Photography By Exum
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Switching Sides
By Barry Yeoman, March-April 2003
Why one of the biggest supporters of doctor-assisted suicide has changed her mind
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In 1992, Diane Meier, M.D., co-authored some of the first guidelines for doctor-assisted suicide. "My sense was that patients were the only ones who knew what was best for them," says Meier, director of the palliative care program at New York's Mount Sinai School of Medicine. "The medical profession's opposition to physician-assisted suicide seemed breathtakingly arrogant."
In the decade since, Meier has become one of the premier opponents of death-with-dignity laws. She now believes that existential despair, not physical pain, is what motivates many patients to end their lives—and that most doctors are ill-equipped to deal with the psychological components of serious illness.
Meier's about-face was spurred by a patient, an 87-year-old immigrant who lived alone and battled a series of chronic health problems: diabetes, high blood pressure, arthritis, loss of hearing and sight. The patient could barely walk. She was constantly irritable. Unable to live as she was accustomed, "her life frame was shrinking," Meier says. "Several times she said she just wanted me to give her a pill."
Since assisted suicide is not legal in New York—nor is it legal anywhere in the U.S. for patients without terminal illnesses—Meier resorted to a treatment that her colleagues frequently overlook. She listened to the woman's litany of problems: her guilt at having been a bad parent to her now-adult children, her anger at their rejection. With the patient's permission, Meier called the woman's adult children and encouraged them to set aside their old resentments. They heeded the doctor's words, taking turns visiting their mother. "By the end of her life, her relationships with her kids were healed," Meier says. "It wasn't until that happened that she allowed herself to die." One day she told Meier, "I'm going to die in five days and see my husband on the other side." And she did.
When a patient asks to die, "nine times out of ten it's an expression of despair and a communication to the physician to hear the despair," says Meier. Unfortunately, most doctors are either ill-equipped or too busy to explore these feelings. Allowing doctors with limited repertoires to prescribe lethal medicines, she believes, is dangerous public policy.
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