Member View Points
Statement for the BBC
from Dr. William Toffler – PCCEF’s National Director
There has been a profound shift in attitude in my state since the voters
of Oregon narrowly embraced assisted suicide 11 years ago. A shift
that, I believe, has been detrimental to our patients, degraded the quality
of medical care, and compromised the integrity of my profession.
Since assisted suicide has become an option, I have had at least a dozen
patients discuss this option with me in my practice. Most of the
patients who have broached this issue weren't even terminal.
One of my first encounters with this kind of request came from a patient
with a progressive form of multiple sclerosis. He was in a wheelchair
yet lived a very active life. In fact, he was a general contractor and
quite productive. While I was seeing him, I asked him about how it
affected his life. He acknowledged that multiple sclerosis was a
major challenge and told me that if he got too much worse, he might want
to “just end it.” “ It sounds like you are telling me
this because you might ultimately want assistance with your own assisted
suicide- if things got a worse,” I said. He nodded affirmatively,
and seemed relieved that I seemed to really understand.
I told him that I could readily understand his fear and his frustration
and even his belief that assisted suicide might be a good option for him.
At the same time, I told him that should he become sicker or weaker, I
would work to give him the best care and support available. I told
him that no matter how debilitated he might become, that, at least to me,
his life was, and would always be, inherently valuable. As such, I would
not recommend, nor could I participate in his assisted-suicide.
He simply said, "Thank you."
The truth is that we are not islands. How physicians respond to
the patient’s request has a profound effect, not only on a patient's
choices, but also on their view of themselves and their inherent worth.
a patient says, "I want to die"; it may simply mean, "I
When a patient says, "I don't want to be a burden"; it may really
be a question, "Am I a burden?"
When a patient says, "I've lived a long life already"; they
may really be saying, "I'm tired. I'm afraid I can't keep going."
And, finally, when a patient says, "I might as well be dead";
they may really be saying, "No one cares about me."
Many studies show that assisted suicide requests are almost always for
psychological or social reasons. In Oregon there has never been any
documented case of assisted suicide used because there was actual untreatable
pain. As such, assisted suicide has been totally unnecessary in
Sadly, the legislation passed in Oregon does not require that the patient
have unbearable suffering, or any suffering for that matter. The
actual Oregon experience has been a far cry from the televised images and
advertisements that seduced the public to embrace assisted suicide. In
statewide television ads in 1994, a woman named Patty Rosen claimed to
have killed her daughter with an overdose of barbiturates because of intractable
cancer pain. This claim was later challenged and shown to be false. Yet,
even if it had been true, it would be an indication of inadequate medical
care- not an indication for assisted suicide.
Astonishingly, there is not even inquiry about the potential gain to family
members of the so-called "suicide" of a "loved one." This
could be in the form of an inheritance, a life insurance policy, or,
perhaps even simple freedom from previous care responsibilities.
Most problematic for me has been the change in attitude within the healthcare
system itself. People with serious illnesses are sometimes fearful of the
motives of doctors or consultants. Last year, a patient with bladder
cancer contacted me. She was concerned that an oncologist might be
one of the "death doctors." She questioned his motives—particularly
when she obtained a second opinion from another oncologist which was more
sanguine about her prognosis and treatment options. Whether one
or the other consultant is correct or not, such fears were never an issue
before assisted suicide was legalized.
In Oregon, I regularly receive notices that many important services and
drugs for my patients-even some pain medications-won't be paid for by the
State health plan. At the same time, assisted suicide is fully covered
and sanctioned by the State of Oregon and by our collective tax dollars.12]
I urge UK leaders to reject the seductive siren of assisted suicide. Oregon
has tasted the bitter pill of barbiturate overdoses and many now know that
our legislation is hopelessly flawed. I believe Great Britain, the
birthplace of Dame Cicely Saunders, and the Hospice movement, and a model
to the rest of the world, deserves better.
On May 12, 2006 the Physicians-Assisted Suicide Bill was defeated in the
United Kingdom (UK) Parliament House of Lords 148 – 100 vote.