeable physician.... well-versed and experienced in death-and-dying.... and well-schooled in "religion" and spiritual matters.... it is absolutely wrong for a loving-and-caring medical practitioner to attempt to "PUMP" life into an obviously suffering-and-dying fellow-human-being.

In my opinion, it is really-and-truly "playing God".... when a physician orders tube-feeding, pump-ventilators, urinary catheters, devasting and ineffective chemotherapy, rectal tubes, tracheostomies, constant intravenous infusions, useless surgical procedures, etc.... all in a clearly futile effort to re-create "functional existence" in a patient who obviously is in the throes of DEATH.... a patient who has expressed his desire to accelerate his "departure" from this world.... a patient who knows that he obviously will not return to any kind of acceptable human activity and existence.

My experience indicates that most informed adult individuals fear and dread the "dying process" much more than death itself. Since suicide is not an event that can be controlled or prevented by laws and regulations, why is not logical and compassionate to allow a fatally-ill patient to employ a simple and fast mode of suicide.... rather than leaving the patient to perform a self-inflicted gun-blast, or to dangle himself at the end of a home-made noose.... or to take a one-way suicidal-trip to the bottom of a lake.

Advice for the reader of this document: Until you yourself have experienced a dreadful and protracted killing-ailment.... or until you have witnessed, managed, and treated your dear family and friends, who are suffering with a dreadful and painful and uncorrectable illness -- DO NOT allow yourself to become preachy or judgmental or "holy" -- in your notions about death.... and about this subject of P.A.S.

When you truly LOVE someone, you cannot bear seeing your loved-one suffering with the agony of uncorrectable terminal disease, and useless existence. I say that the greatest love for your dear-one.... is to hope and pray for that person's early journey to the "life-to-come".




Personal thoughts and comments concerning P.A.S. :

Physician-assisted suicide (P.A.S.) is back in the news.... thanks to a recent (2001) decision by U.S. Attorney-General John Ashcroft, who has ruled that Oregon's voter-approved "physician-assisted-suicide" law violates Federal law concerning the prescribing of medications in amounts that could be fatal.... if a patient should choose to ingest such a dose in order to terminate his life, because of unbearable misery related to an incurable disease.

As for me -- a physician with more that 30 years of practice in Internal Medicine, and Cardiology -- I totally disagree with, and deeply resent, this ruling by our Attorney-General. Once again, in a matter concerning medical treatment and public health, here is a politician making decisions and "rulings".... and imposing restrictions, which drastically affect the health and physical well-being of U. S. citizens.

Once again, here is a politician.... never trained in medical diagnosis. and never schooled in treating sick human-beings.... a politician who has never made a bedside medical decision, and who has never prescribed a medication.... a politician who never evaluated a patient in a hospital's emergency department; a politician who never performed a surgical procedure; a politician who has never dealt professionally with the family of a sick-and-dying dear loved-one; a politician who never witnessed a suffering and dying, miserable human being.... lying in his own excretions, painfully enduring bedsores, dreadful odors, gastric-tubes, indwelling catheters (a "tube in every orifice", as we physicians have sometimes bemoaned).... and other indignities. Here is a politician who probably never perceived the anguish and heartache of loving kinfolks, who hope and sincerely pray that Almighty God will shorten the travail of a loved one who has no HOPE of cure -- and no hope of resuming a functional existence. Here is a politician who probably never suffered, himself, with a potentially fatal illness.... who never personally looked into the face of impending death. Here is a politician who never witnessed a comatose patient, or a patient paralyzed with a severe stroke.... unable to speak intelligibly, and unable to move voluntarily.

Why must politicians persistently meddle in so many areas in which they have no significant knowledge, and no useful personal experience?? In the area of "physician-assisted suicide", is politician-Ashcroft making a "political" vote-seeking decision.... or is Ashcroft attempting to impose a personal "religious" notion upon the citizens of our country? Either way, Ashcroft and his advisers are "way-off-base".... and wrong!!



Additional NOTES by the author of this website:

Dr. Kevorkian, of course, is now in jail for the "murder" of a patient who could barely move, and who could not swallow or breathe. The patient suffered with a progressive and incurable neuromuscular disorder. The helpless patient, who had not even the strength to pull-a-trigger, requested the "services" of Dr. Kevorkian..... who arranged the intravenous infusion of a solution that would quickly and painlessly end the patient's so-called "life". That procedure was performed, and the patient died.... Dr. Kevorkian was arrested.... Dr. Kevorkian was tried, and found guilty of "murder", by a non-medical jury (none of whom, I dare say, suffered with any significant or crippling medical ailment -- and none of whom was skilled in the evaluation and diagnosis and management of critically-ill patients). As I understand it, Dr. Kevorkian is now, unfortunately, in prison....

Physician-assisted-suicide has been considered in a number of states in the United States. Oregon.... alone.... has approved the procedure, in two separate statewide referenda. So far, more than 90 individuals have been "assisted" with "suicide" -- by their personal physician. Each patient has been found to have a terminal illness, with a life expectancy of less than 6 months. The consultation of two other physicians is required, before the procedure can be considered, and consummated.

4/25/03
(Parenthetically, it needs to be mentioned.... here in this essay.... that some "hungry" hospitals literally "love" those patients that are slowly dying in the hospital.... patients with no hope of returning to a functional existence; patients who have been categorized as requiring "intensive care".... especially those dying patients who must have naso-gastric "tube-feeding" for nourishment; and endo-tracheal intubation for "pump-ventilation" -- in order to sustain so-called "life". Obviously, the hospitals cannot be "blamed" for needless prolongation of a patient's care, since all medical decisions are made by the physicians [highly-paid intensive-care "specialists"] who are in charge of the patient's agonal treatment. But.... just consider and remember the financial "rewards" ["reimbursement"] to a hospital, for extensive-expensive-intensive-care of terminal patients.)

10/19/04
And, yes, I am aware that there are many hungry lawyers, who stand-available to encourage certain treacherous family-survivors, who greedily seek a "malpractice" suit ($$$) against a physician who does not continue to "pump" life into a lingering and helpless dying patient. There is no apparent remedy, now, in our United States, for this "disease" of countless inappropriate medical-malpractice suits.... a "disease" that is rapidly "killing" the practice of medicine.

10/23/05
Just a thought.... we hear, nowadays, so much about "a woman's right to choose", in regard to childbirth versus abortion.... "abortion", in which a helpless baby, in utero, is slain because a woman demands the "right to choose", in order to "control her body", and to control the life or death of her unborn child. Now, compare: isn't it interesting that a terminally-ill patient (male or female).... infested with a ghastly illness, is not now allowed, by law, to "control his body".... and that he-or-she has no "right to choose" the means and method of alleviating the misery and duration of his own impending and unavoidable death-process.

Compare also, the circumstance of prisoners who have been condemned to death by "juries of their peers" -- other human-beings. Isn't it interesting that timid society now requires that these murderous criminals be allowed to avoid "cruel and unusual punishment", at execution.... and so we legislate that despicable evil-doers on death-row be given intravenous infusions.... just like those "prescribed" by Dr. Kevorkian.... so that imposition of the death-sentence will be quick-and-easy, painless, and peaceful.

What a pitiful shame.... that our sanctimonious national and state "leaders" will not introduce and support consideration of "physician-assisted suicide".... and thus encourage humane "leniency" for those guiltless humans that are now being heartlessly condemned to endure the "cruel and unusual punishment" of a slow and torturous death-sentence..... imposed by an undeserved and agonizing and dehumanizing illness. What a pitiful shame.... simply because a few vocal politicians, and certain holier-than-thou churchy individuals, hope to aggrandize themselves.... or beatify themselves.

Gee whiz.... consider again.... "man's inhumanity to man".
Lord, help us.





The proper function of a physician is to prolong life (functional existence). The proper function of a physician is NOT to prolong suffering and agony.

2/27/07