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Evidence suggests that such relationships are not always positive anyway. Opponents of legal assisted dying point to the potential damage to the physician-patient relationship to explain away public demand for legal change, and argue that the answer to the problem is more compassionate care, not assisted death. They further argue that some physicians may find it easier to help patients die than to respond to their patients' therapeutic needs, pointing to research that shows that physicians are "seldom comfortable, intimate, and competent in the management of terminal suffering," and that they frequently fail to respond to the needs of dying patients. Instead, they suggest that physicians can feel an antipathy toward the dying, and that this may arise from their own anxieties about death, ideas on quality of life, and feelings of failure about their inability to cure these patients. As a result, physicians may emotionally withdraw from the dying and both minimize and under-treat their patients' pain.
If this is true, then this relationship cannot get much worse with legal assisted dying unless it were quickly and less-than-thoughtfully provided and merely seen as another technological option available for use in an already faulty physician-patient relationship. This relationship, however, can only improve if assisted death is seen as an extraordinary act that requires extraordinary dialogue, and is legalized with guidelines, safeguards, and a model of clinical practice that opens up this currently private relationship to professional input and scrutiny. It must increase - rather than decrease - the accountability of physicians for: (1) meeting the needs of dying patients; (2) communicating with patients and their significant others about their end-of-life concerns; and (3) addressing issues of relentless pain, suffering, and possible depression. In this way assisted dying doesn't have to conflict with compassionate care, but can help ensure it by shifting current emphasis to a model that recognizes both the inevitability of death and the necessity to provide comfort for their dying patients -- a model of compassionate medicine that already exists within the hospice concept. With this model in place, a patient’s request for assisted death could require physicians to responsibly face the suffering of patients, and by so doing help to humanize the dying process, teaching physicians that death -- regardless of how it comes -- is not failure if it arrives at the end of an intensified process of assessment, discussion, and decision-making; it can become part of a new model of care that redefines the concept of healing to place greater emphasis on the emotional, relational, and spiritual aspects of being, than on the physical.