Political medicine

Legislators should consult medical community

Last week, the state House of Representatives passed a bill that would ban assisted suicide in Michigan if signed by Gov. Engler. Passing by a margin of 66 to 40, the bill entails criminal penalties for anyone found helping to end the life of another. Though the state Legislature has displayed its disapproval of assisted suicide through last week's vote, the final assessment of the issue and its medical and ethical implications should not come from politicians - a group ignorant of the medical causes that motivate the terminally ill to seek help in ending their lives. Instead, the medical community - the group with the most comprehensive understanding of the issue - should help decide the suitability of assisted suicide for terminally ill individuals.

In the years since physician-assisted suicide first sparked national debate, the issue has been distorted by candidates for public office using the issue to enhance their platforms and by sensational media portrayals. In fact, just two weeks before the passage of the bill, the story of a Southfield man who sought help in ending his life caught national attention. Typically, headlines failed to emphasize that the man suffered from incurable quadriplegia. Instead, they highlighted the fact that he was 21 years old. Such heartwrenching treatments appeal primarily to the emotions, diminishing the influence of rationality upon decision-making.

The medical profession, by contrast, consists of men and women whose education on the physiological bases of afflictions enables them to aptly assess the appropriateness of performing assisted suicide. In addition, their everyday exposure to terminally ill and severely debilitated patients makes them far more qualified than politicians to determine whether individuals' motives in seeking aid in ending their lives are valid. Neither emotional media portrayals nor manipulative political campaigns likely will distort their thorough first-hand understanding of the issue.

The passage of the ban actually highlights the danger of leaving legislators to decide this issue without medical input. The bill effectively strips doctors of a provision that enabled them to control patients' pain with increased medication - even if that medication expedites death. Legislators eliminated the provision primarily to prevent Jack Kevorkian - a former doctor who has helped more than 100 patients end their lives - from further evading conviction. In its haste to trample out the work of Kevorkian, the Legislature has unnecessarily affected the quality of health care for Michigan residents. Had the state consulted the medical community, the legislation would have lent a sensitive ear to the needs of the state's ill.

In approving the ban on assisted suicide, state lawmakers erred by failing to consider input from the best-educated group on the issue - the medical profession. Before depriving Michigan residents of jurisdiction over one of the most intimate life decisions, legislators should draw heavily on medical expertise. As assisted suicide continually proves to be a controversial issue, debate and legal change likely still loom ahead. Future regulatory and legal change must include the perspectives of the doctors whose careers afford them first-hand expertise on the dynamics of the assisted-suicide debate.

03-20-98