Comfort Over Death: An Argument Against Medical Aid in Dying

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This article is in response to the series, “Medical Aid in Dying: Leaving the Choice to the Patient” by Douglas W. Heinrichs, MD.

Douglas W. Heinrichs, MD, attributes objections to MAID to “religion-derived assumptions as to humanity’s distinct status,” emphasizing that individuals are not likely to give up on such first principles based on logical arguments. However, he does not specify what logical argument could lead to the conclusion that there is no meaningful, dignity-implying difference between humans and other intelligent creatures. There seems to be no convincing logic that can provide answers some such questions.

This also applies to the status of individual autonomy. Those who assume there is no higher principle are unlikely to be convinced otherwise by simple “logic”; rather, they need to experience an appreciation for the value of other considerations.

I would respond to the question of what gives a physician the right to preclude an “option against a competent patient’s wishes” by saying that it is our individual and socially mandated responsibility to do what we understand to be in their best interest. As physicians, we regularly decline to grant patients’ wishes (for example to use medication recreationally rather than therapeutically) on this basis. Whether we see it as in our patient’s best interest to be dead depends on what we see as possible for them while they are still alive, and on our basic moral and metaphysical commitments. Although recently qualified in some jurisdictions, there has long been a social, ethical consensus that a physician should intervene not to end a person’s life, but instead to comfort always.¹

Dr Peteet is the Psychosocial Oncology Fellowship Site Director in the department of Psychosocial Oncology and Palliative Care at Dana-Farber Cancer Institute and Brigham and Women's Hospital.

Reference

1. Amonoo HL, Harris JH, Abrahm JL, et al. The physician's role in responding to existential suffering: what does it mean to comfort always? J Palliat Care. 2020;35(1):8-12.