"If the only tool you have is a hammer, it is tempting to treat everything as if it were a nail."
[Abraham Maslow, 1966]
All of us have some cognitive bias — “…a systematic error in thinking that occurs when people are processing and interpreting information in the world around them and affects the decisions and judgments that they make.” In my 2023 article “Deadly Choice” I listed some of the common cognitive biases in relation to supporters of Assisted Suicide and Euthanasia. (Click image or on the link)
Maslow’s Hammer is a cognitive bias which I fear will become prevalent in the next generation of doctors. Maslow’s Hammer, otherwise known as the law of the instrument or the Einstellung effect, is a cognitive bias causing an over-reliance on a familiar tool. This can be expressed as the tendency to overuse a known tool (perhaps a hammer) to solve issues that might require a different tool.
(https://fourweekmba.com/einstellung-effect/)
Many doctors change slowly from a natural caution which arises from the principle of “Primum non nocere” — First, do no harm. (e.g. using a tried-and-true drug instead of the “magic new pill” till there is evidence of adequate safety.)
There are people like Philip Nitschke who admit that he gets his jollies from helping people to kill themselves, but in the context of the Maslow’s Hammer of euthanasia, this will come from poor training or a lack of experience or simple laziness. Some will use the same old tool of death — every time, for everything.
Medical Students
To treat patient properly, one must be taught properly. Any moron can kill — not everyone can care, or comfort.
An unknown author noted: “Treatment, on the other hand, involves various therapeutic measures aimed at managing symptoms, slowing disease progression, and improving quality of life. It is an ongoing process that often demands commitment and dedication from both the patient and the healthcare team.In contrast to cure and treatment, comfort emerges as a constant and unwavering factor in patient care.” Remember the Hippocratic aphorism: “Cure sometimes — Treat often — Comfort always.”
While still a representative to the Alberta Medical Association in 2016 (NB: prior to MAiD legislation being passed in the Canadian parliament) a representative from one of the two medical schools laughed at my proposed motion which would direct the AMA to oppose medical students being taught how to kill patients as undergraduates. He asserted that the universities were teaching it already!
“If the only tool you have is the hammer of euthanasia, it is tempting to treat all distress or pain as if it were a nail."
Teaching medical students that the treatment for suffering is death means that in time, all suffering will be hit with the hammer of euthanasia. Killing of a patient is a rank admission of failure. It says there is nothing more to live for — that this person’s life is worthless.
Hopelessness is a terrible illness — even worse, when the medical profession suffers from it.
Kevin Hay
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