Robert, Provan, 52, a devoted father and husband, is an attorney at law devoted to protecting people threatened by managed care's tendency toward quality of life judgments. Specifically, he is deeply concerned about the plight of people with disabilities whose lives are often the first on the list of those whose treatment is denied.
Bob contracted polio at the age of five; initially, he was paralyzed from the neck down. Doctors told his parents that he would never walk again. Due to impairment of respiration and other problems, they believed that he would not live to the age of twenty-one. He also might have been a perfect candidate for physician-assisted suicide.
Bob is certain that in today's cost-cutting environment, which would have prevented aggressive treatment, he never would have survived. Combine the present environment with assisted suicide, and it is easy to understand why many in the disability rights community fear the viewpoint "better dead than disabled."
Bob's History
In fact, it was aggressive treatment that saved Bob. Dr. Charles Pease, a physician and orthopedic surgeon, agreed to help Bob if he and his parents agreed to a very aggressive and demanding regimen. He wanted a commitment from Bob's parents that their goal would be "independence and self-reliance" for Bob. According to Bob that meant, among other things "no braces, no special schools, no coddling, no pity."
Dr. Pease used innovative ideas-some no longer used-to treat Bob. He performed various transplants, grafts, and fused most of the vertebrae in Bob's spine. Through it all, Bob had immense confidence in his physician. According to Bob, "I could trust him to tell me the truth... These were the facts. We could face them together. In short, I trusted him - not when I first met him - but as we conquered the horrible disease that had struck me down so early in life. We were a team with a goal, and we had a mission to accomplish together-patient and physician."
At age ten, Bob walked out of the hospital and in his own words, "to lead a useful and, I hope, productive life." He is now married, has one child and a career.
Bob believes that patients enter the physician-patient relationship with certain expectations-specifically that the physician will use their skills to help them. Says Bob "if a physician recommended to me that I choose or consider suicide as a 'treatment option,' I would lose all my trust in that physician... Physician-assisted suicide turns medicine on its head."
The Doctor-Patient Relationship
According to Bob, "Dr. Pease rebuilt me and gave me a life." He claims to be a testament to what American medicine has done and can do. Says Bob, "I want that system, and dedicated physicians like Charles Pease, to continue to exist and survive in a world where proposals to ration medical care threaten to dismantle and dismember the best medical system the world has ever seen."
The aggressive treatment that saved Bob stands In stark contrast to offering physician-assisted suicide. Bob suffered greatly-both physically and emotionally-in order to heal from such a devastating illness. Yet, he was able to rely on his doctor to try to heal him, and "to do no harm." The suggestion of assisted suicide by a physician--the same physician who is entrusted with protecting a patient--may gravely damage the doctor-patient relationship.
There was an incredible trust between little Bobby Provan and Dr. Pease. According to Bob, Dr. Pease believed very strongly in informed consent. Bob says that before each surgery, Dr. Pease would describe the operation:
He never lied to me. He told me that it would hurt. And then he would say, 'Bobby, your parents have already signed a piece of paper that will let me do this but I won't--not unless you say I can.' And I would always answer, 'Yes, you can do it.' Although sometimes, I must admit, that I said it with a lump in my throat.
You see, Dr. Pease understood something that we need to remember today, . that the doctor-patient relationship has a personal dimension. It is based on trust and trust is something that grows over time. It is not instant. ... Healing and curing are two different things. He not only wanted to cure my disease, but also he wanted to heal me as a person. He wanted to restore my health, and he knew that restoration must include my sense of well-being, not just my being well.
The tragic consequences of physicians assisting their patients with death would have immeasurable and devastating effects on our culture. According to Bob, "Many people find a new purpose in their lives in coping with their disease and disabilities. Their struggle even brings new meaning to those who care for them." He adds, "The value of life cannot be destroyed by disease or by disability. Life has a value beyond them."
National Right To Life Committee
Suite 500, 419 7th Street, N.W. Washington, D.C. 20004-2293
(202) 626-880O (FAX) 737-9189 or 347-5907 http://www.nrlc.org
Contact: Michele Arocha Allen
(202) 626-8825