Thursday, 30 April 2009

Medical issues in Euthanasia, and Suicide

The whole are of the management of the terminal phase of illness and the end of life is one in which medical practice is, of necessity, deeply involved. the manner in which the patient dies, whether in acute illness or in longer term chronic illness, may even be something of a touchstone for the quality of medical care. Since the dawn of the profession, doctors have been involved in dying; relieving its distresses, seeking to support tha patient in the process, whether long or short.

Acceptance of Death One of the most difficult disciplines for the physician or surgeon is to come to terms with the ultimate failure of all the therapeutic measures available to them and with which they have practiced. Death may be posponed, even avoided, but not ultimately evaded. If it is difficult for the doctor to countenance death, seeing it as the ultimate failure of art and skill, it would be even more difficult for the doctor to see him or herself as the personal agent of that failure. The wise and experienced doctor will certainly seek to use the skills of medicine to alleviate the pains and distresses of death, and indeed to make the process of dying as free of distress as possible for the terminally ill person.

Suicide, although not an offence in law, is perceived among the most negative of emergencies to be handled in the casulaty and intensive care areas of general hospitals and, while compassion and understanding are readily extended to the unsuccessful victim, that sympathy and understanding are directed towards the person, rather than towards the act. The suicide of a patient who has been under regular care, whether terminally ill, psychiatrically depressed or in severe distress for other reasons, is a particular trauma to most health care professionals who may carry, in addition to the sense of failure when the patient dies, an equally distressing feeling that in some way they have failed that person while they were still alive and still amenable to supportive help.


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