Comments on Kamisar.

• Author: Polsby, Daniel D.
• Position: Response to article by Yale Kamisar in this issue, p. 1121 - Pope & John Lecture on Professionalism

Each of us is going hence from this world, and if for no other reason than that it behooves us to think about how our departure might be made less terrible. Professor Kamisar, as a twenty-seven-year-old prodigy in legal studies many years ago, argued that it is illusory to think of the institution of mercy-killing as a way out. I am going to focus my remarks on a narrow point because on the broader question--whether this is a slope too slippery for the law venture upon--it seems to me that Professor Kamisar has utterly routed the opposing arguments. Still, he concedes, as everyone must, that the problem of suffering at the end of life makes demands on the human conscience, and upon public policy, that will not go away--even though the right argument may already have been propounded. It may be that what makes this problem so durable for us is that much of what makes a given case heartwrenching is that it dwells in a world of background legal assumptions and institutions which no longer portray or represent us as we believe we are or would like to be.

In his article forty years ago, Professor Kamisar wrote: "The whole field of severe pain and its management in the terminal stage of cancer is, according to an eminent physician, `a subject neglected far too much by the medical profession.'"(1) Before the subject of euthanasia becomes apropos, his point was, one must fully exploit less exorbitant means of speaking to the problem of human affliction.

The very same point is still being made today by people interested in the twin questions of euthanasia and assisted suicide, including, ironically, by physicians with special competence and expertise in the management of terminal pain. We do not train residents well enough in palliation, it is said; drug companies do not devote adequate funds to research; this is not a priority for the Food and Drug Administration--and so on. If only we could furnish adequate comfort to dying patients, we should be much less likely to think ourselves justified in killing them to save the wrenching of our fastidious hearts; and they should be much less likely to demand that we help them kill themselves. Well and truly, the pith of this moral problem is a problem of technology. Give us the right analgesics and the set of one thousand compelling cases will become a set of one hundred or of fifty. So where are these palliative drugs for which we have been waiting these last forty years? And where are the doctors and...