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- <text id=94TT0863>
- <title>
- Jul. 04, 1994: Ethics:Killing the Psychic Pain
- </title>
- <history>
- TIME--The Weekly Newsmagazine--1994
- Jul. 04, 1994 When Violence Hits Home
- </history>
- <article>
- <source>Time Magazine</source>
- <hdr>
- ETHICS, Page 61
- Killing the Psychic Pain
- </hdr>
- <body>
- <p> A Dutch court says doctors can assist suicides of depressed
- but physically healthy patients
- </p>
- <p>By Anastasia Toufexis--Reported by James Geary/Amsterdam and Alice Park/New York
- </p>
- <p> Hilly Bosscher endured 25 years of repeated beatings by an alcoholic
- husband before the marriage ended in divorce. One of her two
- sons committed suicide at 20; the other died of lung cancer
- at the same age. When the 50-year-old former social worker from
- the Dutch town of Ruinen went to see psychiatrist Boudewijn
- Chabot, she had but one desire: she wanted to die and she wanted
- the doctor to help her.
- </p>
- <p> Over the next four months, Chabot tried to ease Bosscher's depression
- and change her mind about suicide, but she did not respond to
- counseling and refused medication. Having already made an attempt
- to kill herself by overdosing on drugs, she thought about other
- methods. "Rope only offers a 70% chance of success," she worried. "I
- do not know about the train. And I would resent it--the mess."
- </p>
- <p> Chabot consulted with seven colleagues, all of whom concurred
- that Bosscher's prognosis was dismal. Finally, Chabot agreed
- to help her. On Sept. 28, 1991, he handed Bosscher 20 sleeping
- pills and a toxic liquid mixture. Along with this deadly cocktail,
- she swallowed some medicine to prevent nausea. Then she lay
- down on her bed; a friend, Chabot and another doctor sat by
- her side. She kissed a portrait of her sons and, while Bach
- played on a tape recorder, peacefully drifted into death.
- </p>
- <p> The Netherlands boasts one of the worlds most liberal policies
- on mercy killing, but the Bosscher case caused a sensation.
- Never before had a physician reported helping a depressed but
- otherwise healthy patient commit suicide. Of the estimated 2,300
- cases of euthanasia and 400 cases of assisted suicide in Holland
- each year, virtually all involve patients suffering from a terminal
- illness or unbearable physical pain. Officials charged Chabot
- with violating the strict guidelines that permit doctors to
- help patients end their lives. Last week, in a landmark decision,
- the country's highest court ruled that though Chabot neglected
- to have another physician personally examine Bosscher, the psychiatrist
- would not be punished. "The ruling," says Chabot's lawyer, Eugene
- Sutorius, "recognizes the right of patients experiencing severe
- psychic pain to choose to die with dignity." Contends Chabot: "Intolerable
- psychological suffering is no different from intolerable physical
- suffering."
- </p>
- <p> In the U.S., where debate flares around Dr. Jack Kevorkian and
- assisted suicide for the terminally ill, the Dutch decision
- troubles ethicists. "Terminal illness at least gives you some
- line to draw," says Arthur Caplan, director of the University
- of Pennsylvania's Center for Bioethics. Critics are worried
- that Holland has pointed the way to "assisted suicide on demand." Can
- one say no to a despairing Vietnam vet or rape victim? "If you're
- worried about the slippery slope, this case is as far down as
- you can get," warns George Annas, health-law professor at Boston
- University.
- </p>
- <p> Still, critics recognize that the issue is far tougher when
- it moves from abstract principles to the reality of a desperate
- patient. "I do not know if I made the right choice," says Chabot, "but
- I believe I opted for the lesser of two evils."
- </p>
- </body>
- </article>
- </text>
-
-