It is late, nearly 9 P.M., seeing a final consult at the end of a punishing call day, in the ICU. The patient, chronologically young yet physiologically Methuselan, lies in his bed, oxygen mask affixed to his face by heavy straps, bleeding, as he has for months, from a tumor in his kidney. He would not survive surgery, nor even radiological intervention to stem the hemorrhage by strangling its arterial lifeline. He is, furthermore, in the parlance of modern medicine, “non-compliant”: refusing treatments and diagnostic studies; rude and abusive to nurses and physicians alike; demanding to go home though unlikely to survive there for any significant length of time..
The nurse — young, competent, smart, hard-working, the very best of the modern nursing profession — apprises me of his situation, closing with this knockout punch: “You know, we just passed that initiative — you know, the suicide one. He’d be an excellent candidate.”
She wasn’t joking.
Taken a bit off guard, I responded that it is most unwise to give physicians the power to kill you, for we will become very good at it, and impossible to stop once we are
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