By Jennifer Popik, JD, Robert Powell Center for Medical Ethics
In a record push, Compassion and Choices or C&C (formerly the Hemlock Society) has introduced bills in nearly half of U.S. states. Although they are promoted as simply another medical option at the end of life, comments made by C&C’s president that appeared in an April 17, 2015 USA Today article point to its real goal – euthanasia on demand for any reason.
Although there are still a handful of states that remain at risk this year for this dangerous legislation, such as California, these bills are being defeated one by one across the country. In state after state, the broad coalition of opponents including disability rights groups, the American Medical Society along with its state affiliates, and scores of other groups have successfully raised the alarm that these laws are just too dangerous.
C&C has gained attention using the case of Brittany Maynard, a California woman with a brain tumor. Maynard moved to Oregon–where it is legal to have a physician prescribe a lethal dose of barbiturates–to kill herself.
The case is being used to motivate death advocates and influence legislators, and in many states that did not advance legislation this year, we can be sure stronger efforts will be made in the next legislative session. The legislation being promoted in the states purports to allow doctor-prescribed suicide for competent terminally ill patients, so long as some illusory “safeguards” are followed.
Evidence that safeguards are not working is available from both Oregon and Washington. There are state-issued reports that provide evidence of non-terminally ill persons receiving lethal prescriptions.
Further, there is nothing in existing Oregon, Washington, or Vermont law that requires doctors to refer patients for evaluation by a psychologist or psychiatrist to screen for depression or mental illness. There is also no such requirement in any current proposal in any state. The doctors can make a referral, but nearly never do. In fact, according to the Oregon’s official state reports, in 17 years of legalized doctor-prescribe suicide, a mere 5.5% of death candidates have been referred for psychological evaluation.
In short, there is evidence that any so-called “safeguards” simply are not working. What is more shocking is that this is exactly what C&C President Barbara Coombs Lee wants. She would prefer to expand the list of those who can receive lethal drugs to any kind of discomfort a person might believe she or he is suffering from. In the USA Today article, “Half of U.S. states consider right-to-die legislation,” Coombs Lee told reporter Malak Monir that “It’s not as simple as pain. Everyone gets to identify their own definition of suffering.”
In another telling remark, Coombs Lee congratulated our close neighbors in Canada on its astounding Supreme Court decision that allows euthanasia for virtually any reason, and possibly for people whose wishes are unknown. In a press release she wrote, “We are heartened, as availability of aid in dying in Canada will have an impact here, especially in border states like New York and Maine.”
The situation in Canada is bleak. On February 6, 2015, the Supreme Court of Canada unanimously found a constitutional right to “termination of life” for anyone who has an “irremediable medical condition” and wants to die.
Unlike doctor-prescribed suicide laws in Oregon, Washington, and Vermont that theoretically are limited to those with terminal illness, the sweeping ruling allows killing any Canadian who “has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.”
“Irremediable,” the court stressed, “does not require the patient to undertake treatments that are not acceptable to the individual.”
While the ruling on its face only applies to “a competent adult person who . . . clearly consents to the termination of life,” the court hinted that it may later hold that surrogates have the right to kill people with disabilities who cannot speak for themselves and have never asked to die. After rejecting any distinction between rejecting life-preserving treatment and direct killing, stating that both hasten death, the court noted, “In some cases, [decisions to reject life-saving treatment] are governed by advance directives, or made by a substitute decision-maker.”
The court suspended the invalidation of Canada’s law against assisting suicide for a year to allow the Parliament and provincial legislatures to create some guidelines, should they choose. However, in light of the court’s insistence to defer judgment of potential patient vulnerability to physicians it will be very challenging for Canadian legislators to craft laws that provide any realistic measures of protection.
Now that attention in Canada is turning to see what sort of guidelines, if any emerge. The Canadian Medical Association is hard at work attempting to at least protect doctors’ right of conscientious objection to euthanasia. However, it is getting aggressive pushback from the prominent Queens University Professor Udo Schuklenk, editor-in-chief of the journal Bioethics.
In arguing against this one meager right of doctors to at least not be forced to participate he writes on his blog
The very idea that we ought to countenance conscientious objection in any profession is objectionable. Nobody forces anyone to become a professional. It is a voluntary choice. A conscientious objector in medicine is not dissimilar to a taxi driver who joins a taxi company that runs a fleet of mostly combustion engine cars and who objects on grounds of conscience to drive those cars due to environmental concerns.
While what happens in Canada, our close neighbor, certainly impacts us all, we again can look to C&C and find that it too adopts this dangerous thinking. Essentially, it began by promoting legislation with “safeguards” to make people comfortable with a doctor issuing a lethal prescription – but in quote after quote, we see that it is now moving to authorize lethal prescriptions for anyone who asks. Moreover, C&C has an open hostility to any sort of conscience rights doctors or pharmacists might have.
In the final days of the administration of President George W. Bush, the Department of Health and Human Services issued a rule preventing employment discrimination against medical professionals who refused to provide certain medical services in violation of religious or moral beliefs.
At the time, Barbara Coombs Lee wrote about this regulation
“This is why the Refusal Rule — called ‘Conscience Rule’ by its proponents — is so dangerous. It’s like a big doggy treat for healthcare bulldogs who would love to sink their teeth into other people’s healthcare decisions…These dogmatists want to fill our hospitals and clinics with workers who place their beliefs over the needs of their patients.”
Be on the lookout for these dangerous laws in your state. These laws will not alleviate pain. In fact pain is not even a top 5 reason people seek prescriptions (“losing autonomy” and “becoming a burden” are the top 2). These lethal prescriptions will be given to non-terminally ill people. Profit-driven insurers and cash strapped state health care plans have and will encourage the use of these inexpensive suicide drugs. These laws will inevitably expand!
It is time to contact your legislators, particularly in California, Massachusetts, New York and New Jersey and tell them that these laws are too dangerous!