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Editorial: Death of ALS patient may be major breach of medical ethics

  • July 28, 2020
  • , The Asahi Shimbun , 5:20 p.m.
  • English Press

Two doctors were arrested on suspicion of murder after they allegedly gave a drug to an amyotrophic lateral sclerosis (ALS) patient that is believed to have caused her death.


The patient’s blog and Twitter pages contained posts that expressed her desire for mercy killing. But there are many unknowns about what really occurred.


Specific communications among the three persons involved, for instance, have yet to be uncovered. It is not known either what were the thoughts and objectives of the two suspects.


We need to wait for these questions to be answered before we can understand the full implications of this distressing story.


As to what we have learned so far, it is impossible to justify the act of the arrested doctors as a legitimate medical practice.


They were neither her doctors nor experts in ALS. It is believed that the two came to know her only through social media.


The two doctors did not contact her family, while the patient reportedly paid some 1.3 million yen ($12,340) into a bank account of one of the doctors.


There are past cases in which a doctor faced criminal charges after ending the life of a terminally ill patient. 


They include a 1991 case in which a physician at Tokai University Hospital put to death a terminal cancer patient who had been in a coma. In 1998, a doctor at Kawasaki Kyodo Hospital in the city of Kawasaki terminated the life of an artificially ventilated patient apparently in an irreversible coma.


But both cases are clearly different from this “contract killing” case in that the doctors conducted the acts in question on patients they had been properly treating.


In some countries including the Netherlands, Belgium and Switzerland as well as some states in the United States, certain forms of voluntary euthanasia, or the termination of gravely ill patients with incurable diseases at their request to relieve their suffering, are legal.


In such cases, doctors are allowed to end their lives by administrating or prescribing euthanasia drugs.


But strict requirements and procedures are established for such doctor-prescribed suicide, such as the existence of unbearable pain or the patient’s own well-thought-out decision.


Still, there are many critics of the practice who argue that such assisted suicide could lead to a view that places less value on the lives of gravely ill and disabled people. The alleged homicide by the two doctors is far from acceptable even from the viewpoints of these nations’ policies concerning the issue.


Needless to say, doctors, who get deeply involved in protecting the life and health of their patients, are required to act according to high ethical standards and a keen sense of human rights.


Under these conditions they are allowed to deal with dangerous drugs. We cannot help but wonder how well the two suspects were aware of their ethical responsibility.


ALS is a progressive nervous system disease that affects nerve cells in the brain and spinal cord, gradually causing the patient to lose control of their muscles. There is no fundamental cure for the disease.


As the condition progresses, it becomes increasingly more difficult for the patient to communicate with others and remain connected with society.


It is painful to imagine how much pain and suffering the disease caused the victim, who is described as an active woman who loved traveling.


It is necessary to establish an effective system to provide solid daily physical and mental support for ALS patients based on an accurate understanding of the circumstances and challenges facing them. 


The incident has raised concerns among ALS patients and their supporters that it could draw public attention to the issue of the “right to die” and undermine public awareness of the importance of the “right to live.”


To allay such concerns, it is vital for society as a whole to recognize the dignity of life.


Such recognition would help build a society where people with various disabilities as well as ALS patients can live comfortably with other members.

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