July 13 1998

ARTICLE TOOLS

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One of the most important stories of recent months was Dr. Diane Meier's change of heart about physician-assisted suicide (PAS). Meier, a New York physician and professor of geriatrics, is a specialist in "palliative care"—pain relief—for dying patients. For some years, she was an influential advocate of the legalization of PAS. But this past spring, Meier publicly reversed course. In a column in the April 24 New York Times, Meier made public the reasons for her change of mind. Her insights suggest broader connections for those committed to the sanctity of human life.

First, according to Meier, PAS advocates assume patients are mentally alert and competent to make a rational choice to end their lives. Meier now argues that these patients rarely are able to exercise such judgment. Normally they are confused, anxious, depressed, or simply incapable of thinking clearly—hardly a propitious context for making an important, life-or-death decision.

Second, those in favor of PAS normally would restrict its use to situations in which patients are within six months of death. Meier argues that it is nearly impossible to predict when patients are going to die until the last few days of their lives.

Third, PAS advocates claim that patients can be protected from coerced decisions to end their lives through the use of a doctor's signed certification. Meier now claims that noncoercion is impossible for a doctor to certify. Especially given the enormous financial pressures that medical bills impose, the availability of PAS is itself coercive. Dying patients know that merely by signing a document they would reduce the financial pressure on their families. No one needs to say a word about it.

Why this sounds all too familiar Advocates ...