Euthanasia--the twenty-sixth specialty?

Abstract

Twenty-five medical specialties currently offer board certification in the United States. The question is, should there be a 26th specialty--that of euthanasia? Physician-assisted suicide has clearly been brought to the forefront of public debate by Dr. Jack Kevorkian, the retired Michigan pathologist, and the passage of the Oregon Proposition. The concern becomes multifold; should physician-assisted suicide be allowed? On whom should it be allowed? Should all physicians be allowed to participate, or only a select few? All physicians take either the Hippocratic Oath or World Health Organization Oath (or both) at medical school commencement, which forbids the taking of a life. How then are we to reconcile physician-assisted suicide? The Dutch have extensive experience with euthanasia assisted by physicians. It has become increasingly clear that a great deal of pressure will be directly or indirectly exerted on physicians to withhold or minimize treatment with terminally ill patients at both spectrums of life. The need to face these decisions will be pushed by economic interests. It is well documented historically that Nazi doctors conducted numerous experiments on concentration camp inmates in the name of research and scientific truth. How did these doctors become part of Hitler's killing machine in the 1940s? By 1942, the Nazified physicians were ready to cure the nation by killing off "useless eaters," and Jews, the "cancer" of the Nordic race. If we are taught that history repeats itself, how can we condone the helping of one patient and assisting another with ending his life? Perhaps it is fitting that Dr. Kevorkian was a pathologist, not directly involved in caring for patients and families. Perhaps we will need the 26th specialty, but the real questions is "Should those of us who took the Hippocratic Oath take the first step?"