If the U.S. Supreme Court were made up of physicians, it is likely that the court would reject the Bush administration's opinion that writing a lethal prescription for terminally ill patients -- as allowed under Oregon's law permitting physician-assisted suicide -- is not a "legitimate medical purpose," according to a recent survey.
Almost two-thirds (62%) of the 677 physicians responding to a national survey conducted in October said they believe physicians should be allowed to dispense lethal prescriptions. This result closely matched a corresponding poll of the general public in which 64% of the 1,057 people surveyed said the same thing.
The surveys were conducted by HCD Research, a Flemington, N.J.-based marketing and communications research company. HCD co-founder and managing partner Glenn Kessler said the company has no ideological slant. Kessler said the survey was statistically significant, with a margin of error of plus or minus 3 percentage points.
Kenneth Stevens, M.D., a Portland, Ore.-based oncologist and president of Physicians for Compassionate Care, which opposes assisted suicides, dismissed the survey results. "With a lot of these surveys, you can get the results you want by how you craft the question," Stevens said. "One of the things I'm concerned about is that proponents of assisted suicide have been purporting the false premise that physicians can do a better job of taking care of a person's death than a person's life."
"It's always assumed that we have an agenda, but we just don't have one," Kessler said, adding that the results of this survey matched those of previous polls it has conducted on physician attitudes toward embryonic stem cell research, the withdrawal of Terri Schiavo's feeding tube and other ethical and moral questions. "The physician results were absolutely predictable," he said. "Physicians are always -- without putting any subjectivity into it -- on the progressive side."
Kessler added that the poll was designed as a response to the Oct. 5 arguments before the U.S. Supreme Court pertaining to the Bush administration's appeal of a 2-1 ruling last May by a three-judge panel of the 9th Circuit Court of Appeals. In that decision, judges said former U.S. Attorney General John Ashcroft overstepped his authority in 2001 when he said lethal prescriptions were not a legitimate medical purpose and threatened to take away the license to prescribe controlled substances from any physician who wrote a lethal prescription under the auspices of Oregon's Death with Dignity Act. In their decision, the judges stated that they were not ruling on the issue of physician-assisted suicide, but on the question of whether states -- and not the federal government -- were the primary regulators of medical practice.
According to the survey, physicians are torn over the question of who should be given the right to decide whether assisted suicide is a legitimate medical purpose: about 20% said it's a federal matter, 25% said states should decide and 54% said neither.
Kessler said the main question was asked this way: "Do you think physicians should be given the right to dispense prescriptions to patients to end their life?" He added that the term "suicide" was not included in the question because HCD "felt it was not a neutral word."
Arthur Kover, an HCD consultant and a fellow at the Yale University School of Management in New Haven, Conn., helped write the survey and interpret its results. He said the question was fair and the survey results were important.
"One of the first defenses of an ideologue is that the questions are wrong," Kover said. "But I think (the survey) is very significant and I think that, when push comes to shove, there will be a fair number of physicians who would be willing to do this if allowed and a small-but-vehement number who will not."
Kover added that the poll didn't measure the depth of support each side felt, but it was his belief that the people in favor of assisted suicide were casual in their support while opponents were more passionate about their position and they will "continue to fight despite their shrinking numbers."
Among physicians, 76% said they believed that the justices' personal experiences with serious illness will bias their decision. In the general public poll, 52% of those surveyed held this opinion.
"I think people's life experiences affect how they relate to a lot of things," Stevens said, adding that he knows this from experience. When his first wife was dying from cancer, she asked her doctor if there was anything more that could be done and his response was to offer to prescribe an extra large dose of pain killers, Stevens said, even though this was more than a decade before assisted suicide was allowed in Oregon.
"Her doctor suggested she take an overdose and that her life was no longer of value," Stevens said.
Oregon's Death with Dignity Act, twice approved by voters in a statewide referendum, allows terminally ill, adult Oregon residents to obtain a lethal prescription to end their lives after two doctors agree that they have only six months to live and are mentally competent. Doctors are allowed to dispense, but not administer the lethal prescription. The Oregon Department of Human Services, reports that 208 people have hastened their deaths between 1998 and 2004 under the law. The Supreme Court's decision is expected in the middle of next year.
View the results of the physician survey.