By Jennifer Popik, J.D. Robert Powell Center for Medical Ethics
Amidst an election night full of surprises, Colorado voters approved Proposition 106, known as the “End of Life Options Act” which will legalize assisted suicide.
Colorado becomes the 5th state to legalize the dangerous practice joining California, Oregon, Washington, and Vermont. Additionally, the Supreme Court of Montana allows a doctor, if prosecuted or sued for assisting in a suicide, to raise the defense that a person consented.
This bill, which passed roughly 2-1, faced opposition from a wide variety of groups including disability rights activists, several medical groups, right to life groups, and many others. After long and thoughtful hearings this year and last, the Colorado legislature voted to reject nearly identical proposals as being too dangerous.
Unfortunately, voters chose otherwise.
Because the law is so similar to Oregon’s nearly 20-year-old law, we know for a fact that this law will not work the way proponents say it will. One of the major deeply flawed “safeguards” states that the patient is supposed to be terminally ill.
For instance, under the new Colorado law, as in the other states with similar laws, the patient is supposed to have six months to live or less.
However, we know that many people in Oregon who receive lethal prescriptions but postpone taking them long outlive their prognosis.
This is not due merely to errors in prediction, commonplace though these are. It is because the term “terminally ill” is interpreted to include those likely to die within the time limit without life-saving treatment, even if they could live for many years with treatment.
Consequently, this so-called “safeguard” has allowed the killing of diabetics, those with HIV, or those with hepatitis simply because without treatment they would die within six months—even though with treatment they could live much longer. Assisting suicide legalization has led people to give up on treatment and unnecessarily lose years of their lives.
Many observers have noted that medical cost concerns will be an inherent problem with these kinds of laws since the lethal drugs are relatively cheap. In fact, The Denver Post, in opposing the law agreed that “…Proposition 106 would entice insurers to drop expensive treatments for terminal patients even when medical advances might add months or years more to a life that a patient may wish to take.”
Other abuses ranging from patients with dementia and mental illness receiving a lethal dose, to numerous non-terminally ill people getting prescriptions, to pressure from the state health plans to utilize the cheaper suicide option have been documented and exposed. Nevertheless, the real depth and number of abuses is difficult to know.
The law relies on doctors to self-report. However, there is no penalty for physicians who do not report statistics and complications. Furthermore, doctors are not held to the ordinary standard of medical malpractice in implementing the “safeguards,” but a far lower one.
Under Oregon law, the death certificate is actually falsified so that it lists the underlying illness, not suicide, as the cause of death. And much to the dismay of many families who found this out too late, the law does not require families to be notified of a patient’s suicidal intent.
We can expect that after a year or two, Colorado will claim that the law is working well and that there have been few or no “abuses.” That is significant because these misleading reports will be used to push for legalization in additional states. Several places are still actively considering assisted suicide bills – D.C. and New Jersey, and we expect many, many more fights in legislatures next year.