Brief Amici Curiae of C. Everett Koop, M.D., Sc.D. et al., in support of Attorney General Ashcroft *.

• Author: Collett, Teresa Stanton

Interest of Amici (1)

Amici are physicians, philosophers, and law professors engaged in the study and teaching of bioethics. Each supports the conclusion of the Attorney General of the United States that assisting suicide is not a "legitimate medical purpose," and in fact undermines the foundational commitment of medicine to healing and the promotion of human health. The signatories also strongly support improved pain management and palliative care for terminally ill patients, and believe that condoning the "quick fix" of physician-assisted suicide will undermine society's commitment to the more difficult but infinitely more rewarding task of meeting patients' real needs.

Summary of Argument

Amici seek to place before the court the historical record and current professional consensus that assisting suicide is not a "legitimate medical purpose" for use of federally-controlled drugs. Assisting suicide is antithetical to the proper conduct of a physician in the "usual course of his professional practice." See 21 C.F.R. [section] 1306.04(2001). Medical treatment has as its ultimate end the restoration or preservation of the patient's health and the relief of suffering, not the termination of the patient's life. The public's health, their confidence in the beneficence of the medical profession, and the foundational ethos of the medical profession would be profoundly eroded by recognition of physician assisted suicide as a legitimate medical treatment.

Argument

1. The Proper End of Medicine is Restoration and Preservation of Health and Relief of Suffering, Not Termination of Life.

   The profession of medicine is distinguished from other human activities, including other professions, by virtue of the good or goods to which its practitioners publicly profess devotion. Lawyers profess devotion to "a belief in the ability of human beings to communicate with each other by means of rational argument ... a belief that human beings can arrange their affairs fairly ... [and] a belief in the value of purposeful process." John T. Noonan, Jr., Choice of a Profession, 21 Pepp. L. Rev. 381,383 (1994). Theologians profess a belief in the existence of God and the human capacity to attain some understanding of God's nature. Physicians profess devotion to human health and healing, "a naturally given although precarious standard or norm, characterized by `wholeness' and `well-working,' toward which the living body moves on its own." Leon R. Kass, "I Will Give No Deadly Drug," in The Case against Assisted Suicide: for the Right to End-of-Life Care (Kathleen Foley & Herbert Hendlin, eds. 2002) at 21.

   This devotion to health and healing necessarily requires the cultivation of particular virtues, such as self-restraint, patience and sympathy. Id. More to the point, devotion to health and healing sets certain limits on the physician's conduct, chief among which is the prohibition against physicians killing or helping to kill their patients.

   The prohibition against killing patients, the first negative promise of self-restraint sworn to in the Hippocratic Oath, stands as medicine's first and most abiding taboo.... The deepest ethical principle restraining the physician's power is neither the autonomy and freedom of the patient nor the physician's own compassion or good intention. Rather, it is the dignity and mysterious power of human life itself, and, therefore, also what the [Hippocratic] Oath calls purity and holiness of the life and art to which the physician has sworn devotion. A person can choose to be a physician but cannot simply choose what physicianship means. Id. at 32. The essence of the medical profession lies in its fundamental commitment to the preservation of human life and health. This commitment precludes inclusion of assisting suicide within the list of activities that constitute "legitimate medical practice."

   By virtue of a centuries-old practice and ethic, the medical profession, while committed to diagnosing illness, curing patients, preventing disease, and relieving pain, is deeply opposed to killing patients. Physician-assisted suicide has "[l]ong [been] viewed as outside the realm of legitimate health care.... "Brief of the American Medical Association, et al., as Amici Curiae in Support of Petitioners, at 4, Vacco v. Quill, 521 U.S. 793 (1997) (No. 95-1858). (2) This ethical...