Health Policy Watch: Rappelling on the Slippery Slope: Negotiating Public Policy for Physician-Assisted Death

Abstract

The rock climber and the law share in a common etymological allusion when each reaches a steep, high, and hard place. The climber “appeals” to the mountain by inching down on a rope and the law's “rappel” is similarly a route to more comfortable footing. Each step in this common process is germane to the eventual resolution, for it is to be found in the rappel process itself and in the meaning of each appeal.

Hospital Social Workers' Attitudes Toward Euthanasia and Assisted Suicide

“…An example of an appropriate case for assisted suicide would be when a patient is terminally ill and whose pain from their illness (i.e., end-stage cancer) is uncontrollable (Brody, 1992;Emanuel, 1994). Most opposition to euthanasia and assisted suicide concerns the belief in the potential for abuse of the practices; that if allowed in a limited manner, this would then lead to possible coercion or obligation to die (to submit to the practices) if perhaps others determine that a patient does not have an adequate quality of life (D'Oronzio, 1997;Emanuel, 1994;Kamisar, 1993;Koenig, 1993). Populations most vulnerable to such abuse of euthanasia or assisted suicide would likely include the elderly and persons with AIDS.…”

Euthanasia and Assisted Suicide

“…Are these decisions to be left to the impersonal methods and constraints of managed care officials who are increasingly scrutinizing medical care to reduce costs? For these vulnerable people, a risk also exists for coercion or suggestion of obligation to accept euthanasia if it is determined that their life is not of value to society (D'Oronzio, 1997;Emanuel, 1994;Kamisar, 1993;Koenig, 1993) in order to relieve society of the burden or to spare family of perceived financial hardship and emotional distress that they may incur during the course of the patient's care.…”