If a doctor prescribes a drug that will kill you, is he effectively killing you?
Tom Beauchamp, Professor of Philosophy at Georgetown University, took on this issue and a plethora of others in a lecture on the medical ethics of physician-assisted suicide Wednesday evening.
After giving a brief summation of Western medical ethics, Beauchamp lambasted Attorney General John Ashcroft’s recent attack on Oregon’s assisted suicide law, the Death with Dignity Act.
Attorney General John Aschroft, in a brief filed with the Ninth Circuit Court of Appeals Wednesday, has asked that federal court to overturn Oregon’s law. Beauchamp believes that both the appeals court and the Supreme Court will throw out Aschroft’s appeal, since the high court has ruled that states have the right to allow for physician-assisted suicide.
In 1993, Oregon witnessed its first passage of an assisted-suicide law, which was codified and upheld on appeal. The Supreme Court upheld the right of states to make their own laws on the issue. In so doing, the Court then allowed for physician-assisted death in 1996, he said.
Beauchamp discussed an issue that many Americans and physicians wrestle with, that of killing or letting die. He suggested that this apparent polarity was illusory.
Rather, he said, the idea of killing or letting die overlap in amazing ways.
“It’s unclear how to distinguish killing from letting die,” Beauchamp said. “The classes overlap.”
Doctors, he stated, have long held that letting die is when one is removed from medical technology, such as a respirator, and thus dies a “natural” death, since they would have died naturally had the technology not been available.
But Beauchamp then presented a scenario where a patient was killed when a doctor mistakenly took someone off a life-support system without her consent.
The problem, he said, is one of authorization; in this situation, the patient had no agency to decide their own fate.
“Physician-assisted suicide in the 21st century will be about letting alone, it will not be about letting die,” he said.
Beauchamp also believes such decisions are privacy issues where the government has little moral or legal basis to intervene.
He cited a change in American public opinion by doctors.
“Polls show that 49 percent favor physician-assisted suicide,” he remarked. “Over 45 percent of physicians believe it should be legal.”

Since Oregon’s assisted-suicide law went into effect five years ago, only about 20 people have used the law to die each year. Twenty-one deaths occurred under the law in 2001, with another 20 invoking the law, but electing not to take their own lives and dying of natural causes.

“Most have cited fear of loss of autonomous control for the reason for their decision,” he said. “Loss of control…is what most patients are worried about.”

“Only a few feared intolerable pain, not controllable by medication,” he added.

Beauchamp also noted that any consideration of “experience of five years of practice” of the law were “strikingly absent” from Ashcroft’s brief.

Beauchamp is a senior researcher at the Kennedy Institute of Ethics.