Medical aid in dying should not be proscribed by society’s laws or condemned by its mores
WASHINGTON » Late last year, at 3 a.m. in what is a now-normal night, Kim Hoffman awoke with “an unbelievable headache.” These are related to the 30 brain lesions, and the steroids needed to reduce the swelling of the brain. After dawn that day, she said, speaking by phone from her home in Glastonbury, Connecticut, “I felt a new neck lesion.” She has so many skin lesions that “it feels as though my skin is being torn like someone has a serrated knife.” What began as ovarian cancer has, she said, metastasized to “both breasts, my right lung, the lining of my spine, and many lymph nodes.” She says, “I’m a pretty sick puppy.”
When she was 16 and “a car broadsided me while I was on my bike,” her injuries were “really, really painful.” Then, however, “I knew I was going to live. The difference here is I’m not going to get better. And the pain is indescribably worse.”
A few days before her initial diagnosis in June 2013, she ran a three-mile, 20-obstacle race through mud. For years, the arsenal of modern oncology has been unable to defeat her disease, and has left her debilitated by constant fatigue and pain. In November, she was told she had two to four months to live. She turned 59 on Dec. 27. She and her wife — “It hurts her so much to see me suffer so deeply” — and other loved ones hope she won’t live far into her 60th year.
While resisting her disease with surgery, radiation and chemotherapy (one treatment she likens to “injecting your body with Agent Orange),” she has twice testified to Connecticut’s legislature in support of legalization of medical aid in dying (MAID). Although 75% of Connecticut voters favor MAID, the legislature tabled the measure this past year without debating this question: What is Connecticut’s compelling interest in preventing Hoffman from receiving such assistance?
Writing in the London Review of Books, Stephen Sedley, a former judge and current Oxford University professor, notes that in the 19th century the law “got itself into such a tangle” that a person who injured himself or herself in a suicide attempt “could be indicted for wounding with intent to kill,” a capital offense. Some believers in an interventionist deity argued that terminal suffering, being God’s will, should not be curtailed, an objection they could also lodge against anesthesia. The British common law of “trespass to the person” entitles a mentally competent adult to refuse invasive treatment even if it is painless. “Yet,” Sedley writes, “the ability of a rational individual in unbearable and untreatable distress to opt for terminal medication remains beyond the pale of the law.”
Increased life expectancy, increased medical competence, increased secularism, and increased insistence on privacy and autonomy are producing increased support for legal regimes that respect the right of mentally capable and terminally ill individuals to protect themselves from lingering intense pain and mental decrepitude. A November survey by Susquehanna Polling and Research found that 68% of likely voters believe that a mentally sound person with no more than six months to live should have access to a prescription medication that will produce a peaceful
Dying is a facet of every life. An anticipated death, in the presence of loved ones, a death chosen after reflection about predictable, unavoidable pain, should not be proscribed by society’s laws or condemned by its mores.
death while asleep. Ten states and the District of Columbia, with a combined 22% of the U.S. population, have comparable laws.
Compassion & Choices, which advocates for medical aid in dying, sensibly insists that this terminology, not “assisted suicide,” is proper. Suicide connotes despair and perhaps derangement. Dying is a facet of every life. An anticipated death, in the presence of loved ones, a death chosen after reflection about predictable, unavoidable pain, should not be proscribed by society’s laws or condemned by its mores.
“I do want to live,” Hoffman says. But not in her increasingly, irreversibly “whittled down” condition.
She is a tad testy about the legislature ignoring her cause but making pizza the state’s official food. Before she was incapacitated, she was a social worker in local high schools. “My God,” she says, humorous even in extremis, “I worked with teenagers for 30 years. If that’s not paying my dues …” She is speaking, she says, “tonguein-cheek,” but pointedly: What does she owe, and to whom, that justifies the state government’s standing between her and consensual measures that would stop the prolongation of her agony?
A subsequent column will consider the qualms that many thoughtful people have concerning MAID. And the accumulating data pertinent to the serious issues involved.