Aid-in-dying much different than suicide

The op-ed seeks to equate suicides with medical aid-in-dying by using a dictionary definition of suicide, which should be ignored. Why? Because there are stark differences between these two ways of dying.

People who die by suicide could continue to live but choose not to do so. They usually have a mental illness, die often impulsively, in isolation, and often violently. Their deaths are tragic.

To the contrary, people who die by medical aid-in-dying would prefer to live but cannot do so as their disease is killing them and they are expected to die, as determined by two doctors, within six months.

These terminally ill patients must go through a rigorous process before they can end their suffering with prescribed medications. They can only obtain them after two doctors not only determine the patient is terminally ill but also that the patient has decision-making capacity, and then only after at least two requests, an oral and written one, are made.

The process from the first request to the taking of the medications is several weeks on average. (About 35% of those who obtain a prescription never take the medications.) And the process for these patients is empowering.

It is no wonder that numerous organizations have rejected suicide terminology, including, among others, the American Academy of Hospice and Palliative Medicine, the American Public Health Association and the American Medical Women’s Association.

And in 2017 the American Association of Suicidology issued this statement: “Suicide is not the same as physician aid-in-dying.” It discusses 15 points of distinction between the two ways of dying. It is clear that medical aid-in-dying is much, much different than suicide.

And while the article rails against those who choose to hasten their deaths by medical aid-in-dying, no similar concern is expressed about the far greater number of people who have their deaths hastened by never starting or by stopping life-sustaining treatments. In both cases patients will die. For decades patients have had the option, as they should, to have their lives ended by this means when suffering becomes intolerable.

The concern that people may die by medical aid-in-dying because it is less costly than hospice is baseless. In fact, in Oregon, which has had a medical aid-in-dying law for 25 years, about 90% of those who die by medical aid-in-dying are receiving hospice care and almost all have health insurance.

While hospice is generally excellent and adequately relieves the suffering of the vast majority of patients, it can’t sufficiently relieve the suffering of all the dying.

There is now over 90 years of cumulative experience with medical aid-in-dying in the

US. The laws have worked as intended. None of the problems has emerged, as expected by opponents. Very few patients — about 4 in 1,000 — die in the U.S. by medical aid-in-dying, but it gives dying patients great comfort and peace of mind to know it is available.

Medical aid-in-dying is a compassionate end-of-life option, a safe, ethical and rarely used medical practice that benefits dying, mentally competent patients and causes no harm to anyone.