Physician-Assisted Suicide Ruling in Montana: Struggling with Care of the Dying, Responsibility, and Freedom in Big Sky Country

摘要

Like many Americans, especially New Yorkers like me, and probably most readers of Palliative & Supportive Care around the world, I don't often think about the great state of Montana (aka Big Sky Country) in the Western United States. It usually doesn't make news, and because it's ranked 44th in population (about 1 million people) and has very few electoral college votes, it isn't even one of those states that ends up determining who wins a U.S. Presidential election. So Montana, despite being the 4th largest state in terms of land area in the U.S., does not typically influence the Zeitgeist. Many of us in palliative care are mainly familiar with Montana through our awareness of Ira Byock, M.D. and his groundbreaking work in Missoula Montana, through the Missoula Demonstration Project, as described in his book Dying Well (1997). So, it is with some surprise that I awoke on December 31, 2009 to news from Montana that, for reasons that I will explore in this editorial, disturbed me greatly!