X-Message-Number: 6340
Date: Mon, 10 Jun 1996 15:35:41 -0700
From: David Brandt-Erichsen <>
Subject: Review of medical book on assisted death

The following book review is by Derek Humphrey of the Euthanasia Research
and Guidance Organization and is without copyright.  Mr. Humphrey is the
author of "Final Exit" and founder of the Hemlock Society.

	"Drug use in Assisted Suicide and Euthanasia"
	Editors: Margaret P Battin PhD and Arthur G Lipman PharmD
	Pharmaceutical Products Press, Binghamton, New York
	Hardcover $29.95 US   ISBN 1-56024-814-9
	Softcover $17.95 US   ISBN 1-56024-843-2

	The publication of such a book by an academic house is a measure 
of how far the campaign for the right to choose to die has reached by 
l996.  It could be described as the health profession's own version of 
'Final Exit' which, of course, was aimed at the patient.
	Edited jointly by professors of philosophy and pharmacology, the 
16 chapters by different experts range from surveys of the arguments for 
and against hastened death, through the concerns of physicians and 
nurses, to the law, pain control and drug dosages -- all important 
information for those doctors and nurses coming fairly new to this 
complex subject.
	For those already well briefed on the issue and its history, 
there are at least four important chapters which point to the future 
application of assisted suicide and euthanasia which I found useful.
For instance, the role of pharmacists has been little explored, and the 
chapter by Kristine Marcus hints they they feel somewhat left out.  The 
drafters of the Oregon Death With Dignity Act, she writes, "appear to 
have thought that pharmacists simply act as agents of physicians".  
	She points out that her profession has deep concerns about which 
drugs should be prescribed, their efficiency, and whether the pharmacist 
might be legally liable if the assisted suicide fails.
	In the chapter by two leaders of Compassion in Dying, of Seattle, 
they detail how the group has helped nearly 50 dying people with their 
suicides at home.  They describe the counseling, the comfort care, and 
drug methods used in the final deliverance.  The authors of this chapter 
say only about eight percent of patients who made serious inquiries about 
rational suicide actually met Compassion's criteria and were helped.  
Nevertheless, they say, the others received reassurance and comfort 
knowing that the option existed.
	Any physician considering actively helping a patient to die needs 
to read Dr. Gerrit K Kimsma's fascinating chapter on how it is carried 
out in the Netherlands.  He summarizes the failures and the successes of 
different drug methods over many years, and reports precisely which toxic 
agents are used today.
	As America moves inexorably towards legalizing physician-assisted 
suicide but banning euthanasia, Dr. Kimsma has an important warning in the 
book:  "Experience has taught us (in the Netherlands) that there are many 
cases of assisted suicide in which the suicide fails. Physicians need 
tobe aware of the necessity to intervene before the patients awaken."
	Dutch doctors give a lethal injection if the drugs which have 
been taken orally do not work after about 4-5 hours, but for American 
doctors that would be illegal.  

 <David Brandt-Erichsen>


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