Originally created 11/08/97

Matters of life and death



Doctor-assisted suicide may be legal in Oregon but decisions about giving up life - what many call sacred life - are never simple or easy.

Augusta doctors, students and other health professionals in the St. Luke's Society of Physicians will discuss End of Life Decisions Nov. 18.

Dr. Tom Swift, chairman of the Department of Neurology at the Medical College of Georgia, and Jeffrey Flowers, MCG director of pastoral care, will join Superior Court Judge Albert Pickett in presenting the topic.

Oregon voters decided Tuesday to retain the state's law allowing doctor-assisted suicide. Any terminally ill person with less than six months to live can ask for a lethal dose of an oral medication. The law is the only one of its kind in the United States. It passed in 1994 but was never used because of legal challenges.

The difference between doctor-assisted suicide and euthanasia hinges on the willingness of the patient. "Euthanasia (an active process with the intention of taking another's life) strictly speaking, is not legal under any circumstances in this country," said Dr. Swift. In passive euthanasia, life support is withdrawn.

"If a spouse of someone with Alzheimer's disease puts a pillow over the person's face and suffocates the person, the district attorney will call it homicide," said Dr. Swift. "An expert witness testimony would call it euthanasia."

"To my way of thinking, if you took oxygen away, that would be pretty active," said Dr. Swift.

Is withdrawing life support equipment any different from withholding it in the first place? Is withholding a life-saving antibiotic the same thing as withholding food and water? "There are things like that that go on and on," said Dr. Swift.

If patients have stated their wishes through a living will, a doctor has some direction. But having a durable power of attorney would be a valuable addition, he said. "A living will may be very rigid and may not speak to the particular area you are concerned about."

Doctors worry about doing something illegal and getting sued, he said. "To my knowledge, there has never been a successful prosecution of a doctor for withholding or withdrawing life support."

General principles, however, are hard to come by. Two patients might have the same illness, but treatment would differ because one is 26-years-old, the other 96, said Dr. Swift. "I can tell them what I would recommend, and hope the family will go along with it once I have presented all the facts," he said.

There is a difference between withdrawal of treatment and withdrawal of care, said Chaplain Flowers. "If we are not treating a patient any longer, we are still caring for the patient."

Death comes to everyone, he said. "We don't have to like it. There is a mystery about it that we will never totally decipher." Instead of trying to eliminate the mystery, people need to embrace it. "We need to realize that the mystery is part of the healing of death."

Death is a very individual experience and having a peaceful death differs for everybody, said the Rev. Flowers. "Saying what is on their mind and heart, making peace with God, it differs for everybody."

While the doctor must approach a decision from what the patient wants and what is in the patient's best interest, the chaplain's role is to be a support. "Chaplains help make sure that everyone is being heard," he said. "They are having to make decisions that they don't want to make."

Much about death and dying is spiritual in nature, he said. "If we have missed that aspect we have failed to care for the whole person."

Rather than death, he believes it is the pain of dying that people fear. The pain, both physical and emotional, is an unknown, and that is where faith is the great provider, he said. "Our faith tells us we will be cared for in this world and into the next."

Society of St. Luke the Physician

What: Group offering an open forum where physicians can talk about issues related to Christianity and the practice of medicine.
Topic: "End of Life Issues.
Presenters: Dr. Tom Swift, Chaplain Jeffrey Flowers and Judge Albert Pickett
When: 6:30 p.m. Tuesday, Nov. 18
Where: Call the Rev. Chip Edens, 724-2485.