Recent broad interest in euthanasia and assisted suicide by society at large has prompted this review of euthanasia. This fine, concise, and readable book completely defines the issues, both moral and professional, that are central to the euthanasia debate.
The author argues that the failure to adequately treat the pain and other symptoms experienced by the terminally ill patient is confused with a lack of choice and dignity in the dying process. He notes that the poor education and training in pain and symptom management received by health-care professionals often results in uncontrolled symptoms, during which time a patient may request euthanasia. Despite this situation, however, terminal patients rarely ask for euthanasia or assisted suicide.
Insights into patients' reasons for requesting assisted death are descriptively portrayed in case presentations arising from the author's personal experiences as a hospice physician.
Traditional arguments against euthanasia are enumerated briefly but effectively: The "slippery slope" argument holds that the few cases of euthanasia that may appear to be justified could result in a vast number of immoral executions. Also, any law legalizing euthanasia could easily extend its indications beyond mercy killing. Moreover, according to the author, the diagnosis and, more likely, the prognosis of "terminal" cancer, are frequently incorrect. Of major concern to the medical profession is that legalization of euthanasia and assisted suicide will bring about the irreversible destruction of the doctor/patient relationship. Another concern is that the right to die will soon become the duty to die.
Recent voter referendums on euthanasia are described in some detail, along with the prohibition of euthanasia by the world's major religions. The frightening experience with euthanasia in Holland provides a major incentive against any nation's adopting a myopic view on this issue.
Finally, the book describes, in excellent detail, the use of opioids in cancer pain management. Also, the hospice alternative is explained fully and expertly.
A 52-year-old man presented with an erythematous lesion in the axilla of unknown duration. Surgical excision was performed. What is your diagnosis?
