DOS 518 - Week 2 Discussion
http://www.thebrittanyfund.org/ (to access her video(s): http://www.thebrittanyfund.org/category/videos/)
A response to her story was generated that went somewhat viral as well. Kara Tippetts (terminal cancer patient as well) responded to Brittany through a blog by letting her know she did not have to choose that option. This individual is very spiritual in nature but feels Brittany was lied to about the suffering she would endure during her terminal illness. Read her blog post here:
Obviously their diagnoses are much different and their suffering will be much different. They also both have different backgrounds (children, religion, age, etc.). More importantly, they both had choices.
Share your thoughts on this controversial topic. You don't have to voice your specific opinion necessarily if you don't feel comfortable. But think about what patients are considering during diagnoses, terminal disease processes, etc. It's something many of our patients experience every day. What ethical/legal issues must be taken into consideration? What legal issues are being challenged in these situations?
Initial Post: Informed Consent Requires Disclosure
The topic of death with dignity often elicits strong opinions either for or against its practice based on numerous forms of justification. Those who argue in favor of it cite a patient's right to participate in treatment decisions based on full knowledge of all options, including no treatment at all, which is part of the Patient's Bill of Rights section of the Affordable Care Act.1
Some who argue against death with dignity may cite religious beliefs that forbid such actions under one interpretation or another. There is no way to argue for or against such rationales; one can only choose to agree with them or disagree with them. In either case, religious convictions do not affect law because of the separation of church and state in the US.
Some opponents of death with dignity may cite the Hippocratic Oath, saying that its core principle is "First, do no harm". This is a common misattribution, as the oath contains no such phrasing.2 There is a passage written by Thomas Inman some 2400 years after the first version of the Hippocratic Oath that states "Practise two things in your dealings with disease: either help or do not harm the patient", which some believe to be the origin of the "First, do no harm" idea.3 Wherever the phrase comes from, it is not part of the original Oath, and modern physicians typically recite a completely different oath primarily as a form of ceremonial tradition, rather than as any sort of binding contract with society.2 The original Oath is out of touch with modern society, since among other things it forbids doctors from performing surgery.
In modern practice, physicians are still not allowed to cause harm to a patient, so the big legal question would seem to be whether or not providing lethal drugs that the patient can self-administer constitutes doing harm. Brittany Maynard, who suffered from terminal brain cancer in 2014 and who sought out physician-prescribed drugs that would let her end her life at the time of her choosing, argued that a patient who is still sound of mind and an adult should have the option of choosing the time of their own death.4 I see this as a natural extension of the principle of allowing patients the choice of how to manage their own treatment or non-treatment.
- Patient's Bill of Rights. American Cancer Society Website. http://www.cancer.org/treatment/findingandpayingfortreatment/understandingfinancialandlegalmatters/patients-bill-of-rights. Published January 6, 2014. Accessed July 22, 2015.
- The Hippocratic Oath. History of Medicine Division, National Library of Medicine. https://www.nlm.nih.gov/hmd/greek/greek_oath.html. Updated February 7, 2012. Accessed July 22, 2015.
- Hippocratic Oath. Wikipedia Website. https://en.wikipedia.org/wiki/Hippocratic_Oath. Updated July 11, 2015. Accessed July 22, 2015.
- About Brittany Maynard. The Brittany Maynard Fund Website. http://thebrittanyfund.org/about/. Accessed July 22, 2015.