Psychiatrists Must Prevent Suicide, Not Provide It

Psychiatrists Must Prevent Suicide, Not Provide It

 

We fundamentally disagree with our two colleagues that public opinion is an ethically appropriate means of informing public policy decisions or even more crucially, determining professional norms of physicians.

Polls have not just moral but also methodological problems. Response rates are often low, and typically it is those with the strongest feelings about the issue who respond. Responses are also highly sensitive to the ways questions are worded (eg, “assisted suicide” vs. “aid in dying.”2,3) The most robust and proper way to explore ethical questions—especially radical shifts proposed in such an enduring and venerable professional ethos as this one—is not by simply doing a “gut check,” and quickly answering a poll. It is by a process of deep examination, study and consultation with a variety of professional experts in philosophy, medical ethics, and sociology, as well as our patients. Medical ethics is not so much about finding the one “right answer” as it is about pursuing the right process.

This “deep dive” is precisely the process that was brought to bear by the American Medical Association (AMA) and the World Medical Association (WMA) in their recent reexaminations of their ethical opposition to these practices.4 That process was repeated several times at the request of PAS proponents, and each time, though acknowledging the caring intentions on both sides of the issues, these organizations kept coming to the same conclusion—that these practices are “firmly opposed.” Similarly, for the second largest medical organization in the US—the American College of Physicians5—and even for the organization that works professionally in the “end-zone” of life—the International Association for Hospice and Palliative Care6—these and other articulations, are not mere polls. They are robust deliberations by organizations representing physicians and others, whom society is asking to do the killing. Moreover, no medical organization in the US has actually endorsed PAS as a laudable practice so far. At most, those organizations not opposed to PAS have expressed official “neutrality” on this issue…

Read the full article at The Psychiatric Times…