Since the emergence of human existence, global healthcare institutions have been tailored to the community and geographic area in which they have served. Despite this cultural diversity, one role has remained unchanged: the physician’s responsibility to do no harm and save lives at all costs. With the increasing popularity of medical aid in dying (MAiD), the purpose of physicians has shifted away from these fundamental values of medicine to heal and promote human well being (1). This change not only discourages entrance into medical fields, but threatens adverse effects for physicians being forced into these complex ethical situations. Kenneth Stevens, Professor in Radiation Oncology at the University of Oregon, cites the feelings of physicians asked to aid in this process as “suddenness, powerlessness, and isolation” (1). These effects are further exacerbated in cases of pressure on and intimidation of doctors, which presents them with a moral conflict between their personal belief and duty in their occupation. In a study conducted to examine physician attitudes versus willingness to perform euthanasia-related procedures, only 13% of physicians who thought the practice should be legalized or decriminalized reported that they would be unequivocally willing to perform it themselves (3). These results suggest a large discrepancy between endorsement and practice of MAiD that is a result of a conflict of duties: “the duty to preserve life on one hand and the duty to relieve suffering on the other hand” (2).
In evaluating the risks of MAiD, we must then factor into the conversation the risk of emotional burdens for the participating physician associated with preparing and performing these procedures on their patients. Mainly, dealing with death on a constant basis in addition to handling these challenging situations can have significant impacts on clinician health, causing feelings of self doubt, intense memories, and disconnection from patients. The direct effect of such feelings may be burnout and depression, which would reduce the ability of physicians to communicate and empathize with patients and families in times of great need (4). The implementation of MAiD also lowers boundaries between professional and personal life for physicians, which can consequently lead them to internalize feelings of their patients and question their own mortality.
Although we may have not fully accepted the integration of MAiD into our healthcare systems, it is important to address concerns about undermining the role of the physician and provide necessary support that is needed to adjust to significant change within our medical systems.
Designed By: Angie Huang
Edited By: Katherine Hinton
Works Cited:
Stevens, Kenneth R. “Emotional and Psychological Effects of Physician-Assisted Suicide and Euthanasia on Participating Physicians.” Issues in Law & Medicine, vol. 21, no. 3, 2006, pp. 187–200, pubmed.ncbi.nlm.nih.gov/16676767/.
Evenblij, Kirsten, et al. “Physicians’ Experiences with Euthanasia: A Cross-Sectional Survey amongst a Random Sample of Dutch Physicians to Explore Their Concerns, Feelings and Pressure.” BMC Family Practice, vol. 20, no. 1, 17 Dec. 2019, bmcprimcare.biomedcentral.com/articles/10.1186/s12875-019-1067-8, https://doi.org/10.1186/s12875-019-1067-8.
Hetzler, Peter T., et al. “A Report of Physicians’ Beliefs about Physician-Assisted Suicide: A National Study.” The Yale Journal of Biology and Medicine, vol. 92, no. 4, 20 Dec. 2019, pp. 575–585, www.ncbi.nlm.nih.gov/pmc/articles/PMC6913834/.
Siden, Harold. “Physician Stress in the Context of Medical Aid in Dying.” UBC Medical Journal, 2016, med-fom-ubcmj.sites.olt.ubc.ca/files/2017/03/v8i1-feature2.pdf.