It’s called the End-of-Life Option Act. That sounds appealing — until you realize that one of the options on offer is killing.
Patients and doctors should have a full array of dignified end-of-life options. But there’s a reason, for two and a half millennia, doctors have taken the Hippocratic oath: “I will keep [the sick] from harm and injustice. I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.”
Physicians devoted to their patients’ care should not be in the killing business.
Human life doesn’t need to be extended by every medical means possible. Doctors can help their patients to dignified, natural deaths. But killing their patients or helping them to kill themselves is a whole different ballgame — a horror that advocates of physician-assisted suicide seek to conceal behind euphemisms such as “death with dignity” and “aid in dying.”
Physician-assisted suicide violates the fundamental principles of medical care. It turns the tools of healing into lethal weapons. And it threatens to fundamentally distort the doctor-patient relationship because it reduces patients’ trust in doctors and doctors’ undivided commitment to the life and health of their patients.
No surprise, then, that virtually every professional medical association, including the American Medical Association, the American Nurses Association and the World Health Organization, opposes assisted suicide. The AMA states: “Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer.” Paul McHugh of Johns Hopkins Hospital explains what happens when this boundary is crossed: “Once doctors agree to assist a person’s suicide, ultimately they find it difficult to reject anyone who seeks their services. The killing of patients by doctors spreads to encompass many treatable but mentally troubled individuals, as seen today in the Netherlands, Belgium and Switzerland.”
And it’s the weak and vulnerable and marginalized who will be most at risk in a culture in which assisted suicide is permitted.
The bill’s “safeguards” against abuse are grossly inadequate. No amount of “safeguards” — waiting periods, second opinions or otherwise — can prevent family members from pressuring patients into taking their own lives. And the bill allows patients to be sent home with a lethal dosage and absolutely no protection against emotional or physical coercion that may be waiting at the doorstep.
We’ve known this for a long time. Back in the 1990s, the New York Department of Health established a task force to study physician-assisted suicide. It concluded that the practice “will pose the greatest risks to those who are poor, elderly, members of a minority group, or without access to good medical care…. The clinical safeguards that have been proposed to prevent abuse and errors would not be realized in many cases.”
The European experience bears this out. In 2013, the High Court of Ireland noted that: “The incidence of legally assisted death without explicit request in the Netherlands, Belgium and Switzerland is strikingly high.”
A Netherlands commission argued in 2013 that as many as 650 infants per year should be eligible for euthanasia on the basis of the children’s “poor prognosis and very poor expected quality of life.” The U.N. Human Rights Committee formally condemned this: “The Committee is gravely concerned at reports that newborn handicapped infants have had their lives ended by medical personnel.”
Perversely, the End-of-Life Option Act would not only put vulnerable Maryland lives at risk, but it also would, over time, leave all Maryland residents with fewer end-of-life options.
The “option” of physician-assisted suicide provides perverse incentives for insurance providers — public and private. It offers a quick way to cut costs in a world of increasingly scarce health care resources.
Thus, you get arguments like this: “If you’re demented, you’re wasting people’s lives — your family’s lives — and you’re wasting the resources of the National Health Service.” So says Baroness Mary Warnock, a leading “ethicist” in the United Kingdom, who went on to suggest that such people have a “duty to die.” A study of Dutch hospitals found that more requests for euthanasia came from families than from patients themselves. The investigator concluded that the families, doctors and nurses were all pressuring patients to request euthanasia.
As I said, the legal safeguards inevitably fail.
This debate over physician-assisted suicide distracts us from pursuing real health-care options at the end of life. Lawmakers should be considering how to expand choice and dignified options for patients, options such as palliative care, hospice care and pain management.
The End-of-Life Option Act advances a dignity-denying, final solution to end-of-life challenges.
Death comes for us all. And no one would be safe from this dangerous bill.
This piece originally appeared in The Washington Times