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JAMA 100 Years Ago
September 22/29, 1999


Author Affiliations

JenniferReiling, Editorial Assistant

JAMA. 1999;282(12):1112B. doi:10.1001/jama.282.12.1112B-JJY90030-2-1

A presumably learned jurist, a law lecturer in Yale University, has, in an address recently delivered, emitted the opinion that it is wrong to prolong a life in hopeless misery by medical art. He says: "In civilized nations and particularly of late years, it has become the pride of many in the medical profession to prolong such lives at any cost of discomfort or pain to the sufferer or suspense or exhaustion to his family." He asks: "Is not this a misapplication of the healing art?" in other words, are not physicians interfering with a beneficent providence, which, if left to itself, would abbreviate suffering and really make life happier to the surviving? This address has been extensively noticed in the daily press and commented on by physicians, lawyers, and others, and it is satisfactory to see that the ethical instincts of our profession are so firmly upheld in nearly all the parts that medical men have taken in the discussion. One or two points, however, have been perhaps too much emphasized, viz., that we can not say when a disease is hopeless, and that the desire for life is universal. Every physician of any amount of practice must have repeatedly seen cases where the near fatal termination was as certain as a mathematical axiom and others where the desire for death was stronger than the love of life, to say nothing of the vast majority where disease has produced a mental apathy or indifference. In any case, the physician has no question as to his duty, and needs no such excuse to keep him to it. Doctors are not generally accused of being religious, but the ethics of our profession go parallel with the best Christian doctrine in this as in other matters. In only one case reported in the daily press has an alleged physician uttered sentiments in accord with those of the jurist referred to, and the report of his remarks reads like a criminal confession. He has, he says, in hopeless cases given chloroform at the patient's request to shorten his existence. "Suicide," he says, "is justifiable in many cases provided the suicide has no obligations." He has advised suicide and specified the method, though he naively acknowledges he does not know that his advice has been seriously taken. This doctor may be safe in his own state, where the judge referred to presides in the higher courts, but his quoted remarks, if taken seriously, would make him liable to criminal proceedings in some sections of the country. They sound more like the reckless utterances of one who not only lacks principle but has times "when the wit is out," or when his desire to see his name in print overbalances any correct judgment he may possess. It is to be regretted that there is a physician whose ideas even, are based on such pagan principles as seems to be the case here.

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