Tuesday, May 23, 2006
The Adverse Effects of Euthanasia on Doctors
In yesterday's post at Secondhand Smoke Wesley Smith presented this stunning article on a subject to which few of us have given much thought. The survey methods and responses differed between the Dutch doctors and the physicians in Oregon, but it is clear that for a significant number of doctors there is serious emotional fallout from physician assisted suicide and euthanasia.
Results and Discussion: The physician is centrally involved in PAS and euthanasia, and the emotional and psychological effects on the participating physician can be substantial. The shift away from the fundamental values of medicine to heal and promote human wholeness can have significant effects on many participating physicians. Doctors describe being profoundly adversely affected, being shocked by the suddenness of the death, being caught up in the patient's drive for assisted suicide, having a sense of powerlessness, and feeling isolated. There is evidence of pressure on and intimidation of doctors by some patients to assist in suicide. The effect of countertransference in the doctor-patient relationship may influence physician involvement in PAS and euthanasia.
Conclusion: Many doctors who have participated in euthanasia and/or PAS are adversely affected emotionally and psychologically by their experiences.
The report is worth reading beyond the abstract for the chilling glimpses it gives into the experiences of these doctors. Here's one jaw-dropping comment from a Dutch doctor:
Response by Dr. Zylicz: "I was giving consultations in several situations like this, when the GP was calling me about a patient with gastrointestinal obstruction. He said, 'The problem is that the patient is refusing euthanasia.' I said, 'What happened?' He said, 'In the past, all these kinds of situations, when people were intractably vomiting, I solved by offering euthanasia. Now this patient does not want it, and I do not know what to do.' That was really striking. Providing euthanasia as a solution to every difficult problem in palliative care would completely change our knowledge and practice, and also the possibilities that we have . . . . This is my biggest concern in providing euthanasia and setting a norm of euthanasia in medicine: that it will inhibit the development of our learning from patients, because we will solve everything with euthanasia."
In an interview with a doctor in Oregon there is a good example of a recurring theme: doctors being intimidated into participation in assisted suicide despite their qualms.
I had to accept that this really was going to happen. Of course I could choose not to participate. The thought of Helen dying so soon was almost too much to bear, and only slightly less difficult was the knowledge that many very reasonable people would consider aiding in her death a crime. On the other hand, I found even worse the thought of disappointing this family. If I backed out, they'd feel about me the way they had about their previous doctor, that I had strung them along, and in a way, insulted them.
This experience was found in Holland as well:
Response by Professor Jochemsen: "I know from physicians who are opposed to performing euthanasia that they are afraid of saying so when applying for jobs and trying to find a post as a physician. In certain circumstances, that will make it much more difficult for them to get a job."
The findings of this report support the notion that euthanasia is a juggernaut that cannot be restrained by guidelines and "bio-ethical standards". Once set into motion the process is too powerful for either doctors, patients or policymakers to control. I'm reminded of the medieval momento mori painting that portray Death as a skeletal rider on a white horse, trampling humanity under it's feet, beggar and king alike...
Results and Discussion: The physician is centrally involved in PAS and euthanasia, and the emotional and psychological effects on the participating physician can be substantial. The shift away from the fundamental values of medicine to heal and promote human wholeness can have significant effects on many participating physicians. Doctors describe being profoundly adversely affected, being shocked by the suddenness of the death, being caught up in the patient's drive for assisted suicide, having a sense of powerlessness, and feeling isolated. There is evidence of pressure on and intimidation of doctors by some patients to assist in suicide. The effect of countertransference in the doctor-patient relationship may influence physician involvement in PAS and euthanasia.
Conclusion: Many doctors who have participated in euthanasia and/or PAS are adversely affected emotionally and psychologically by their experiences.
The report is worth reading beyond the abstract for the chilling glimpses it gives into the experiences of these doctors. Here's one jaw-dropping comment from a Dutch doctor:
Response by Dr. Zylicz: "I was giving consultations in several situations like this, when the GP was calling me about a patient with gastrointestinal obstruction. He said, 'The problem is that the patient is refusing euthanasia.' I said, 'What happened?' He said, 'In the past, all these kinds of situations, when people were intractably vomiting, I solved by offering euthanasia. Now this patient does not want it, and I do not know what to do.' That was really striking. Providing euthanasia as a solution to every difficult problem in palliative care would completely change our knowledge and practice, and also the possibilities that we have . . . . This is my biggest concern in providing euthanasia and setting a norm of euthanasia in medicine: that it will inhibit the development of our learning from patients, because we will solve everything with euthanasia."
In an interview with a doctor in Oregon there is a good example of a recurring theme: doctors being intimidated into participation in assisted suicide despite their qualms.
I had to accept that this really was going to happen. Of course I could choose not to participate. The thought of Helen dying so soon was almost too much to bear, and only slightly less difficult was the knowledge that many very reasonable people would consider aiding in her death a crime. On the other hand, I found even worse the thought of disappointing this family. If I backed out, they'd feel about me the way they had about their previous doctor, that I had strung them along, and in a way, insulted them.
This experience was found in Holland as well:
Response by Professor Jochemsen: "I know from physicians who are opposed to performing euthanasia that they are afraid of saying so when applying for jobs and trying to find a post as a physician. In certain circumstances, that will make it much more difficult for them to get a job."
The findings of this report support the notion that euthanasia is a juggernaut that cannot be restrained by guidelines and "bio-ethical standards". Once set into motion the process is too powerful for either doctors, patients or policymakers to control. I'm reminded of the medieval momento mori painting that portray Death as a skeletal rider on a white horse, trampling humanity under it's feet, beggar and king alike...
papijoe 11:17 AM
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