Neil Gorsuch, Hospice and the Right to Die – by Dr. Richard B. Fife

Neil Gorsuch, Hospice and the Right to Die
One of the most haunting and disturbing images in American literature is Thomas Wolfe’s description of the death of his own brother as depicted by Ben Gant in LOOK HOMEWARD ANGEL. “Ben’s thin lips were lifted in a constant grimace of torture and strangulation, (and the) sound of his gasping – loud, hoarse, unbelievable, filling the room and orchestrating every moment of it -gave to the scene its final note of horror.” Though written almost 90 years ago, this could be a contemporaneous description of a dying, untreated patient. A number of studies indicate a high prevalence of uncontrolled pain and dyspnea, among other symptoms in dying patients. It is hardly surprising that some patients would elect to accelerate their own death rather than undergo protracted, unrelenting physical suffering, even if only contemplated and not yet experienced. Under such circumstances, if a rational person chooses to die rather than to live miserably, should society have the right to say no?

Many would say that the goals of hospice care – pain management and emotional and spiritual support would alleviate the need for one to consider such a thing as physician-assisted suicide. About 20 years ago, I chaired a national committee on ethics composed of physicians, ethicists and scholars from around the country. On this particular year, physician-assisted suicide was not yet a legal question in any state in the country. At the time, it was being considered and voted on in the state of Oregon. Our committee discussed the upcoming legislation in Oregon and talked about patient autonomy, the patient’s right to choose, existential suffering, inadequate symptom management, and other ethical issues related to assisted-suicide. At that time, we also talked about “slippery slope”, about patient autonomy not being limitless, and physician-assisted suicide being a violation of the Hippocratic Oath The committee ultimately voted overwhelmingly against assisted-suicide and the impending legislation.

Now, 20 years later, one wonders how the committee would vote today. Since the early nineties several states have voted to allow assisted-suicide. Moreover, in the past year it has become a question that hospices have been facing across the country. It is also about to take the forefront of the news again because of the nomination of Neil Gorsuch to become a member of the United States Supreme Court. He brings a history of writing and decision-making to the question of assisted-suicide. In his 2009 book, The Future of Assisted Suicide and Euthanasia”, he states “All human beings are intrinsically valuable and the intentional taking of human life by private persons is always wrong.”

I think that now is a good time to discuss the goals of hospice, assisted-suicide, and the opinions of a newly nominated Supreme Court justice.

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