Can Conn. live with aid-in-dying being law?
Proponents of legalizing assisted suicide insist that the practice would be tightly controlled. Doctors would only be able to write lethal prescriptions for state residents with a six months prognosis who are mentally competent and who have made two requests at least 15 days apart. The drugs must be self-administered. As Dr. Diane Meier, a palliative care specialist has said, hoever, “the entire heartfelt adherence to restrictions that are announced when you first get the public to vote in favor of this go up in smoke once the practice is validated.”
Proponents seem to feel that it is a good strategy. J.M.
Sorrell of Massachusetts Death with Dignity in referring to “the hoops you have to go through” under the bill Massachusetts is considering has stated, “Once you get something passed, you can always work on amendments later.”
Almost all of the few states that have legalized assisted suicide are considering loosening eligibility requirements. California has reduced the reflection time between requests to 48 hours. Bills introduced in Hawaii, New Jersey, Oregon and Washington would do likewise.
Following New Mexico’s approach, Hawaii, Oregon and Washington are considering bills allowing nurse practitioners and, in the case of Washington, physician’s assistants to determine eligibility for assisted suicide and write death causing prescriptions. This belies the complexity in judging life expectancy and implies that assisted suicide is an ordinary medical procedure like wrapping a sprain.
Mistakes in prognosis occur regularly. 12-15 percent of hospice patients outlive their prognosis by six months or more. Sometimes a pessimistic prognosis may be based on the assumption, erroneous or not, that the person will not receive the in-home support needed to stay alive.
What constitutes “terminal illness” is elastic. An Oregon health official has opined that conditions can be deemed terminal even if there is lifesaving treatment but the person does not want it, is uninsured or cannot afford it. This viewpoint sweeps in any chronic condition that might turn fatal if not medically managed. This is not a theoretical concern. Among the persons who died in Oregon in 2021 under its assisted suicide law were people with conditions such as arthritis and anorexia.
Indeed, a Colorado doctor has written of helping thirtysomethings with anorexia obtain socalled “aid in dying” drugs. Anorexic persons do not meet eligibility requirements. As Dr. Angela Guarda, director of the eating disorders program at Johns Hopkins University, said, “Anorexia is treatable, not terminal … it is impossible to disentangle this request (to die) from the effects of the disorder on reasoning, and especially so in the chronically ill, demoralized patient who is likely to feel a failure.
If a state legalizes assisted suicide, there will be an assisted suicide industry, albeit probably a small one, seeking to pursue its interests. In Oregon, the requirement that only state residents be eligible for assisted suicide was challenged by a doctor in court and the state chose not to fight it. The state is amending its statute accordingly. Vermont is seeking to do so as well. It is not clear how lack of a residency requirement will play out in this day of teleconferencing.
Proponents scoff at any concern about assisted suicide morphing into “voluntary” euthanasia of the disabled, although this is what has happened in Canada and in other countries that legalized assisted suicide. In California, four doctors and two patients brought a federal lawsuit challenging the provision in the state’s law that patients self-administer the lethal drugs.Their argument was that this discriminated against people lacking functional ability to do it themselves. With major disability groups filing an amicus brief in strong opposition, the case was dismissed but assisted suicide laws may fuel more such cases.
A Connecticut legislator explaining why she is a proponent used a quote attributable to Nietzsche. “One should die proudly when it is no longer possible to live proudly.” Hopefully she did not intend the obvious implication behind the quote that some folks need to hurry and die.
Before you support the legalization of assisted suicide and view it as just “aid in dying,” think carefully about the values you want for the health care system and the type of society you want to live in.
Proponents scoff at any concern about assisted suicide morphing into “voluntary” euthanasia of the disabled, although this is what has happened in Canada and in other countries that legalized assisted suicide.