Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
To the Editor.—It is easier to find dogmatic
statements than guiding principles in the assisted-suicide debate. I am inclined
to rely on my intuition in such situations, and work backward to a principle.
I do not wish to belittle the need for legal definitions. In fact, these often
clarify precedent and serve to make us all pause where we once felt so certain.
But, I must place the legal system in perspective in this debate. Mr
Gostin's article1states, "The judiciary
has transformed not only the practice of medicine and the rights of patients,
but has also shaped societal values." Rights are inherent and need to be defined.
The judiciary cannot and should not try to transform them. The judiciary also
cannot shape societal values. It has a duty to reflect societal values (common
law?). On the issue in question, however, this inflated view of "judiciary
impact" fails to acknowledge that the overwhelming majority of "end-of-life"
decisions are comfortably and quietly carried out between patients and their
physicians. This compelling empirical observation should guide us to seek
the truth in these decisions, rather than assume that they must be occurring
unethically without the watchful eye of the judiciary.
Farrell JP. Deciding Life and Death in the Courtroom: Debate and Clarification. JAMA. 1998;279(16):1259-1261. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-16-jac80007