The Lords of Life and The Lords of Death

Physician-assisted suicide, which is now legal in Oregon and may soon become so in the state of Washington, is putting an intolerable strain on the medical profession.

It used to be much easier to be a doctor. You knew just what you were supposed to do: preserve and save lives. You took an oath swearing not to harm your patients in any way. It was not always a lucrative profession but you were admired, even revered, and depended upon. And your conscience was at peace with God and men.

Then things got complicated. First, for German doctors, there were concentration camp assignments where preserving life was not the job at all. Then, abortion suddenly became legal and a pregnant woman might ask a doctor to destroy her unborn child rather than protect it. At first, there were some problems and needful readjustments, as coat hangers were replaced by more sophisticated tools. But gradually, abortion became a more professional affair and the proper instruments and clinical procedures were developed and standardized. And the Oath of Hippocrates ("...I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy....") was altered to fit the spirit of the times.

But moral issues, and the emotional conflict between life preservation and life-taking, remained. Ultimately, obstetricians and clinics responded to these pressures by largely separating into those that seldom or never perform abortions and those that do nothing else.

Since then, several countries have enacted legislation enabling doctors to extend their professional scope to assisting suicides. And here in Oregon, doctor-assisted suicide is now legal, with the blessing of the Supreme Court.

This has created new problems. Once again, after early improvisations with clumsy gadgets such as Dr. Kervorkian's, the proper technology has begun to emerge. Pharmaceutical houses will soon have selections of "thanatogenic" drugs, which will of course be ethical drugs, definitely not for over-the-counter sale. And alternative apparatus, such as portable lethal-injection systems, will no doubt also be developed.

But being a physician will become even more stressful. Hospitals and physicians, who are already notorious for occasionally operating on the wrong eye or leg, will have to take great pains to avoid confusing patients who are to be healed with those who are to be "assisted". Undoubtedly, there will be occasional regrettable errors in scheduling. And think what that will do to the cost of malpractice insurance.

There will also be an inevitable blunting of purpose. It's hard to maintain a keen dedication for saving life when you are frequently terminating it. The same will be true of the more thanatogenically inclined members of the profession. It's hard to take pride in one's skill in terminations when the profession is still, at least ostensibly, oriented toward the opposite goal. And in either case, patients will welcome a doctor less warmly when they're wondering whether he's come to heal them or kill them.

It is obviously time for the medical profession to split in two. The old-fashioned ones will still call themselves "physicians" and will dedicate themselves exclusively to healing and saving life. The second group will be called "thanaticians", with a degree of T.D., and will specialize in the opposite activity. Just as physicians wear white coats or green operating gowns, thanaticians will wear black coats or red gowns. That way, when a doctor enters a hospital room, the patient will know exactly what to expect.

Thanaticians will soon develop a professional milieu of their own. They will have their own professional schools (what do they need to know about diagnosis or antibiotics?), their own examining boards, and their own technical conferences and learned journals. They will soon diverge into specialties such as pediathanatics or thanatogeriatrics.

And the new profession will provide career openings for students who cannot get into traditional medical schools-or the other way around, since, judging from past experience with abortion clinics, thanaturgy may become the more lucrative of the two professions. And above all, thanaticians will need a very special code of ethics and a new oath.

Thanaticians of the world, I salute you-from a respectful distance.
Physician-assisted suicide, which is now legal in Oregon and may soon become so in the state of Washington, is putting an intolerable strain on the medical profession.

It used to be much easier to be a doctor. You knew just what you were supposed to do: preserve and save lives. You took an oath swearing not to harm your patients in any way. It was not always a lucrative profession but you were admired, even revered, and depended upon. And your conscience was at peace with God and men.

Then things got complicated. First, for German doctors, there were concentration camp assignments where preserving life was not the job at all. Then, abortion suddenly became legal and a pregnant woman might ask a doctor to destroy her unborn child rather than protect it. At first, there were some problems and needful readjustments, as coat hangers were replaced by more sophisticated tools. But gradually, abortion became a more professional affair and the proper instruments and clinical procedures were developed and standardized. And the Oath of Hippocrates ("...I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy....") was altered to fit the spirit of the times.

But moral issues, and the emotional conflict between life preservation and life-taking, remained. Ultimately, obstetricians and clinics responded to these pressures by largely separating into those that seldom or never perform abortions and those that do nothing else.

Since then, several countries have enacted legislation enabling doctors to extend their professional scope to assisting suicides. And here in Oregon, doctor-assisted suicide is now legal, with the blessing of the Supreme Court.

This has created new problems. Once again, after early improvisations with clumsy gadgets such as Dr. Kervorkian's, the proper technology has begun to emerge. Pharmaceutical houses will soon have selections of "thanatogenic" drugs, which will of course be ethical drugs, definitely not for over-the-counter sale. And alternative apparatus, such as portable lethal-injection systems, will no doubt also be developed.

But being a physician will become even more stressful. Hospitals and physicians, who are already notorious for occasionally operating on the wrong eye or leg, will have to take great pains to avoid confusing patients who are to be healed with those who are to be "assisted". Undoubtedly, there will be occasional regrettable errors in scheduling. And think what that will do to the cost of malpractice insurance.

There will also be an inevitable blunting of purpose. It's hard to maintain a keen dedication for saving life when you are frequently terminating it. The same will be true of the more thanatogenically inclined members of the profession. It's hard to take pride in one's skill in terminations when the profession is still, at least ostensibly, oriented toward the opposite goal. And in either case, patients will welcome a doctor less warmly when they're wondering whether he's come to heal them or kill them.

It is obviously time for the medical profession to split in two. The old-fashioned ones will still call themselves "physicians" and will dedicate themselves exclusively to healing and saving life. The second group will be called "thanaticians", with a degree of T.D., and will specialize in the opposite activity. Just as physicians wear white coats or green operating gowns, thanaticians will wear black coats or red gowns. That way, when a doctor enters a hospital room, the patient will know exactly what to expect.

Thanaticians will soon develop a professional milieu of their own. They will have their own professional schools (what do they need to know about diagnosis or antibiotics?), their own examining boards, and their own technical conferences and learned journals. They will soon diverge into specialties such as pediathanatics or thanatogeriatrics.

And the new profession will provide career openings for students who cannot get into traditional medical schools-or the other way around, since, judging from past experience with abortion clinics, thanaturgy may become the more lucrative of the two professions. And above all, thanaticians will need a very special code of ethics and a new oath.

Thanaticians of the world, I salute you-from a respectful distance.