By Lisa Blumberg (pictured right) and Not Dead Yet.
The pandemic has made evident the deadly health care disparities that people of color, older people and persons with disabilities have always been subjected to. Any law which enables doctors to write lethal prescriptions at the request of people deemed to have six months or less to live, as this bill would, increases risk for devalued patients.
Despite common misconceptions, uncontrollable pain is not a primary reason that people turn to assisted suicide. Data indicates that people often request lethal prescriptions due to perceived lessening of autonomy, or feelings of being burden. As Cliff Perez, a disability rights activist, states, “these reasons are… existential or disability related and ought to be addressed with quality, multidisciplinary care, not death.” It is not so much how individuals view living with limitations caused by illness or disability, but society’s stigma and failure to provide practical supports to address such limitations.
The assisted suicide bill does not address these concerns. One of its supposed “safeguards” is that a person’s doctors must consider him to be mentally capable of making an informed decision in order to eligible for assisted suicide. This means that the person must be able to understand that taking the pills will cause death. There is no requirement though that the individual be evaluated to determine whether he has a stress related mental health issue that might be fueling a desire to die. Terminally ill and newly disabled persons frequently experience demoralization syndrome, a condition which is different from clinical depression, but which is characterized by feelings of being a burden, hopeless and loss of purpose – feelings that could make anyone consider dying. Proponents of the bill can debate what does or does not constitute suicide, but an unbiased medical system does not view suicide prevention services as being only for the young and fleet of foot.
To the extent pain is a factor in sapping a person’s will to live, we should be ensuring doctors can provide patients with appropriate pain management, rather than authorizing them to prescribe drugs to cause death. As a result of mishandling of the opioid crisis, many people with long-term pain for which carefully monitored opioid medicine will provide the only effective relief have found it very difficult to obtain help. Again, there are disparities. Black and Latinx patients with advanced cancer appear less likely than whites to receive opioid medication to address pain in the last weeks of life.
It is also a myth that the pills will always cause a quick, peaceful death. In Oregon, it has sometimes taken people up to 72 hours to die. (9) The FDA has not approved any drug specifically designed to cause death. With doctors free to devise the drug cocktail, side effects like burned mouths occur. Terry Law, a frequently active assisted suicide doctor, says “There’s lots of data on stuff that helps people live longer, but there’s very little data on how to kill people.”
The bill, like most assisted suicide proposals, mandates deception on the death certificate. The bill provides that the death certificate must state the patient’s underlying terminal condition as the cause of death. This hides mistakes in diagnosis and prognosis – demonstrated by the fact that 12%-15% of hospice patients outlive their prognosis by six months or more. It provides a barrier to identifying potential wrongdoing.
As Dr Joseph Marine, professor at Johns Hopkins University School of Medicine, has stated, assisted suicide “has no basis in medical science or medical tradition…no one will be immune to its long-term corrosive and destructive effects on the health care system.” (13)
Legalizing assisted suicide for one patient group would clear the way to normalizing death-making as “medical treatment,” in an increasing number of instances leading our healthcare system to further endanger those who are already devalued.
Lisa Blumberg is a lawyer, writer and disability activist.