Doctors who try to prescribe large enough doses of these compounds--morphine and its derivatives--are often suspected of inducing a dying patient's addictive craving.
This is a cruel joke to anyone who is dying with intractable pain and who may reasonably argue that one cannot be addicted when one is dead.
Beyond the tragedy of dying people having to hasten their death with the same compounds that might have given them a reason to live longer, the denial of proper painkillers damages a person's body.
The "how" of mental life--the mechanisms of gene expression, protein synthesis, and cellular communication that work so well for a century in some brains but not well at all in others--are at the intersection of basic biomedical science and the right of a dying person to full membership in society until the last moment of life.
And Byock believes that the way to take advantage of that opportunity is to face the suffering and challenges dying brings.
A long-term survivor of AIDS, the author of Living Our Dying: A Way to the Sacred in Everyday Life (Hyperion, 1996) has served as a hospital chaplain and spent much of the past decade facing his own dying and learning to care for others as they die.
We learn not to hold on to possessions, titles, power, or even the solace of absolutely certain answers but to live simply and consciously up against the mystery of our dying lives.
Isn't it self-evident, therefore, that, in order to grant the wishes of dying patients for help to end their suffering, we have to change the fact that doing so is against the law?
Even if a large percentage of doctors were already providing aid in dying, the question of whether they should continue to do so covertly, free from any legal oversight or protocols, would still demand an answer.
The thought of thousands of individual doctors applying an equal number of different subjective criteria to their practice of aid in dying should be profoundly unsettling to anyone.