Social Justice, Doctor Assisted Suicide Don’t Mix

Editor’s note. The following appears today on the blog of “True Dignity Vermont: Vermont Citizens Against Assisted Suicide” at http://truedignityvt.org/?p=273. It is an op-ed that appeared in today’s issue of the Burlington (Vermont) Free Press.

My Turn: Social justice, doctor assisted suicide don’t mix
By Pete Gummere

I recently came across a copy of a Free Press editorial from back on April 17 (“Assisted suicide bill fails transparency test”). In that piece, the Free Press editorial board articulated its serious misgivings about the bills pending in the Legislature that would allow a doctor to prescribe a lethal dose of medication for a patient with a terminal illness.

One of my major objections to what I call “doctor prescribed death” has always been founded on a matter of social justice. That issue was underscored recently by an apparently serious suggestion now circulating around the state that doctor prescribed death is one component of a sound plan to get health care costs under control!

First, consider some history: In Oregon, the state in which doctor prescribed death was first introduced to the United States, a little known but absolutely outrageous turn of events took place. It is documented that in at least two cases, cancer patients seeking to beat their disease through chemotherapy were denied their chemotherapy by Oregon Medicaid officials. Both were sent letters explaining that the chemotherapy requested by the patient and recommended by their doctors would not be covered, explaining that “the state cannot cover everything for everyone.” The letter went on to explain that they could avail themselves of the benefits for doctor prescribed death.

Wait a minute! Wasn’t access to doctor prescribed death in Oregon supposed to be free of coercion? Weren’t decisions supposed to be the patient’s own decision free from any pressure from anyone?

Neither of the patients (Barbara Wagner and Randy Stroup) in question opted to accept the state’s offer to pay for them to kill themselves. Both died natural deaths. When these cases came to light Oregon officials stopped trying to coerce patients into killing themselves.

However, the message was clear: Part of the motivation behind doctor prescribed death is cost control.

Such behavior on the part of state officials is a breach of an important societal agreement, having the ethical force of a contract, if not the legal force. People pay into the “system” which pays for their health care when they need it. It really does not matter whether the “system” is a commercial insurance company or a tax-payer funded system such as Medicare or Medicaid. Society has chosen (up to this point in time) to put this system in place; and that system really should work for everyone who needs it.

Breaching that societal agreement by encouraging some people to kill themselves is a most serious violation of trust and a betrayal of us all. If today the “system” can deny chemotherapy to two people today and offer them doctor prescribed death, what is to preclude the “system” from arbitrarily denying far more treatments for many others tomorrow and offering them doctor prescribed death?

Shift now to Vermont, where proponents of doctor prescribed death simply refuse to take “no” for an answer. Previous versions of House bill H. 274 and its Senate counterpart S. 103 have died in committee or else been defeated on the floor of the House. The bills have remained dormant since introduced earlier in the year.

I dread to think about how aggressively insurers might ration people into choosing doctor prescribed death. I dread to think how a state could contemplate adding to the distress of its most vulnerable citizens — those with a terminal diagnosis, by offering them doctor prescribed death, especially in these economically distressed times.

It is time for advocates of social justice and all Vermonters to unite against H. 274 and S. 103. It may very well be “some other guy” who feels pressured to opt for doctor prescribed death in the first year of the existence of Vermont’s proposed doctor prescribed death experiment. But we may rest assured that we will each be vulnerable to such a pressure.

Pete Gummere writes and teaches on bioethics topics. He lives in St. Johnsbury.

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