Medically assisted death: Don’t alter definition of medical care

The Hawaii Legislature is hearing bills to legalize physician-assisted suicide to radically change the practice of medicine. We should stand in strong opposition. Without an accepted medical protocol for suicide, doctors are guessing on the proposed protocol for medical suicide. In the places that have legalized physician assisted suicide, the suicide medicine often comes with dangers of unintended survival of the patient with new health issues, or organ failure, coma and the like.

In 1896, the Hawaii Territorial Legislature enacted the statutory definition of the practice of medicine to be the treatment of disease in humans. That concept has been the definition of the practice of medicine since Hippocrates of Kos offered it in the late 5th century BC. For the last roughly 2,500 years, that understanding has led to the trust between medical professionals and their patients that continues to today. The Hawaii definition has only been changed a couple of times since 1896, and all of those changes increased the type of treatment permitted, and permitted those new treatments only for maintaining health and treating disease.

Now, proponents of doctor assisted suicide want to change the definition to include intentionally ending the life of a patient instead of treating the symptoms, which is inconsistent with the concept of maintaining health and treating disease.

In 2017, the main proponents filed a lawsuit asking the Hawaii court to legalize physician-assisted suicide. Contrary to their arguments since 2011, this practice is not legal in Hawaii. They argue that the law must permit a doctor to facilitate a dignified and peaceful death when the patient desires to end their life; however, for ages, people all over the planet have been taking their own lives for any number of personal reasons.

The second argument in the lawsuit is that no legal difference exists between medical directives (instructions a patient may give a doctor defining the treatment the patient wants and does not want) and a doctor giving dangerous and controlled medicine intended to be used for suicide. No common understanding of the practice of medicine includes physician-assisted suicide, yet the proponents unbelievably argue in the lawsuit that physician-assisted suicide is, in fact, another way to treat disease in humans.

Here’s how it works: The physician writes a prescription for anti-nausea pills and 100 capsules of seconol, a sedative drug. After giving the patient the prescription, that is the end of the doctor’s assistance in the suicide process. Without help, the patient must empty the 100 capsules to accumulate nine grams of pure, bitter-tasting seconol. To mask the bitterness of the suicide medicine, it is mixed with something to make it somewhat easier to swallow.

Before the patient actually consumes the suicide mixture, she must ingest the anti-nausea medication, to avoid rejection of the suicide mixture which would result in failed suicide. The doctor is not present to help with any complications: suffocation or multiple organ failure. On the other hand, in places in Europe when the doctor is present for the suicide, he fixes a failed suicide by lethal injection.

“Physician–assisted” suicide is very little assistance from the physician. It quite easily is not a peaceful and dignified death. Recognize that intentionally taking the life of the patient to alleviate health symptoms is not the treatment of disease so not the practice of medicine understood for 2,500 years. Don’t radically alter the practice of medicine to include the intentional elimination of the patient.

James Hochberg is a Honolulu lawyer and an Alliance Defending Freedom allied attorney.