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On another level, many in the medical community acknowledge that the assisted-suicide debate has been fueled in part by the despair of patients for whom modern medicine has prolonged the physical agony of dying.
Just three weeks before the Court’s ruling on physician-assisted suicide, the National Academy of Science (NAS) released a two-volume report, Approaching Death: Improving Care at the End of Life. It identifies the undertreatment of pain and the aggressive use of “ineffectual and forced medical procedures that may prolong and even dishonor the period of dying" as the twin problems of end-of-life care.
The profession is taking steps to require young doctors to train in hospitals, to test knowledge of aggressive pain management therapies, to develop a Medicare billing code for hospital-based care, and to develop new standards for assessing and treating pain at the end of life.
Annas says lawyers can play a key role in insisting that these well-meaning medical initiatives translate into better care. “Large numbers of physicians seem unconcerned with the pain their patients are needlessly and predictably suffering," to the extent that it constitutes “systematic patient abuse." He says medical licensing boards “must make it clear…that painful deaths are presumptively ones that are incompetently managed and should result in license suspension."
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