BOSTON — The forces are gathering in Massachusetts for what could prove a strategically crucial political battle over assisted suicide, climaxing with a vote on specific legislation in the November elections.
So far, only Washington and Oregon have legalized the prescription of fatal drugs to the terminally or incurably ill who wish suicide.
In Montana, a court has ruled that it may be legal for a doctor to assist a suicide, while in New Mexico two physicians have recently sought a more binding ruling from the courts. The Pennsylvania Legislature is currently considering an assisted-suicide bill, while Georgia has just passed a law against assisted suicide.
Meanwhile, in Canada, activists are following both routes to enable assisted suicide or euthanasia.
Massachusetts’ population of 6.6 million and the state’s historical significance mean a third victory for the so-called dying-with-dignity lobby could well set an example that other Eastern states would follow.
A petition with 79,000 signatures has already guaranteed the state Legislature will consider a bill submitted by supporters of assisted suicide. With 10,000 more names, which they are very likely to get, they can put the bill on the ballot in November.
“Massachusetts is the gateway to the East,” said Jim Driscoll, executive director of the Massachusetts Catholic Conference, which represents the state’s four dioceses at the Statehouse. “People look to Massachusetts on these issues for leadership.”
Driscoll said that there were many groups — doctors, nurses, the disabled, hospice-care advocates — who would join the Church in opposing assisted suicide, but added that only preliminary discussions had taken place on the campaign. “Things should heat up after Labor Day for the November vote,” he added.
Driscoll said the Church’s theological basis for opposing the bill was that “life is a precious gift to us. It’s not humanity’s role to take life.”
“Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons,” the Catechism of the Catholic Church states. “It is morally unacceptable. Thus an act or omission which, of itself or by intention, causes the death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his creator.”
It goes on to say, “The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded. Discontinuing medical procedures that are burdensome, dangerous, extraordinary or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted” (2277-2278).
Among those groups that are opposed to the Massachusetts initiative is Second Thoughts, which was started by disabled people in 2011. Director John Kelly, a long-time disabled-rights advocate in the Boston area, said the proposed law has inadequate protection for disabled people, the elderly or terminally ill, in light of family members who are heirs or institutional caregivers intent on cutting costs.
“We already have elder abuse and abuse of the disabled,” said Kelly. “And it’s usually the caregiver who is the abuser. Once the lethal dose is in the house, there is no control over it. A caregiver could administer it without anyone’s knowledge.”
With elder abuse, said Alex Schadenberg, executive director of the Ontario, Canada-based Euthanasia Prevention Coalition, “70% is done by friends or family. Those abused don’t tell anyone because they are afraid of the abuser, who is their caregiver.” Assisted suicide would, therefore, put lethal drugs into the hands of their abusers.
Kelly said that many people who are depressed by their illness or disability would be inclined to seek assisted suicide. “When other people are depressed or suicidal, they get treatment for the depression. But under this bill, the disabled or terminally ill would get a fatal drug, not treatment for depression The assumption in their case would be they were seeking suicide rationally. It’s a form of discrimination.”
Kelly also said mistakes are made in diagnosis which could prove fatal with the legalization of assisted suicide. He cited the case of Jeannette Hall, an Oregon woman diagnosed with a terminal illness who sought an assisted-suicide drug. But her doctor refused, recommending a new treatment. It worked, and 11 years later, she is still alive.
Kelly also pointed to several cases that have emerged from Oregon of institutional penny-pinching. Cancer patient Barbara Wagner complained that the state health plan had rejected her request for a new cancer drug and instead offered to fund her (much cheaper) assisted suicide. “I’ve still got things I want to do,” the retired bus driver told one TV reporter. Despite two appeals, the health plan refused to pay for more cancer treatment, but the drug maker provided it for free. She died after a year of treatment.
On the other hand, a 1998 study published in the New England Journal of Medicine concluded that savings to the health-care system from assisted suicide would be less than 1% of total health costs — or $627 million nationally.
Schadenberg said the basic social argument against euthanasia or assisted suicide is that “society should be caring for people, not killing them.” And the people society should be caring for the most, “the most vulnerable, the seriously ill, seniors and the disabled, are the most at risk from both of these measures.”
Stephen Crawford, spokesman for the Dignity 2013 initiative campaign, said the concerns expressed by disability groups had already been proved groundless. “We’ve had laws, just like the one we are proposing, operating for a few years in Washington and for 15 or so in Oregon. There’s never been any evidence of those kinds of abuses.”
Crawford says the Massachusetts law would have safeguards to protect the vulnerable. First, the person seeking the lethal prescription must be terminally ill, with just six months to live. Second, he or she must request it three times, twice verbally and once in writing with two witnesses, with two weeks separating each request. Only about 45 people actually follow through in action each year in each state.
People are not trying to play God, Crawford insisted. “They are dying anyway. They are just choosing a more dignified way to go, in the company of their loved ones.”
Polling shows majority support for euthanasia and assisted suicide among the general public, doctors and even Catholics. Most recently, a Public Policy Polling survey found 43% of people in Massachusetts approving of assisted suicide and only 37% opposed.
But Schadenberg argues that fewer people would support euthanasia and assisted suicide if they realized that sufficient drugs can be administered to remove all the pain for terminally-ill patients, even if this has the unintended consequence of hastening death.
In Canada, a liberal judiciary is considering two constitutional challenges to the law against assisted suicide. And the Quebec government is considering a report recommending euthanasia.
“It’s Belgian-style euthanasia,” said Schadenberg. “It wouldn’t be for just the terminally ill, but for anybody facing physical or mental suffering. It’s very vague. Does it mean psychological suffering? We think the depressed need good help, not death.”
Polling indicates Canadians favor such measures, but the Canadian Parliament last year defeated an assisted-suicide bill resoundingly. While Quebec legislators might support euthanasia, they cannot change the federal law making it a crime. The proposal would try to get around that by simply directing Quebec prosecutors not to prosecute such cases.
“The report also recommended increased spending on better palliative care for the dying,” said Schadenberg. “That is what we’d like to see.”
Register correspondent Steve Weatherbe writes from Victoria, British Columbia.