Abdication of Professional Responsibility to Lead
I wrote a post a few days ago criticizing the decision by the board of directors of the American Academy of Hospice and Palliative Medicine to assume a position of "studied neutrality" on the crucial moral issue of physician-assisted suicide. It is simply a disgrace that the professional academy of hospice and palliative doctors is now on record as taking no position on what may be the most important issue facing the care of their dying patients. More, it is a cowardly abdication of the professional responsibility to lead.
I write more in this article in the Weekly Standard. Here is my conclusion: The AAHPM properly urges that "medical practitioners carefully scrutinize the sources of fear and suffering leading to the request" for assisted suicide "with the goal of addressing these sources without hastening death," along with practice guidelines for accomplishing these important goals. But this promotion of good medical practice rings hollow given the association's explicit neutrality on assisted suicide, which in effect grants member doctors permission to help kill their patients without threatening their good standing with the association.
Such terminal nonjudgmentalism is a profound abandonment of the organization's professed goal of promoting proper hospice care--a philosophy that unequivocally opposes assisted suicide. Perhaps more egregiously, it abandons patients--whose lives depend on ethical doctors acting energetically to relieve suffering while abiding by the Hippocratic Oath's sacred duty to "neither give a deadly drug to anybody who asked for it, nor . . . make a suggestion to this effect."
Let us hope that the membership of the AAHPM follows the lead of the members of the British Medical Association, who, when their leaders also assumed a neutral stance on assisted suicide, reversed the decision the first chance they had. Hospice doctors: It is up to you.
posted by Wesley J. Smith @ 3:00 PM
4 Comments
4 Comments:
This is a result of the ideology that you can do absolutely anything with or to your own body and doctors not only shouldn't judge it wrong but should help you to do it.
Yes. It is the deprofessionalizing of medicine.
I blame nose rings.
Not really, but people have done all kinds of things to themselve to express their "individuality."
I agree that the human body is the most beautiful canvas - I love henna and regular tattoos, I love moderate piercings, I love when people work out and build their bodies up and make themselve look nice. I like guys who shave their faces but leave cute goatees, all that stuff. It's fun, and it's a great way to say, "I'm pretty and I'm showing off that I'm pretty."
But then it gets taken too far. Normal piercings are perfectly fine, but people who go overboard pierce parts of their body, like their tongues, that shouldn't be cut into - your tongue is an organ, after all, and the human mouth is the source of the largest number of germs, worse even than a dog or cat biting you.
But people keep doing things like this and screaming "It's my body" whenever someone talks against it. Tattoos are beautiful, until you get those guys who cover their whole bodies and end up with scars and injuries or poisoning because of improperly cleaned appliances.
Then you get to the weird stuff where you have scarrification and cutting, which are *not* the same things at al - scarrification is cutting up for the purpose of making markings on the body, and cutting is a way of punishing the body for the percieved stupidity of the intellect. Again, you get that whole, "It's my body and I'll do what I want to."
It's a carry-over mentality. Person feels useless, so he punishes the body for the uselessness by wanting to cut it off. "I'm chained to this horrible body that's dying all around me and makes me miserable. I'm sick and I can't run around. I can't talk politics. I can't run a business. This body is bad and it belongs to me, so I'm going to get rid of it by killing it. After all, it's my body."
Problem - if the hospice system is neutral to the euthanasia debate, that means that they're not out there *really* trying to explain why that's bupkis. Yes, you own your body, but you're also part of your body. It's controlled by you, it's a part of you, and punishing it is also punishing yourself. You need to stick this out - you won't have to wear it forever, after all.
And again, there's that whole percieved stupidity on the part of the intellect that makes someone want to punish the body. "I've lived a horrible, horrible life, and I've been worthless in everything I've ever done. I never had enough children, I treated my family like dirt, I never married that girl that I wanted to" - all these regrets show up and you're trapped in a body that's not going to get up and tap-dance its way down the steps in a second so you can go out and try again.
And you don't see the beautiful things in your life that made living worthwhile. No day is wasted - you are always with yourself, always leanring about something, either something about yourself or something about your world. Sadness clogs the love and beauty and memory.
But when you get past the sadness and the wish to hurt someone (namely yourself), you realize that your time isn't up yet, and you're still in a position of power. Maybe you can't run home to your long-dead mother and make peace with her but you can learn to make peace with your own past, to focus on the love and the good that you've done and try to spread that love and good, and learn from the pain, and learn to forgive yourself.
That's what a hospice is supposed to be for. Without the hospice system firmly against euthanasia, you have a bunch of people who want to hurt themselves, either their intellect for failing to make life better, or their bodies for failing to keep working right. They forget that the key to happy life is to live in the moment.
To live in this moment is something that all great religions teach - Buddhism, Hinduism, Christianity, Judiasm, Taoism, Confuciousism, Islam, and even Shintoism. They all teach that you should make peace with your past mistakes, and learn from them. Pay attention to what you did. Then, put it behind you. And think of the future but don't worry about it. Worry is what kills the now, and dispaire over the past kills the now. Instead, plan for the future, keep positive, and live in every moment, savoring the good things, and be happy and free from all anxiety.
Even a dying person has the ability to do that - moreso than anyone else. A dying person knows the future and has faith in one type of outcome or another. That puts away all future worries, and only leaves the past and the present. The total freedom to reconcile the past and enjoy the present is the greatest gift that approaching death offers.
The natural life span of a human is designed with this in mind - the end of the life is when we have the most leisure to put our affairs in order, quite literally. Why rush our elders out the door so soon? Taking the lessons they have learned from the past, and being free from worry about the future, they should have the joy of expriencing every moment as vividly as possible, and passing away in their own time, when they're ready to go.
The hospice was designed to help people live fully before their deaths. It was designed to relieve fears of the future and reconcile the past, so that this present moment is all the patient needs to worry about.
If the hospice system isn't working to give the patients the time they need to collect their thoughts and to apply what they've learned to their final days, then what good is it? Pushing for euthanasia is a way of pushing back that critical time it takes to consolidate past, present, and future. Those last days before a natural death are totally necessary to get what thier lives were about and to use that to help them find meaning and understanding at the end.
It's a shameful turn of events.
Hospice does work, Tabs. Assisted suicide circumvents it.
I see all of the piercing and extreme tattooing as a sign of deep unhappiness and nihilism. So is assisted suicide. And from there we will be onto other destructive "choices." There always has to be an outer frontier.
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