California Flirting With Physician-Assisted Suicide

SAN FRANCISCO — As a history professor focusing on Colonial America and George Washington, Paul Longmore thinks a lot about freedom.

But the freedom rhetoric that is infused into a campaign to legalize physician-assisted suicide in California is “a fiction,” he said.

Two state legislators want to codify this “freedom” by making assisted suicide legal in California. Their bill, introduced Feb. 17, would make California the second state to allow “mercy-killing” suicides, after Oregon.

Longmore, who has a physical disability resulting from contracting polio at age 7, said the most precious freedom of all — the freedom to live — is endangered by assisted suicide legislation clothed in the language of choice and autonomy.

 “If you are middle class, working class or poor, if you are African American, if you are a person with a disability — then you are in danger,” said Longmore, professor of history at San Francisco State University and winner of the 2005 Henry B. Betts Award given by the American Association of People With Disabilities.

“I think people from the disability community have a much clearer understanding of how the health care system operates,” Longmore said.  “So, we better be listened to.”

The California lawmakers sponsoring the assisted suicide legislation, State Assembly Democrats Patty Berg and Lloyd Levine, predict passage by the Democrat-controlled legislature.

California Gov. Arnold Schwarzenegger, a pro-abortion Republican, has not said whether he would sign it.

Berg said her bill is modeled on Oregon’s Death With Dignity Act. An adult whom a physician has predicted has less than six months to live may receive deadly medication to self-administer. The person must be determined by the physician to be mentally competent to make a decision — but that does not preclude being depressed — see two physicians, make written and oral requests for the medication, and wait two weeks.

“There have to be alternatives to the way some people spend their final days,” Berg said at a public hearing.

The California Catholic Conference takes the threat so seriously it has made squashing the legislation its top priority, joining with the Alliance for Catholic Healthcare. In addition, the California Medical Association and 12 disability rights groups, including Not Dead Yet, the National Spinal Cord Injury Association, and the National Council on Disability, oppose assisted suicide.

Assisted suicide took effect in Oregon in 1997, the only place in the U.S. where it is legal. According to Oregon statistics based on self-reporting by physicians — with no enforcement mechanisms or oversight — 171 people committed physician-assisted suicide from 1998-2003. Oregon Medicaid, and most Oregon HMOs, except Catholic ones, provide assisted suicide as a treatment option, according to Portland-based Physicians for Compassionate Care Educational Foundation.

Suicide advocate Carol Van Aelstyn claims, “We have found from looking at the data in Oregon that just giving people that control gives them peace of mind, and they usually choose to die naturally,”

Wesley J. Smith, consultant to the International Task Force on Euthanasia and Assisted Suicide, disagrees. “The practice of assisted suicide is conducted in utter secret. The State of Oregon exercises no independent oversight,” he said.

Reports that have made the newspapers are disturbing, Smith said. In one case, a woman’s own doctor refused to provide assisted suicide, and so did a second doctor. So she went to a suicide advocacy group that referred her to a doctor willing to write a prescription and she died two weeks later, he said.

Suicide advocacy group Compassion in Dying Federation was involved in 79% of the assisted suicides in Oregon the first year after the law took effect, according to Physicians for Compassionate Care. In 2004, based on their own statistics, 29 of 35 deaths were assisted by Compassion in Dying.

“Of course it’s cheaper to provide a $35 lethal prescription rather than take care of someone,” said Carol Hogan, executive director of the California Catholic Conference.

Even as the Bush Administration is challenging the Oregon law in court, legislation modeled on it is under consideration in Vermont and Arizona. In early February, Hawaiian lawmakers killed an assisted suicide bill while a Connecticut legislator introduced one that would make people accused of assisting a suicide eligible for a special form of probation.

The Catholic Conference warns that legal assisted suicide would be a dangerous law in an environment in which many people do not carry health insurance. “Millions of Californians don’t have access to health care. A society that refuses to guarantee the right to health care has no business considering a so-called right to assisted suicide,” the conference notes on its Web site.

Stephen Drake, policy analyst for Not Dead Yet, said that reading old newsletters of the Hemlock Society, now known as End of Life Choices, it is clear that physician-assisted suicide is a first step. He said it is also a strategy that could lead to the situation in the Netherlands where euthanasia — even on disabled newborns — has been practiced for years. In 1997 8% of infant deaths in Holland were “physician induced,” according to The Lancet, a British medical journal.

The Lancet estimated that in 2001, physicians euthanized about 3,000 patients, assisted in the suicide of about 140 patients — but ended “life without patient’s explicit request” for some 840 patients.

“What we’re saying about the assisted suicide advocates is that they are engaging in an incrementalist strategy. This is Political Strategy 101,” Drake said. “I am not accusing them of being an evil cabal. I am accusing them of being competent political operatives.”

If assisted-suicide legislation is enacted, the economics of what can be expensive end-of-life care will take over, Hogan predicted.  “Unfortunately what starts as a choice often ends as an obligation.”

Previous California assisted suicide efforts failed in 1992 and in 1999. The 1992 legislation included euthanasia.

To combat the ongoing assisted suicide campaign, the Catholic Conference in 2002 created a Web site “Embracing Our Dying.” It states, “We believe that a dying person’s request for ‘assisted suicide’ is actually a cry for help coming from a fear of helplessness and a fear of abandonment.”

Valerie Schmalz writes

from San Francisco