Crossing the Rubicon: assisted dying in general practice

David R Grube

doi:10.3399/bjgp25X740841

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Physician assisted suicide, response to Dr. Grube.
Brick Lantz

Published on: 17 March 2025

Published on: (17 March 2025)
Page navigation anchor for Physician assisted suicide, response to Dr. Grube.
Physician assisted suicide, response to Dr. Grube.
Brick Lantz, Orthopedic surgeon & director of pregnancy center & volunteer at indigent clinic, American Academy of Medical Ethics
As a practising physician in Oregon for over 34 years, I disagree with some of the comments by Dr Grube in his response to Lily Lamb. I found Lily Lamb's article completely accurate. Dr. Grube mentions "intolerable suffering." Pain, or the fear of pain, has rarely ever been in the top 5 reasons for pursuing PAS in Oregon. The most common reasons are a fear of being a burden to others or loss of autonomy. Dependency is a normal part of human relations from birth until death and should not be frowned upon. With palliative care in Oregon my patients, friends, and family members have had a peaceful and dignified death without resorting to assisted suicide. There are horrific stories of death with those taking the oral medications prescribed by physicians. Dr. Grube mentions "respecting their wishes." There are numerous medical situations in which we do not prescribe what the patient wishes as it is detrimental to their health and well-being. We are to profess what is good and healthy, not be a vending machine for their desires. Most commonly this applies to drug addicts and alcoholics, as well as other poor lifestyle choices. As opposed to Dr. Grube I do walk "alongside them in times of darkness." That is my privilege of being their doctor. Mental illness is poorly evaluated and treated in patients requesting PAS. The safeguards we put in place in 1997 have gradually been eroded. PAS creates a culture that devalues life. I believe that is the...
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As a practising physician in Oregon for over 34 years, I disagree with some of the comments by Dr Grube in his response to Lily Lamb. I found Lily Lamb's article completely accurate. Dr. Grube mentions "intolerable suffering." Pain, or the fear of pain, has rarely ever been in the top 5 reasons for pursuing PAS in Oregon. The most common reasons are a fear of being a burden to others or loss of autonomy. Dependency is a normal part of human relations from birth until death and should not be frowned upon. With palliative care in Oregon my patients, friends, and family members have had a peaceful and dignified death without resorting to assisted suicide. There are horrific stories of death with those taking the oral medications prescribed by physicians. Dr. Grube mentions "respecting their wishes." There are numerous medical situations in which we do not prescribe what the patient wishes as it is detrimental to their health and well-being. We are to profess what is good and healthy, not be a vending machine for their desires. Most commonly this applies to drug addicts and alcoholics, as well as other poor lifestyle choices. As opposed to Dr. Grube I do walk "alongside them in times of darkness." That is my privilege of being their doctor. Mental illness is poorly evaluated and treated in patients requesting PAS. The safeguards we put in place in 1997 have gradually been eroded. PAS creates a culture that devalues life. I believe that is the reason that the overall suicide rate has increased yearly since 1997. PAS creates a social contagion that counteracts our suicide prevention programs. We have created a crisis of anxiety, depression, hopelessness, purposelessness, and despair. We have created poor incentives for families and insurance companies to help individuals near the end of life. I completely disagree with the statement, "that these worries are only theoretical and imagined, and don't exist here." My hope is that you do not follow the path of Oregon.
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Competing Interests: None declared.