Second Thoughts grow on Assisted Suicide

By Alex Schadenberg, executive director, Euthanasia Prevention Coalition

Diane Coleman and Stephen Drake have co-wrote this article that was published in the Wall Street Journal April 5 titled: Second Thoughts Grow on Assisted Suicide. The article is reprinted below.

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Second Thoughts grow on Assisted Suicide :The Risks of Mistake, Coercion and Abuse are too great to warrant legal immunity for doctors who help end lives

By Diane Coleman and Stephen Drake

An initiative to legalize assisted suicide will be on the November ballot in Massachusetts. Last month, advocates on both sides of the issue testified at a legislative hearing in Boston. Although the debate about assisted suicide is often portrayed as part of the culture war—with typical left-right, pro-con politics—the largest number of witnesses at the hearing were 10 disability-rights advocates who oppose the initiative.

In Massachusetts, the disability advocates call their opposition group “Second Thoughts.” They say that assisted suicide may sound like a good idea at first, but on second thought the risks of mistake, coercion and abuse are too great to warrant legal immunity for doctors or others who assist suicide.

Proponents of assisted suicide claim that 14 years of data from Oregon—which legalized assisted suicide for people who are predicted to die in six months, with purported safeguards to ensure that it’s voluntary—prove that such mistakes or abuses do not materialize. How would they know?

Oregon’s annual reports tell us very little. For one thing, assisted-suicide laws like the one in Oregon and the one proposed for Massachusetts lack teeth. Doctors who fail to report giving a lethal prescription face no penalty. The state does not talk to doctors who denied a request to prescribe lethal drugs in order to find out why, or to families to learn why the person requested assisted suicide and what happened after the lethal drugs were obtained. No form of noncompliance with the law’s relatively flimsy safeguards is monitored or investigated.

Assisted-suicide proponents have been pushing the term “aid-in-dying,” hoping to get people to view a life-ending prescription as merely one option on a continuum of palliative or “end-of-life” care.

People already have the right to refuse unwanted life-extending treatments, and they have the option of using advance directives to determine their care when they can no longer express their wishes. But death that results from withholding or withdrawal of life-sustaining treatment has always been separated by a bright line from active measures to cause death. Assisted-suicide proponents seek to blur this line, while opponents want to hold the line against increased medical authority to end life.

The Massachusetts Medical Society and the Massachusetts Hospice and Palliative Care Federation testified against the ballot initiative. The Medical Society has stated that “allowing physicians to participate in assisted suicide would cause more harm than good.”

Proponents say that assisted suicide increases self-determination, but actually it puts one’s life in the hands of others. It gives doctors the power to issue a lethal prescription with blanket legal immunity for any mistake as long as they claim “good faith.” It gives insurers a cheaper option than providing the care you need.

People assume there are safeguards to ensure that withdrawing life-sustaining treatment is voluntary or at least consistent with the patient’s directive. Few are aware that most states have laws granting doctors a “safe harbor” for denying care the patient wants if the doctor feels that it’s “futile” or inconsistent with local standards of care. Aside from such futility policies, studies show that the protections people expect have proven unreliable.

A recent study in the Journal of EmergencyMedicine found that having a living will might give people a false sense of security about getting the treatment they want. Based on survey responses from more than 700 physicians in 34 states, researchers from the University of Pittsburgh Medical Center found that over 50% of physicians misinterpreted a living will as having a “do not resuscitate” (DNR) order when it did not. About the same percentage over-interpreted DNR orders as meaning no treatment except “comfort care” or “end-of-life” care.