How the Assisted-Suicide Ruling Affects Doctors' Work
MELISSA BLOCK, host:
Peter Rasmussen is a doctor of medical oncology, hospice and palliative medicine in Salem, Oregon. At the request of patients, he has written prescriptions for lethal doses of medicine. He was also a plaintiff in one of the cases that resulted in the Supreme Court's decision today. Dr. Rasmussen says he's pleased by the court's decision, though he admits his views are different now than when he first went into medicine.
Dr. PETER RASMUSSEN: Certainly, when I was going to medical school I had no inkling that this would become part of my practice. And it took me some time to think through whether there could even be situations where a person could actually wish to die and yet not be insane. And right now I'm quite comfortable that that's the case. But the training I had was that that's a red flag for depression, and the role of the physician is to not let the patient have what he wants.
BLOCK: So it took a while to get there?
Dr. RASMUSSEN: It did.
BLOCK: Do you think much about talking about alternatives to lethal doses?
Dr. RASMUSSEN: Yeah, that's part of the requirement of the law, is that alternatives have to be clearly described to the patient, not only by one physician, but by two physicians. And it's often the case that as we describe these alternatives that, in fact, one of those alternatives is what they end up choosing.
BLOCK: And what might that be?
Dr. RASMUSSEN: Well, there are several. Probably the most common is simply good hospice care.
BLOCK: Could you walk us through maybe a couple of cases that you've handled where the patient decided that they wanted to get a lethal prescription dose and you helped them do that?
Dr. RASMUSSEN: Well, I can think of one woman who had suffered a stroke. It was clear that the stroke was due to a brain cancer, and that her quality of life, her neurologic capacities, were going to diminish over time. And she decided she didn't want to put her family through a long process where she became weaker and weaker and had to be cared for for every little thing. She announced a time when she was going to take the medicine. She had family come in, literally, from all over the United States. And when I arrived there, the day she took the medicine, there must have been 50 people. And one by one the family members would go into the bedroom and say goodbye to her. And it was a very poignant experience for me to see, and a stark contrast to a lot of the deaths that I witness.
BLOCK: But you would make it a point to be there? In other words, not just to dispense the prescription?
Dr. RASMUSSEN: Yes. Now the law does not require that, but I want to be there.
BLOCK: And why is that?
Dr. RASMUSSEN: I think it's very helpful to the family. And I don't actually require it. I say that I'd like to be there, and I've never had a family say anything other than, `Oh, good, I'd like you to be there.'
BLOCK: And to people who say, whether it's doctors or anyone else, that this is doctors essentially abdicating their role in patient care and in preserving life, what do you say?
Dr. RASMUSSEN: I think they have a very narrow view of the role of physicians and the role of medicine. What that suggests is that we are failures every time a patient dies, and I fundamentally disagree with that. I think that death is an integral part of life, and how we die, how we go through that dying process, is a very important final chapter in our lives. And there's a lot that physicians can do to help the patient make that final chapter as important and successful and meaningful as they possible could. And for some small number of people, that involves a death-with-dignity type of law.
BLOCK: Since you're now pretty widely known, I take it, as someone who will prescribe lethal doses of medication to patients there, have you found that your practice has shifted in some way? In other words, that the people are gravitating to you because of this and that the nature of what you do has changed?
Dr. RASMUSSEN: I've always had an interest in end-of-life care, ever since I was in a lecture by Cicely Saunders, the founder of the modern hospice movement, in my residency. A substantial part of my practice is end-of-life care. A small part of the end-of-life care is the death with dignity. But I'm in a six-person group and the other five partners do refer a lot of their patients to me for end-of-life care.
BLOCK: And has it--have you found it squeezing out any other parts of your practice that maybe before you would have spent more time with?
Dr. RASMUSSEN: Probably, but this is the part of practice that has always had the greatest interest for me. It's great to cure people of cancer. But the greatest need, I think, is to care for people where that cure has not been possible.
BLOCK: Dr. Rasmussen, thanks very much.
Dr. RASMUSSEN: Sure.
BLOCK: Peter Rasmussen is a doctor of medical oncology, hospice and palliative medicine in Salem, Oregon.
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