Doctor and patient must work togetherRe Sara Engram's...

the Forum

September 02, 1993

Doctor and patient must work together

Re Sara Engram's column, "The Persistent 'Dr. Death' " (Aug. 22), she posits that "too many physicians overlook the crucial details that can make life bearable for suffering people."

What Ms. Engram overlooks is the stark reality that "suffering" is not always "bearable."

Also, that indeed there might be a place in the physician's armamentarium for assisted suicide. This is not to suggest support for Dr. Kevorkian, who simply consults and then uses carbon monoxide, not a "medicine."

Quite the opposite: wherein the physician and his patient have formed a caring partnership, have traveled together through the meandering course of the disease, and then one partner is permitted to die with grace.

This is after all comfort measures have been exhausted, where hospice is not an option and the patient has determined that his quality of life is no longer available. As it has been throughout the patient's health and illness, the medical decisions are made in concert.

There should be legal safeguards for the patient as well as the doctor. And there should be caveats for the physician: the patient is indeed terminal; degree of suffering?; death wish real?; how well does the doctor know the patient?

This letter is too brief to include a discussion of the ethical (moral) issues -- though they are relevant.

These thoughts are not evoked by the behavior of Dr. Kevorkian. Nor by a dispassionate glance at the suffering, critically ill, now terminal patient. Rather they have evolved through some 30 years of work in the area of cancer and concern for the patient's need for an advocate.

These thoughts were postulated 10 years ago, a result of listening to the patient. The patient's wishes are paramount and thus guide the physician's hand and heart.

Nathan Schnaper, M.D.


The writer is professor of psychiatry and oncology, School of Medicine, University of Maryland, and head of psychosocial services at the UM Cancer Center.

Media at fault

Over the past few years there has been an increase in violence surrounding the conflict between pro-life and pro-choice groups. The media claim to have no idea what is causing the two groups to become so violent, but my opinion is that the media are part of the problem.

On numerous occasions I have heard news reports from your organization referring to either "abortion clinics" or "abortion doctors." I have reviewed the Baltimore Yellow Pages and cannot find a listing for any firm listing itself as an abortion clinic.

There are numerous listings under abortion services, listing firms that offer that service as part of other services rendered. There are also several listings for firms providing abortion alternatives.

As for "abortion doctors," I can find no listing for a medical specialty called abortion. There are several listings for doctors of obstetrics and gynecology. It is my understanding that some of these doctors do perform abortions as part of their practice.

It would not be accurate to refer to a surgeon as a "people cutter," or refer to a veterinary clinic as "animal killers," simply because they do euthanize animals as part of their prac tice. You do not refer to dentists as "pain merchants," though at times pain is caused by their treatment.

I feel it would be in the best interest of America if you would be accurate in your reference to doctors who perform abortions and firms offering abortion as part of the services they offer women.

It would not hurt if you toned down your rhetoric and reported news rather than expressed editorial comments as news. The alternative is to indicate that you are making an editorial comment.

James S. Wesley III


Favorite son

One of our own Third Ward boys made headlines several weeks ago on TV and in the Baltimore papers as being an investor in the Baltimore Orioles. I am referring to Pete Angelos.

The Angelos family started in our town, McKeesport, Pa. The parents owned a lunch counter and hot dog restaurant, and the three children helped out. They attended the Greek Orthodox Church and Greek School.

World War II came along and the family moved to Baltimore, where the father had a bar and restaurant on Eastern Avenue and prospered there.

Two of the children went to law school, became attorneys and did well. Pete came up the ladder quite successfully, and the Greeks of McKeesport are proud to see one of their own make it up the ladder enough to help keep the Baltimore Orioles in Maryland.

Good luck to you, Pete, in all you do, from all of us here!

Jean G. Cordis

McKeesport, Pa.

Nicotine stain

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