Doctors speak out on physician-assisted suicide bills

BOSTON -- For thousands of years, the profession of a doctor has been associated with healing and the preservation of life. But now, physicians are increasingly being called upon to do the opposite, as more states make it legal for them to facilitate the means for patients to end their lives.

The Massachusetts legislature is now considering two bills, H2381 and S1384, "An Act relative to end of life options," which would allow physicians to prescribe lethal drugs for terminally ill patients who are expected to have less than six months to live. Supporters of this practice call it "medical aid in dying," while opponents call it "physician-assisted suicide" (PAS).

A virtual hearing for these bills took place on Oct. 1, with over 100 people offering verbal testimony and many also submitting written testimony. Among those who testified were many doctors, some of them voicing support, and others voicing opposition to the bills.

One of those testifying in opposition was Dr. Mark Rollo, a resident of Fitchburg who retired a year-and-a-half ago after a 35-year career in family medicine. His youngest patients were unborn infants, and his oldest were over 100 years old. He is now on the board of directors of Massachusetts Citizens for Life, and he regularly discusses medical ethics from a Catholic perspective on a podcast called "First Do No Harm."

Speaking to The Pilot in an Oct. 15 interview, Rollo said he thought it was "a very good hearing."

"I think we were very well represented," he said.

In his verbal testimony during the hearing, Rollo spoke about the results of legalizing PAS in other states, including greater opportunities for elder abuse and the increase in general suicide rates. He also expressed concern about the position it would put doctors in.

"When the power to assist people to commit suicide is given to physicians, how long will trust in the medical profession last? How long will it take for doctors to become tools of the state and insurance companies to steer despairing people toward suicide as a cost-cutting measure? This has already taken place in states which have legalized assisted suicide," Rollo said in his testimony.

Speaking to The Pilot, he recalled how the anthropologist Margaret Mead suggested getting someone other than doctors to perform euthanasia.

"Not only is assisted suicide wrong for a number of reasons, (but also) it's wrong to dirty up a profession that everybody depends on," Rollo said.

He spoke at length about the Hippocratic Oath, which was formulated 2,500 years ago by the Greek physician Hippocrates. At that time, in Greek and Roman culture, doctors were not trusted because they had the power to either kill or heal. The Hippocratic Oath includes the pledge to not give a deadly drug to a patient if asked, nor suggest that they take one.

Rollo said one positive effect of the Hippocratic Oath was that it led to many medical breakthroughs, as it spurred doctors to work hard to find cures rather than eliminate or give up on patients.

Some of those who testified in support of the bills cited statistics regarding medical societies' stances on PAS, alleging a shift from opposition to neutrality. However, the accuracy of those statistics was called into question by later speakers--such as Thomas Sullivan, a member of the American Medical Association and past president of the Massachusetts Medical Society. He said that medical societies' adoption of "neutrality" is misinterpreted as acceptance, when, in actuality, it reflects the fact that many doctors are not comfortable dealing with chronic disability and end-of-life issues.

Rollo said that as PAS advocates try to pass legislation in different states, they try to reverse the stance of medical societies, most of which have long opposed PAS. In Massachusetts, they did this by putting out a survey to physicians, but only about 12 percent of them responded, and those results were split about 50-50.

Rollo confirmed to The Pilot that the Massachusetts Medical Society was strongly opposed to PAS and only adopted a "neutral" stance in the past five years.

"To be neutral about killing one's patients is an absurdity," he said.

In an Oct. 8 email to The Pilot, Dr. Kerry Pound, a pediatrician and the vice-president of Massachusetts Citizens for Life, said that physicians are "fundamentally healers" and that PAS "fundamentally destroys that foundation of medicine -- that is, to do no harm."

This, she said, is the reason why the American Medical Association has called PAS "incompatible" with the practice of medicine.

"This is an evil bill that seeks to enshrine death as the solution to suffering -- rather than encouraging and promoting palliative care. It corrodes medicine at its core. Finally, its effects will be widespread in society as laws are instructive and these laws teach us that some humans are disposable when no longer useful," Pound said.

She also pointed out that in states where PAS has been legalized, the supposed "safeguards" that its supporters say will protect patients from abuse are challenged as "barriers" or "discrimination." One example of this is the requirement for a mental assessment of the patient, which is challenged by those who think suicide should be available to people suffering from psychiatric problems. Other examples are the ability of the patient to communicate independently and self-administer the drug.

Rollo agreed that "Safeguards are nothing more than obstacles for the next round."

He also argued against the idea, mentioned by several PAS supporters during the hearing, that prohibiting assisted suicide is imposing a religious view on other people. Although there are faith-based reasons for opposing it, none were cited during the hearing.

Rollo spoke of the importance of the final stages of life, when people tend to reach out and reconcile with others, asking and offering forgiveness.

"It's wrong to minimize those important parts of life. They may be short in duration, but it's an immensely important time," he said.

In addition to the Catholic concept of "offering up" suffering, there are also secular benefits, Rollo said.

"Our society doesn't like any kind of suffering, they want to avoid it as much as possible, but lots of good things can come out of suffering," he said.

An example of this, he said, is how taking care of patients or family members can help people become more caring.

"As a culture we should never minimize the compassion that exists in taking care of somebody who is suffering instead of trying to eliminate them," Rollo said.