The University Record, May 20, 1997

Issue of physician-assisted suicide,
will determine who controls medical ethics

By Ryan Solomon

A Harvard University lawyer and physician says the issue of physician-assisted suicide will decide who controls medical ethics. Speaking recently at the second annual Waggoner Lecture on Ethics and Medicine at the Medical Center's Maternal and Child Health Center auditorium, Alan Stone says law, not medicine, has gradually assumed the role of determining medical ethics. Stone is a professor of law and psychiatry at Harvard and is recognized by his peers as a national expert on physician-assisted suicide.

Stone links the beginning of the medical profession's loss of control of medical ethics to the 1973 Supreme Court abortion ruling of Roe vs. Wade. He says two 1996 federal court decisions concerning physician-assisted suicide have further helped take control of medical ethics away from the medical profession.

Stone says the Ninth U.S. Circuit Court of Appeals found that patients have the right to hasten their own death. Stone says the Second U.S. Circuit Court of Appeals decision made no distinction between those who need a doctor's help to die and those who have the right to refuse medical treatment. The Supreme Court has established that patients who are receiving medical treatment can refuse treatment. Michigan does not have a statute prohibiting physician-assisted suicide but does consider it illegal under common law.

An informal survey by Stone of his medical colleagues found that many have made arrangements to have someone help them die should they face a slow, painful death. Stone worked with a group of 12 prominent physicians, 10 of whom had prepared for their own assisted suicide should the need arise.

When considering the issue of physician-assisted suicide, Stone suggests that physicians change the standard ethical question they ask themselves from "What would you want if it were your mother?" to "What would you want if it were you?" Stone says of the 125 students in a course he teaches about law and medicine, 90 percent support physician-assisted suicide. He adds that most doctors who oppose physician-assisted suicide do so for religious reasons, not ethical.

Some public opinion polls show the public wants physician-assisted suicide. Stone quoted a 1990 Roper poll and a 1994 Harris poll that showed 64 percent and 73 percent, respectively, favored physician-assisted suicide. He says this public support comes from recognition that medicine can prolong the quantity of life without prolonging its quality. He says fear also contributes to public acceptance: fear that treatment can lengthen suffering to a slow painful death; fear of becoming an isolated, seldom-visited nursing home patient; and fear of dementia with the loss of the ability to make decisions.