Our family spent days at the bedside of my beloved mother-in-law as she lay dying at Johns Hopkins hospital. She had been diagnosed with advanced bone marrow cancer four years earlier, and now her doctors told us her death was certainly imminent. She was unconscious and on hospice care, and we were told she would slip away at any moment.
Defying those predictions, she recovered and went on to live another two years. They were two incredibly precious years, in which she took her three grandchildren to Disney World, saw her eldest son married, her youngest daughter graduate from high school, and made Christmas dinner that year in her high heels.
As the national debate over physician-assisted suicide picks up steam – currently under consideration in 24 states –we should keep such cases in mind. Proponents of these bills claim only those with less than six months to live would be allowed to avail themselves of doctor prescribed suicide, but patients frequently outlive their prognosis. Even the best doctors, like those at Hopkins, are not omniscient and cannot always accurately predict when a person will die.
Many recall the case of the late Senator Ted Kennedy, who was diagnosed with terminal brain cancer and given only four months to live. However, he went on to live almost two more years as an active U.S. Senator. After his death, his widow Victoria Kennedy campaigned against physician-assisted suicide in Massachusetts saying this policy, “ask(s) us to endorse patient suicide — not patient care — as our public policy for dealing with pain and the financial burdens of care at the end of life. We’re better than that.”
In advocating for physician-assisted suicide, groups like Compassion and Choices (formerly known as The Hemlock Society) espouse tragically misleading slogans like “Death with Dignity.” Treating a person with authentic dignity and compassion could never involve helping that person commit suicide. The dictionary defines suicide as the very “destruction of one’s own interests or prospects.” A group promoting physician-assisted suicide is still just promoting suicide. And suicide has always been recognized as a tragedy.
The medical profession knows this, which is why the American Medical Association strongly opposes such bills, saying, “physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.”
Disability rights advocates have been among the first to recognize these societal risks, calling physician-assisted suicide a “deadly form of discrimination.” This policy unjustly singles out a class of people as having lives that are less worthy and less deserving of protection. The highly respected disability advocates at The ARC have been particularly strong in fighting these bills at the state level because of the disparate impact on those with intellectual and developmental disabilities. The disabled are especially vulnerable given the discrimination they already face in a medical environment increasingly squeezed by cost containment pressures.
We can look to Oregon, the first state to legalize assisted suicide, to see the results of this experiment and they are not good. In a well-documented case, a woman was notified by the state health plan that coverage of her cancer treatment was denied, but in the same letter was reminded that the suicide pills were covered. This is not an isolated incident.
The so-called “safeguards” in the Oregon law (the same as those promised in other states) have proved totally insufficient. There has been abuse of the definition of “terminal illness” because many diseases can be considered terminal if proper treatments are not given. Prescriptions for suicide have been dispensed for those suffering from depression, diabetes, and dementia. “Doctor shopping” is common because most family physicians don’t want to prescribe suicide pills. Patients are given the overdose prescription by a doctor who does not know them, and then are left to overdose alone without any further medical care. Results are shrouded in secrecy and reporting requirements minimal.
Finally, the law is an important teacher, especially for young people. What message does legalized, doctor prescribed suicide send to teenagers, who already face tragically high suicide rates? The ‘contagion effect’ of suicide is well known amongst mental health professionals. If adolescents see that our legislatures condone suicide for those facing difficult circumstances, would it be surprising to see an increase in teenage suicides?
Our laws should protect the most vulnerable among us, the elderly, the disabled, the mentally ill, and the young, not assist in their destruction. People facing grave illnesses deserve to be treated with authentic dignity and truly compassionate care. Instead of legally enshrining and dispensing despair, let’s embrace life, even at the end, with all its challenges and mysteries. If life is all about love, then what better time to love than in accompanying our beloved in their final days?
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