In Reply: I am delighted by the Hemlock Society's
endorsement of the dignity-conserving model of care. I was particularly taken
by Dr Girsh's unequivocal statement that, "if most individuals with a terminal
illness were treated this way [according to the dignity-conserving model of
care], the incentive to end their lives would be greatly reduced."
If she is correct, one cannot help but wonder how many fewer patients,
in anticipation of dying, would feel compelled to consider or seek the option
of a hastened death. It is known that patients who are free of pain, clinical
depression, and social isolation are less vulnerable to considerations of
euthanasia or assisted suicide.1- 3
Similarly, patients who do not feel abandoned by their health care providers
are less likely to consider or commit suicide.4
Data from Oregon suggest that the number of patients who died of physician-assisted
suicide is relatively small, about 9 per 10 000 deaths annually.5 In the context of a dignity-conserving care model,
would the correspondent's predication of substantial, further reductions in
the incentive to die be realized?