Speech to Delaware Senate
HB 140 is a bill that allows doctors and nurse practitioners to prescribe life-ending drugs to patients who will then self-administer the drug. ASP spoke in front of the Delaware State Senate in opposition to the bill. At the time of the speech, the bill had passed the Delaware House and was being debated in the State Senate. Unfortunately, the bill passed by one vote and is currently waiting for a decision from Delaware governor, John Carney.
Hello, my name is Zachary Howell and I am currently a medical student at Sidney Kimmel Medical College. I am here today speaking in opposition to HB 140.
In my medical studies we are taught to work primarily with treatments for illnesses. Considering that, it makes it very curious in the context of this bill that what we are going to be asked to do seems completely in opposition to our stated goal of caring for life. The two main areas of concern for me with this bill are the way that having this option available can affect the elderly and the disabled. Namely, relatives with ulterior motives, the feeling of a duty to die as to not be a burden on their family, and sadly, the potential for abusive caregivers. The obvious role of the physician in these cases is to assist and treat, and sometimes palliate. However, this bill seems to assume that the realm of the physician also includes being involved in ending life as well. Are we to call that a treatment? This simplifies medicine to the belief that by removing one’s life we have also successfully removed one’s disease as well. This “baby with the bathwater” approach may make perfect sense in an insurance balance sheet, but the cost to the world for every person who dies in the name of eradicating suffering will be devastating.
The prerequisite for this option is a patient being designated to have six months or less to live, but just as our proclivity to desire life ending drugs showcases our frailty, the estimates themselves showcase our potential for error. Medicine is the most unpredictable profession in the world so it seems extremely worrisome to base legislation regarding decisions of life and death on the supposed infallible judgement of a fallible human. In addition to our human failings, we may never delude ourselves into believing that every decision we make is always in the best interests of the people we serve, hence the discussion we are having today. Considering the problems with health insurance companies that we already face en masse; does it make sense to assume that those will be improved when the decision to pay for a life ending drug is approached legally the same as a lifesaving treatment?
I am nearing the end of my medical education, and I am deciding where I will practice after medical school. Although I would love to come back to Delaware when my studies are complete, I personally feel very uncomfortable with practicing in a place where the purposeful ending of life is even an option for my patients. I take the relationship between a physician and patient very seriously and if the potential for ending my patient’s life before natural end was on the table, I would feel that the relationship between us would be greatly eroded. This is due to the many negative incentives that will inject themselves into the equation. Although this bill makes it clear that the patient ending their life would only be an option in a wide array of other options, one must admit that amid suffering and fears of looming death, the psychological scales can be tipped in favor of the path of least resistance. As a physician, I will strive to be one who will always be with patients until the natural end of their life and continue to make it clear that their life always has dignity and value to the world worthy of saving by the mere fact that they exist as people. Allowing patients to launder their decision through the medical profession makes it quite difficult to honestly affirm that truth. I ask that all of you here today will join me in affirming that sentiment as well.