Jeff you can make the arguement, heck I can make the argument, but you can't do it this way.  Hippocrates as I know you are quite aware was Greek, sucicide was an accepted method of ending your life for any number of reasons amongst the ancient
Greeks, but let us ignore that.  Beyond that we know very little of what Hippocrates thought and what we certainly don't know his opionion on this subject.  The Hippocratic oath is named as such in honor of Hippocrates not because he dreamed it up.

If you're going to make an argument make an argument at least make something factual that relates to something that could actually be true.  Frankly I think Hippocrates would say a "free man" can choose as he sees fit.

The writer first attacks Quetion 2 because “Civilized societies do not encourage people to commit suicide, or seek ways to make it easier for them to do so.”  And then attacks it because it does not allow everyone to do so,  because “It requires a prognosis of no more than six months to live. It is available only to patients who can both speak and write…”   Reminds me of the man who complained about the restaurant because the food was bad and the portions were small.  Hardly a consistent argument, and for JJ, somewho has claimed to be a libertarian, opposition ito Question 2 s inexplicable.

Oops. Saw the title "What about do no harm?", and thought you were suggesting an oath for the honchos and clery of all religions, and particularly The Catholic Church. I guess not though.

There is another element to this question which didn't even get mentioned in the article. Rarely is there going to be any "legalized suicide" without involvement of the person's significant others. Sure, suicide is, by nature, a solitary choice. But the notion of legalized suicide, by definition, has then involved many other people. At that point the questions increase exponentially. How has the thinking about the choice been influenced by others? Who will gain what with the choice? Who will lose what with the choice? What kind of financial implications will emerge? What kind of influence has been exerted on the person who is at the center of the discussion? How does that influence compare to the influence exerted in the family over the years? The list of questions can go on for pages. As those questions are examined, it becomes clear that answers are never clear or easily identified. The outcome of that will create endless stories with massive ambiguities, and lead to many moral qualms. I haven't read any of Dr. Angell's arguments for this position. But I'm aware of her esteemed standing in the field. I find it a bit perplexing that she could be such a strong advocate for a position which is so tenuous. I try to make sense of her position in this way. There is a strong argument to be made for the position that modern western medicine has been infected with a mindset which fails to think and see life systemically. The knee doctor doesn't do ankles. The heart doc doesn't do lungs. The tunnel vision is one of the true weaknesses of contemporary western medicine. It is particularly noticeable as it relates to our emotional lives. We as people are living in a system with our families. That's part of ourselves which is outside the body, but part of us nonetheless. Assisted suicide will definitely be a result of the conversations within the family, both the ones directly about the decision, and the ones that have happened over the years. It leaves a picture which is not easy to defend.

My Father lived with cancer until there were no treatment options left. When he chose to end his own life he had to do it alone, for fear of legal repercussion for his family, and he used a bullet to the head from the only gun he ever owned, bought for that purpose. While I hope is was quick and painless for him, the trauma of finding him and of knowing that he had to be alone when he had a loving family who would have supported his choice to end his life on his own terms remains a central fact of my life 13 years later. Is Question 2 perfect: no. But at least it's a start.

As a physician who has been involved in Hospice Care and home and hospital death pronouncements for 40 years I would like to throw in my two cents.  People deserve dignified comfortable deaths surrounded by loved ones in the setting they prefer if possible.  It should be the job of the health professional to see that this happens, not from a distance away but closely involved.  We do have the medical armentarium today to relieve major suffering.  Most doctors will err on the side of relief even it means a more hasty demise.  We already have this legal ability but it should always be used with detailed facts in hand coupled with patients and their caretakers wishes.  When problems arise it is usually because a more involved approach was necessary.  No new laws with potential abuse and too much second guessing are needed.  We can handle this as long as patients and their families have clear eyed information and then services are provided that show human empathy.  There are always exceptions but they call for better solutions within our present framework that values meaningful existence and knows when it is time to let people go peacefully.   

As with many opponents of Question 2, Mr. Jacoby appears to have little knowledge of the actual language of the proposal. Otherwise he wouldn't have characterized it as arbitrary. On the other hand, maybe he simply doesn't have any better arguments.

Jeff, normally I tend to agree with your editorials, but not this time. The law is not forcing terminally ill patients to voluntarily end their lives. It is not forcing doctors to provide lethal drugs. It is only making that option available if a patient decides it is the right course of action and if the doctor agrees to provide this service.

Normally you argue that government should get out of people's way. But apparently you apply this principle only when it does not violate your moral code. While physician-assisted suicide may not be something you wish to engage in, government should not get in the way of two adults making a personal decision as to what is best for them.

Jacoby seems to mix up Hippocratic Oath with our Constitution. Since when is the HO a rigid guideline which can not be adapted to the changes in society's norms? The purpose of the Constitution is to protect the rights of the minority from the tyranny of the majority. The HO provides no such justification.

Do No Harm? What about the financial harm done to families just to unnecessarily prolong a life (if that’s what it is). What abut the emotional harm to loved ones having to watch a painful death. Life cuts both way and both hurt.

At a time when it seems the hospitals do everything possible to keep someone alive using all means available it would seem appropriate to offer another scenario. The end-of-life costs are what is bankrupting Medicare and there is great resistance letting the dying choose a more natural path. Perhaps this option will help reduce the ridiculous overspending of precious resources.

Hippocrates was alive in the 4th Century B.C. Things have changed since then.

So, Jeff, have you ever watched a loved one die in excruciating pain or when they are no longer anything resembling themselves, kept alive by modern science long past their time.  I doubt it.

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As a Catholic, Jacoby is following the Church's position opposing assisted suicide.  To condone it would

be counter to the right-to-life, anti-abortion, doctrine.

My wife died from lung cancer 18 months ago.  My PCP told me, after the diagnosis, that if it were him he would ask for Atavan and morphine near the end.  My wife wanted no extraordinary measures done and agreed.  I had to make the decision to help her die and she was gone in 15 minutes.  It was the hardest decision I'll ever make, but it was the correct one.  This is a decision between the patient and the MD.  We're already doing this and now it's time to make it just a bit easier and let the patient make the choice.

"As soon as Obamacare passed, you had new rules on pap smear tests, new rules on breast exams, new rules on prostate exams, and 300 others!"

yes, there were new rules and those new rules replaced the old ones. The rules that said you couldn't have pre-existing conditions. The rules that said you could only insure you child under your family plan until (s)he turned 19. The rule that set life limits on payouts from your insurer. All those and many other rules are now gone, thank god.

Jeff: I appreciate that you acknowledge the other side of the argument. I agree it puts Doctors in a very untenable position. My father was dying, and the family made the difficult decision to remove the respirator. We had been told that he would pass away within the hour. His body was septic, his liver failed, jaundiced, deep in coma. Instead, my dad continued to breathe, and we held vigil at his bedside. Six hours later, we were still there. We stepped away to get a bite to eat, and within 10 minutes were called back to the room. His heart rate was fluttering, and I noticed some other changes in his medical surroundings, with apparatus moved away. It was clear the staff knew this was it. I am convinced that the nurse as an act of kindness for the family increased the amount of morphine he was receiving to end the vigil. The nurse could do nothing for my dad, but could try to help the family. I struggle with this. Legally, it is wrong. It may have been right on the border of preventing pain to the patient. But I sincerely believe that the nurse's motives were good. I suspected it at the time, and I can't in my heart find fault with that nurse. That nurse had provided excellent care for my dad for weeks, and built a relationship with both my dad and my mom. There were no motives of cost reduction, freeing an ICU bed, or similar slippery slope dangers in play. It was meant to be an act of compassion. And I am at peace with that. I respect your different perspective.

One might question whether keeping a person with debilitating pain alive against their wishes is "doing no harm".  No one gets out of here alive, and prolonging the suffering of those who wish to end their lives could just as easily be interpreted as cruelty or selfishness.

I sometimes wonder if those who oppose euthansia are really articulating their own fear of death.  Life is of uncalculable value, and none shall leave this place till the body is wasted in the effort to deny death.  If so, this is why refusing another's right to die could be perceived as selfish.

Ironic that religous people are often very opposed to euthanasia, since they supposedly have a place to go when they die.  It's often the poor stiffs like me who just plan on feeding the critters living in the earth who seem to see the dignity and relief that euthanasia could conceivably supply.

Oh, dear, Mr. Jacoby, today's column is both cruelly righteous and misinformed - a lethal mix. As one now retired from a career in medicine, I can only point out that you and your dogmatic views may suffer a reversal later in life, as so many of us do as death impends. Many of my patients have done so over the years, though medicine had fortunately advanced to the point where a humane appreciation for their comfort and their wishes began to supercede the imperative to maintain survival at all costs. As for Hippocrates, the little we know about him and his era makes your arguments laughably ironic. I am not aware of any among the sparse fragments that survive from his teaching which refer to suicide. He is known to have subscribed to the theory of bodily humours, however, although I notice you neglected to draw any support from that. Furthermore, many - although not all - of the medicines in his day were ineffective, and some were downright toxic, lending a somewhat different perspective to his famous dictum to 'do no harm'. By the way, I doubt very much he would have thought highly of your column - he is believed to have said, “There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance.”

How many of us have watched as parents or loved ones ebbed away with the help and ease of morphine that surely quickened their passing. When choosing not to use respirators, we are making the choice to help them die. We're already doing this and now it's time to make it just a bit easier and let the patient make the choice.

Your naivete is showing. Euthanasia is practiced daily all across America.  Patients at the end of life are put on morphine drip so that they can quietly and slowly be put to sleep.  Physician assisted suicide puts the decision in the hands of the patient where it belongs instead of in the hands of family, friends, doctors, first year Residents or whatever.  

As usual, Jacoby shows his ignorance, or he's purposely creating his own facts, or both. Many doctors do take a similar oath, but the oath they take has been repeatedly modified over the centuries. The last modification was only about 60 years ago, after World War Two.

There are several other oaths used for doctors and other medical practicianers that are much more contemporary.

Of course, 400 BC was a few years ago. It seems like we might have learned some things since then, but maybe Jacoby longs for those days.