Physician-Assisted Suicide Is Socially Corrosive

As a physician-assisted suicide bill sits before committee in the California state legislature, Ira Byock, MD, urges a critical examination of the way supporters draw attention to their cause.

Terms like “right to die,” “death with dignity,” and “physician aid in dying” are intended to mean the opposite of what the words signify in reality. Byock argues the terms have taken on Orwellian proportions as supporters redefine them to suit their political ends, repeating them until they appear unquestionably true.

Byock directs the Institute for Human Caring of Providence Health & Services in Los Angeles and is also a professor of medicine at Dartmouth’s Geisel School of Medicine. He has spent his professional career seeking ways to improve end-of-life care so that maintaining a patient’s life is more dignified than helping them commit suicide.

In his Big Think interview, Byock explains what he sees as the real medical issues behind physician-assisted suicide:

“I opposed the legalizing of physician-assisted suicide because I believe that it’s a further distraction from the real deficiencies and dysfunctions in our healthcare system and our medical-education system, that makes dying so hard in America today. …[I]f you legalize physician-assisted suicide nationwide next Monday, next Tuesday we still won’t be educating physicians, medical students in how to communicate with people, give bad news, help people through the inherently difficult time of life we call dying; we won’t be educating them any more on assessing people’s pain or treating pain.”

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It’s difficult to conceive of dying as a right, as assisted-suicide supporters claim, because it ends the exercise of all other rights. In every other arena of discourse, rights allow us to live fuller, more complete lives.

Byock discusses the case of Oregon, which legalized assisted suicide in the 1990s. While supporters passed the bill on grounds that it would allow patients to end gratuitous suffering, more than 75 percent of patients did not cite pain as their primary motivator. They were much more likely to fear being a burden on family members, losing their autonomy, or no longer being able to enjoy life.

Improving end-of-life care means strengthening doctors’ standards when it comes to pain management, communication, and shared-decision making skills. State medical boards have the authority to review and propose these standards, says Byock, so the bulk of responsibility currently falls on them.