SACRAMENTO, Calif. — On Nov. 13, the New Jersey Assembly passed legislation to approve physician-assisted suicide, one of many steps in the ongoing campaign to legalize the practice across the nation.
"The legislation must still win approval in the New Jersey state Senate, where a companion bill has stalled, and then be signed by Gov. Chris Christie," reported Reuters. "If it passes those hurdles, New Jersey would become the fourth state with a so-called 'Death With Dignity' law."
Activists on both sides of the issue acknowledge that the affecting story of Brittany Maynard, 29, a patient with terminal brain cancer who left her California home to take advantage of Oregon’s Death With Dignity Act, could boost support for the practice.
Maynard died in early November, after receiving a lethal dose administered by an Oregon physician, and online video testimonials by the young woman and her family have been viewed by millions of people and promoted by Compassion & Choices, the primary U.S. group advocating for assisted suicide.
New Jersey Assemblyman John Burzichelli, D-Gloucester, the sponsor of the proposed bill, “Aid in Dying for the Terminally Ill Act,” told NJ.com that Maynard’s story stirred support for the measure, which had failed to develop traction when it was introduced in June.
With Brittany Maynard’s story in mind, said Burzichelli, “More people are interested in talking about it because it drew so much attention to the issue.”
In Massachusetts and California, activists on both sides of the issue expect another push to legalize the practice in 2015.
“A doctor-prescribed suicide bill will be filed again in Massachusetts in January,” Anne Fox, president of Massachusetts Citizens for Life, told the Register.
“It has fewer ‘safeguards’ and requires a doctor who refuses [to prescribe the lethal dose] to find one who will prescribe it.”
While pro-lifers, disability groups and religious opponents of the practice are preparing for a tough legislative battle, after a 2012 ballot initiative to legalize the practice lost by a narrow margin, the Archdiocese of Boston also plans to launch a parallel effort in the state to promote palliative care as a critical option for patients dealing with the pain that accompanies some forms of cancer and other medical conditions.
“Hospice is palliative care for terminally ill patients in the last stages of their disease,” explained Father Bryan Hehir, secretary of the Archdiocese of Boston’s health and social services.
“Palliative care takes a holistic approach to caring for the person and involves a team of health-care professionals … who address the physical, spiritual, emotional and social dimensions of a patient’s illness.”
Supporters of assisted suicide cannot re-introduce a ballot initiative this year, so the fight will return to the Massachusetts Legislature.
“We are working hard identifying legislators’ positions. One encouraging thing is that doctor-prescribed suicide is not a litmus test here for Democrats the way abortion is,” said Fox.
Yet despite Maynard’s story, experts note that the public has been wary of the potential abuses associated with a policy that permits physicians to prescribe lethal medication to advance death and could be used to violate the rights of vulnerable patients. Only three states — Oregon, Washington and Vermont — now permit the practice, and past campaigns to secure new beachheads in a swathe of states have failed.
John Kelly, a Massachusetts-based disability-rights activist and the director of Second Thoughts, which helped defeat the 2012 Massachusetts ballot initiative to legalize assisted suicide, said his organization’s name “was chosen to reflect the fact that while assisted suicide may look good at first, the more you learn about it, the more you have ‘second thoughts.’”
He emphasized that Oregon’s Death With Dignity Act, the model for most proposed legislation that would legalize assisted suicide, relies on physician self-reporting and does not require a psychological evaluation, among other problems.
“Assisted-suicide bills have only passed in two states by voter initiatives,” said Wesley Smith, a leading activist and writer who has helped to expose the abuses that often accompany laws that permit doctors to help patients end their lives.
“What happens is that people are given a false premise: You fall ill, and nothing will alleviate your suffering. But when the actual proposal — how assisted suicide will actually work, not the abstract idea — is looked at, support tends to drop pretty dramatically.”
Indeed, while the ethical problems posed by assisted suicide have long provoked resistance among social conservatives, liberals are also divided on this matter, as New York Times columnist Ross Douthat noted in an Oct. 11 column.
Tim Rosales, the Sacramento, Calif.-based spokesman for Californians Against Assisted Suicide, a state coalition that includes California’s Catholic bishops, told the Register that the politics of this issue make it tough for proponents to develop political traction.
In the midterm elections, he noted, political candidates who publicly backed assisted suicide, in states like Maryland, Connecticut and Vermont, lost their races. It is not clear whether their stand on the issue hurt them, he said, but it did not help.
“This is not a top-of-mind issue for most people,” said Rosales, who pointed out that black and Hispanic voters, key elements of the Democratic base, strongly oppose the practice and thus make it easy for party leaders to stay neutral on the issue without incurring any penalty.
The Debate in California
But Rosales also agreed that Brittany Maynard’s impact on the upcoming debate in the Golden State is a “wild card.”
“Compassion & Choices is good at painting a surface-level, rosy picture of this issue. The job of our coalition is to educate on the issue,” he suggested.
In California, disability-rights activists, as well as physicians’ groups and churches, are part of a state coalition that has worked to educate the public regarding the dangers posed by assisted suicide.
“If you only consider an individual case, assisted-suicide laws may look okay [to some people]. But you have to look more broadly at society” and the direction of 21st-century health care, said Marilyn Golden, a disability-rights activist and a senior policy analyst with the Disability Rights Education and Defense Fund, echoing themes she has discussed in public forums.
Laws like Oregon’s Death With Dignity Act fail to provide adequate safeguards, asserted Golden, and so they place vulnerable patients, especially the disabled and the elderly, at the mercy of “our broken, profit-driven health-care system.”
While the testimony of disability groups has been especially effective in the fight against relaxing laws and cultural taboos that bar assisted suicide, the campaign to legalize the practice is gaining ground, and the California affiliate of Compassion & Choices is gearing up for the next legislative session.
Ned Dolejsi, the executive director of the California Catholic Conference, has taken note of fresh efforts to prepare for a state-wide campaign to capture public sympathy for Brittany Maynard’s cause.
Compassion & Choices, reported Dolejsi, “has hired additional staff in California. We can expect that this activity will culminate with legislation introduced in January, most likely.”
The winter 2014 online magazine produced by Compassion & Choices confirmed that staffers have begun to “strategize on making aid in dying accessible within five years” in California. The group’s campaign game plan features “outreach and volunteer-mobilization efforts, including online petitions, phone banking for volunteers and identification of compelling spokespeople.”
Catholic dioceses are also preparing catechetical materials that effectively explain the Church’s consistent opposition to assisted suicide and other forms of euthanasia.
In the Diocese of Orange, Bishop Kevin Vann has just established a Life and Dignity Task Force that includes doctors and ethicists who will help guide plans for a variety of initiatives geared to addressing this issue.
“The diocese is planning to organize a conference to educate Catholics about suicide and assisted suicide,” said Ryan Lilyengren, a spokesman for the diocese.
Some of the education efforts will be devoted to deconstructing the evolving message of advocacy groups that want physicians to help patients with terminal conditions kill themselves.
“Compassion & Choices’ new tactic is to manipulate language to soften people’s natural resistance to suicide. They insist that what they call ‘physician aid in dying’ is not physician-assisted suicide,” said Dr. Aaron Kheriaty, associate professor of psychiatry and director of the Program in Medical Ethics at the University of California-Irvine School of Medicine, who has collaborated with the Diocese of Orange and other local churches to address mental-health issues from a faith perspective.
“They base this claim on the absurd argument that taking a deadly pill prescribed by a physician is a ‘peaceful’ rather than violent death. Are they suggesting by this logic that the tens of thousands of individuals who commit suicide every year with more ‘peaceful’ means — drug overdose, carbon monoxide poisoning, etc. — should also not be considered suicide?”
Kheriaty and Bishop Vann want to educate the public about the dangers associated with such arguments and the tragic reality of rising suicide rates among the young, who, like Brittany Maynard, may believe that such decisions are purely “private.”
“Suicide is the second-leading cause of death among young people,” said Kheriaty.
“Often, it is preventable: There is a lot that we can collectively do to lower the risk of suicide for vulnerable individuals,” he added.
“Any acceptance of assisted suicide will undermine much-needed public-health efforts at suicide prevention and suicide-risk reduction.”
Joan Frawley Desmond is the Register’s senior editor.