To Cure or Kill

Oregon has just become the first state to permit doctors to help patients commit suicide. And in the process, it is changing the very nature of medicine in America. The Oregon measure allows doctors to prescribe lethal doses of drugs to terminally ill patients. Supporters portray the act as a step forward in rational health management. The taboo against doctor-assisted suicide, they argue, is nothing but a vestige of religious prejudice. But ironically it was a pagan culture, not a Christian one, that first prohibited doctors from killing their patients. As Nigel Cameron explains in his book The New Medicine, in traditional and tribal cultures, suicide was a common practice. The person most likely to provide the deadly drugs was the medicine man, the witch doctor, the sorcerer. The power to cure also meant the power to kill. But a major turning point occurred roughly four hundred years before Christ, when the philosophers of ancient Greece enunciated the Hippocratic Oath. For the first time, doctors pledged never to use their medicinal arts for killing. They promised: "I will give no deadly drug, [even] if asked for it." The Hippocratic Oath turned medicine into the first profession, as doctors "professed" a set of moral standards. When Christianity came on the scene, the church fathers embraced the Hippocratic Oath and adapted it to biblical ethics. For two thousand years, the medical profession was defined as a complex fabric of technical skills combined with moral commitments. But today that fabric is unraveling. Medicine is losing its moral dimension and is being reduced to a set of technical skills alone, applied in the service of social engineering. Just consider the Netherlands, which entered the brave new world of euthanasia several years ago. Within a short time, Dutch doctors moved beyond patient requests and began making decisions on their own about who should live or die. Today nearly half of Dutch doctors say they've given lethal injections without the patient's knowledge or consent. Clearly the ancient Hippocratic Oath, with its taboo against killing, was no mere "religious prejudice." It was based on a profound understanding of the temptation that doctors face with their power over life and death. But today that taboo is crumbling. Oregon voters have decided to let doctors kill as well as cure, and similar bills are slated to appear in several other states. Perhaps the greatest tragedy is that patients who request suicide are typically motivated not by illness but by loneliness and depression. What they really need is not a deadly drug but care and companionship. That means if Americans accept doctor-assisted suicide it will not only signal the end of medicine as a morally-based profession, it will also signal a profound failure of our own character—a failure to commit ourselves to love and care for the sick, the handicapped, and the dying. So the challenge is to all of us: Will we allow doctors to do away with the weakest members of the human community? Or will we muster the moral will to succor and care for them? The answer will tell us just what kind of people we are.

11/17/94