On May 21, 2009, Linda Fleming, a woman with terminal pancreatic cancer, took a fatal overdose of medications prescribed by her physician to end her life. She thus became the first person to commit suicide under the "Death with Dignity" law that passed the state legislature November 4, 2008 and took effect during March.
The law in Washington State is modeled after one that has been on the books in Oregon since 1997. About 400 people have ended their lives through physician-assisted suicide in that state.
Under the assisted suicide law in Washington, a patient who is terminally ill and legally competent and who two physicians agree has only 6-months to live, can request lethal medication. The request needs to be made verbally on two occasions, 15 days apart, followed by a written request witnessed by two people. The medication is dispensed by a pharmacy. Patients take the medication themselves, rather than having a doctor administer it to them.
I've counseled people battling fatal illnesses. I've watched a friend struggle against cancer. I've told family members in ICUs and ERs that their loved ones have died. So I know how much pain can come at the end of life, when an illness takes hold.
I understand where the desire for a law like Washington's comes from. It's a tribute to human empathy that lawmakers resonated with the suffering of terminally ill patients enough to pass it. But I wouldn't have voted for it myself.
Alleviating the suffering of 400 or so patients since 1997 in Oregon has carried a pretty high price tag. It has opened the door to thinking of the medical profession not entirely as one devoted to prolonging life, but as one that is also empowered to help end lives. And this can leave patients feeling as though they ought to consider suicide when they are given terminal diagnoses. They ought to be reasonable, not just with what they are willing to go through, but with what they put their families and friends through. They ought not expend health care resources needlessly in their final months. Their clinicians aren't only thinking about what treatment options to provide, after all. They're thinking about other patients who have elected to forego treatment and hasten death.
I fear the law can also take away some of the motivation of doctors to "pull a rabbit out of a hat" and save a patient's life. There's a reason you wouldn't want soldiers going into battle who are also trained in the etiquette of surrender. You'd worry it might unconsciously take away their edge, chip away a little bit at their determination to take that hill.
At present, the criteria which must be met under the Death with Dignity Law sound rational. But laws are not static entities. Now that the door to physician assisted suicide is open, the Death with Dignity law could be amended in the future, perhaps to include those who might not die for twelve months, or longer. How about those who suffer unbearably from medical conditions that will only worsen over the years? If we are willing to use the medical profession to help end the lives of those who have but six months to live, how about those who become quadriplegic and say they cannot bear it?
It is psychologically and spiritually perilous to do harm to the magnificent will to live that keeps us fighting for another day. And it is no less dangerous to blur the mandate of physicians to try to win that fight, however daunting, however seemingly futile. The physician's white coat has meaning-to doctors and their patients. It must remain a bright beacon of the healing powers of the profession, not a flag of surrender to the inevitable.
Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, "Living the Truth: Transform Your Life through the Power of Insight and Honesty" has launched a new self-help movement. Check out Dr. Ablow's Web site at livingthetruth.com.
Keith Ablow, MD is a psychiatrist, and was host of the nationally-syndicated "Dr. Keith Ablow Show." He is a former member of the Fox News Medical A Team.