BU Today

Science & Tech

Physician-Assisted Suicide on the Massachusetts Ballot

Marcia Angell (MED’67) delivers BU’s Pike Lecture today

46

Should terminally ill people have the right to end their lives with a doctor’s help? Massachusetts voters will decide next month whether to pass the Death with Dignity Act. If approved, the Bay State will become the fourth state to legalize physician-assisted suicide.

Marcia Angell (MED’67), a senior lecturer in social medicine at Harvard Medical School and a former editor of the New England Journal of Medicine, was the first person to sign the petition putting the issue on the ballot. She will explain her support for the law today at noon, when she gives the ninth annual Pike Lecture on Health Law at the School of Law. The lecture commemorates N. Neal Pike (LAW’37), a lawyer and activist for people with disabilities.

Oregon passed the nation’s first such law 15 years ago, and both sides point to it to buttress their claims. Among the opponents is Cardinal Sean O’Malley, Roman Catholic archbishop of Boston, who wrote in a recent article that “even proponents of PAS readily acknowledge that modern medicine can manage the pain in almost every case. Very few Oregon residents that request PAS indicate unbearable pain as the reason…”

Angell says that only .2 percent of Oregon deaths, or 1 in 500, have been physician-assisted since that state’s law was passed. She prefers to call it “physician-assisted dying” because “it should be distinguished from the usual suicide, in which someone with a normal life expectancy chooses death over life.” The Massachusetts initiative would allow terminally ill patients who have a prognosis of six months or fewer of life to request a prescription for a lethal drug from a doctor. They would have to make the request twice verbally and then make a written, witnessed request. Two doctors would have to confirm the terminal diagnosis and that the patient was mentally competent to make medical decisions. Doctors would also be required to present patients with alternatives, including pain control. The patient would ingest the drug himself.

The commonwealth of Massachusetts offers a primer on the pros and cons of the ballot initiative here.

BU Today spoke recently with Angell, an authority on medical ethics and health policy, about the ballot measure.

BU Today: The Massachusetts Medical Society opposes the measure, saying that physician-assisted suicide is “fundamentally incompatible with the physician’s role as healer.” To what degree is this debate simply one of differing philosophy?

Angell: It seems to me that this argument misses the point in two ways. First, assisted dying is specifically limited to patients for whom “healing” is no longer possible because they are dying of an incurable illness. And second, the focus of the debate should be on the individual patient’s needs and wishes, not on the physician’s self-image.

Does the society’s view represent the majority of Bay State doctors?

There have been no polls of Massachusetts doctors, so we don’t know how they view the Death with Dignity Act. When the issue was debated by the society’s delegates, the decision to oppose the measure was not unanimous. Moreover, since the delegates are self-selected, in the sense that they choose to be politically active within organized medicine, they are probably not representative of the state’s doctors.

The society also says that patients predicted to die within months often live much longer. Is that a valid concern?

The notion that doctors can’t tell whether a patient is dying from a terminal illness is simply wrong, although it’s true that a life expectancy of six months is a statistical average. Such a patient could live for four or five months or for seven or eight. The point is that the patient faces an imminent death and is suffering unbearably. If they could live a few months longer, they would not welcome it. But it is not hard to diagnose terminal illness, such as disseminated cancer or late-stage Lou Gehrig’s disease, and stories that such patients have gone on to live long lives, suddenly relieved of suffering, are like urban myths—undocumented.

What are the negative public health consequences of not allowing assisted suicide?

It would deny patients who are dying in agony the choice of getting medication to die sooner and more peacefully. And it would deny them the control over their own lives that they had exercised when they were healthy. If death is inevitable, why would anyone want to tell someone else that they must go on suffering?

Many doctors decry how the profit motive hurts American medicine. Do critics who worry about insurers subtly or not so subtly pushing suicide as a cheaper alternative to costly treatment have a point?

We have nearly 15 years of experience with this law in Oregon, and there has been no evidence of insurers trying to coerce terminally ill patients to use the law. Moreover, it’s implausible that it would work.

Marcia Angell (MED’67) will give the 9th Annual Pike Lecture on Health Law, The Least Bad Death: Who Decides? on Monday, October 15, at noon, at the School of Law Barristers Hall, 765 Commonwealth Ave. It is free and open to the public.

46 Comments
Rich Barlow

Rich Barlow can be reached at barlowr@bu.edu.

46 Comments on Physician-Assisted Suicide on the Massachusetts Ballot

  • Lawrence Wenner on 10.15.2012 at 8:08 am

    I am a physician and was brought up as a Catholic. I fully agree with Dr. Angell, and I am sorry I will not be able to attend her lecture today. The notion that a human being should suffer until the very end, have no control over his/her life, is rather ridiculous and very, very cruel. The idea that physicians should play no part in this difficult situation misses the point. Indeed, a physician should help dying patients keep their dignity, give them comfort, assist them in life and death. The point about pain is wrong. My understanding is that for the people who have made this decision in Oregon is that pain was not the main driving factor, although I suspect it will be in some cases. Dr. William Osler, practically the father of American medicine, at the end of his life asked his doctors to give him enough morphine to end it quickly and with dignity. Today, with all due respect to Cardinal Sean O’Malley and others opposed to this Law, physicians are between a rock and a hard place. Giving a medication that could stop breathing, like morphine or others, could place them in a legal (negligence) situation without this new Law. I still do not understand why the clergy want soon-to-die patients to suffer and lose their dignity. If anything, like physicians, religious organizations should provide peace, comfort, dignity. It will not get out of hand and, as pointed out by Dr. Angell, we will not see thousands of patients making this decision. The Law is well written, thoughtful, respectful. Cardinal O’Malley, you don’t have to agree, but you could keep a thoughtful quietness about this issue. Besides, if patients are not disabled, they could simply jump off a building, throw themselves in the river or ocean, take a few more tylenol tables or even aspirin, etc. It’s really a no brainer. This Law would allow unfortunate individuals to make a logical decision, suffer less, have hope, even realize that their God is merciful and understanding.

    • Catholic Student on 10.15.2012 at 11:35 am

      Christianity recognizes the gift that life is, and that that the power to take life away is not meant to rest in our hands. It is important for a physician to “help dying patients keep their dignity, give them comfort, assist them in life and death”, but taking their patient’s life away is crossing a line. To be Catholic is to dignify the value of life. Suicide is never dignified.

      • BU Grad Student on 10.15.2012 at 12:10 pm

        The notion that suicide is “never dignified” is just your opinion, and as the interviewee explains, one could even look at PAS as not really suicide.

        Certainly, regardless of your opinions on the issue, religion shouldn’t be informing whether this is an option for people, since not everyone is a Catholic and shares the Catholic view of what life is.

      • Liz on 10.16.2012 at 5:22 pm

        I think the essential point that is missing here is that suicide itself is not illegal, and so whether or not we think suicide is wrong should have no influence on the law. Suicide is a choice and can’t be made illegal, not in small part because it does not harm anyone else, at least not in any way that any law can regulate. Do we also tell people they are not allowed to withhold life sustaining treatment from themselves as a means to end it?
        That leaves us with the ‘physician assisted’ piece, which is more difficult to argue. I think part of that argument is nullified because doctors will never be required to provide this option. Again, healthcare is a field based on compassion, and there is more than one kind of prescription for compassion. Doctor’s sign on to give caring and compassionate care and if ‘healing’ is no longer an option, must we insist that those individuals suffer for the sake of the principles of doctors?
        I don’t mean to demean anti-suicide efforts in any way. It goes without saying that all our efforts should be directed against preventable suicides BUT does compassion not warrant an exception in cases where imminent death guarantees unquestionable suffering and the loss of human dignity? Personally, I don’t believe it is up to me to decide for someone else what aspect of their own humanity they choose to preserve for themselves in their final days. Perhaps faith leads others to an alternative conclusion, but our constitution dictates that those beliefs can’t be the basis for laws imposed on other members of our society.

        • ThatGirlwhoPostedAComment on 10.20.2012 at 9:46 am

          “In some U.S. states, suicide is still considered an unwritten “common law crime,” as stated in Blackstone’s Commentaries. (So held the Virginia Supreme Court in 1992. Wackwitz v. Roy, 418 S.E.2d 861 (Va. 1992)). As a common law crime, suicide can bar recovery for the late suicidal person’s family in a lawsuit unless the suicidal person can be proven to have been “of unsound mind.” That is, the suicide must be proven to have been an involuntary act of the victim in order for the family to be awarded monetary damages by the court. This can occur when the family of the deceased sues the caregiver (perhaps a jail or hospital) for negligence in failing to provide appropriate care.”

  • Peter on 10.15.2012 at 8:37 am

    The slippery slope to medically prescribed death. Ties in well with Obama-care rationing.

    • Student on 10.15.2012 at 9:05 am

      Well, that’s a very ignorant view of physician-assisted suicide. This is a matter of ethics and human rights, not universal healthcare.

      • Jordan on 10.15.2012 at 10:02 am

        Actually, Student, although it may be a tangential point, does it not seem very relevant to consider WHICH forms of “healthcare” could and/or should be covered by a “single payer” medical bill? Should the government be allowed to fund a physician assisted end-of-life decision?

        • Informed student on 10.15.2012 at 2:27 pm

          Apparently both Peter and Jordan have not bothered to do any research on the ACA before commenting. 1) It is not single payer – it never was (but they have it in Canada, where you probably threatened to move when the Supreme Court upheld the ACA) 2) Healthcare will not be rationed – are you really still on the Sarah Palin “death panel” bandwagon? Even she realized she had no place in politics. 3) Why shouldn’t the government be able to fund the end of life decision – they are not mandating that everyone with 6 months to live make it, it is not a religious decision unless you make it one, and, although this should not be a consideration for people making this decision, it would be cheaper to people who take on the burden of medical debt and/or insurers to have the 0.2% of people who chose to die on their own terms vs. providing ridiculously expensive end of life care for an extra 6 months.

  • RJR on 10.15.2012 at 8:46 am

    I must admit that hearing of such a procedure is rather troubling at first. Personally, it is hard for me to support PAS because it is indeed suicide. On the otherhand, if someone is truly in physical pain and death is guaranteed, I’m not sure that I can justify the prolonging of their pain. Thus, I am torn and wish that I could make it to the lecture today so that I could learn more about PAS and its pros and cons from an expert.

    • Lisa Philpotts on 10.19.2012 at 11:16 am

      It was a great lecture, RJR. People supporting both sides of the issue got a chance to speak and I definitely felt like I was better informed afterwards.

      The School of Law is going to post video of the lecture at some point. Their tweet gave me the impression that the video will be publicly available: https://twitter.com/BU_Law/status/257908833211535360

  • Zach Fehst on 10.15.2012 at 8:54 am

    The ancient Hippocratic Oath which has guided discussions of medical ethics for centuries includes the phrase “I will give no deadly medicine to anyone if asked, nor suggest any such council…I will preserve the purity of my life and my arts.” Doctors groups oppose assisted suicide because it runs fundamentally counter to their role as healers. Putting deadly poison into a suffering person’s hands is not a compassionate act; it’s an act that tells them that society believes they no longer matter as human beings worthy of continued care. True compassion is being with and caring for those who suffer, not eliminating them.

    • Caroline on 10.15.2012 at 1:53 pm

      I would agree with you if the issue were over killing patients without their consent, but that’s not what we’re talking about here. Allowing terminal patients to die with dignity instead of forcing a long, painful drawn-out process upon them and their loved ones IS a compassionate act. It in no way tells them that no longer matter or that they are unworthy human beings. In fact, quite the opposite: it tells them that you are willing to forgo your personal beliefs in order to provide them with the care they want, and that you value them enough to let them make their own decisions about their lives.

      “True compassion is being with and caring for those who suffer”: I could not agree more. It is not compassionate for a doctor to force a terminally ill patient to suffer for months when there is another path that the patient would rather take. How can you say that you care for those who suffer and in the same breath deny them a dignified, peaceful death?

  • Lawrence Wenner on 10.15.2012 at 9:33 am

    I am addressing Peter. Look, I am also against Obamacare. But, this is different, and there is no slippery slope, at least in a logical sense. It’s very easy to jump from one conclusion to another. You have to be at the bedside, talk to people who are dying, understand their fear, etc. Without these opportunities, it’s very difficult to understand. Actually, it’s impossible to understand, and this is the difficulty in passing this piece of legislation. Almost 20 years ago in a couple of weeks, as I took care of my father who had a terminal illness (no hope at all, believe me), I made the decision to forgo any further “treatment” and just provide him with fluids. He kept his dignity. I have no regrets. Personally, I don’t think we are afraid of dying, but we are afraid of the “process” of dying. This Law, which by the way is a personal choice, will give dying people a chance to make a rational decision. The Church, other religions, etc., they should be enthusiastically on the side of this Law. Isn’t pity, comfort, understanding, etc., what it’s all about? The Law will actually decrease the rate of true suicide. One would have to be very thick-minded to imagine that people with terminal illnesses do not commit suicide. This Law, with the full understanding of their family and society, would make them feel better. As for the Hippocratic Oath cited by Zach Fehst, we are talking about an oath of thousands of years ago. Chemotherapy, painful surgical approaches, they were simply not there. People lived a fraction of time of our present lifespan. Many children died of diarrhea. Many children. Now we have people living into their 90’s. How can you justify that Oath, no matter how beautiful the words are? We have to move on, and the medical profession has to take the additional responsibility of truly caring for the dying.

  • David on 10.15.2012 at 9:34 am

    Having buried many loved ones, even this year, who have suffered with horrible diseases that led to to eventual death I am sickened by this grotesque movement that the AMA and the palliative Care community is fully against.

    So many “6 months to live” diagnoses have proven wrong. My children just had an extra two year they were not supposedly going to have with the grandmother who lost a valiant battle with a horrible blood cancer. One of the worst diseases, suffering wise, to die from. But she fought until the end and the palliative care was more than able to ease her last days. It is 2012 we have the medicine to make anyone comfortable. There is never a need to put human beings down like dogs. Even my own mother who was suffocating to death was able to be made comfortable in her last days through palliative care.

    Further sick people will be depressed. Encouraging suicide is always wrong. What message does it send to depressed young people? It tells society that suicide is diginified. It is never dignified. The experts are all against this. Let us not forget that some drugs that treat diseases often have depression as a side effect. So do we want a chemically induced depressed leading to suicide by doctor?

    With all do respect to Dr. Wenner. Suicide is never dignified. A last good day to say goodbye to tell someone you love them is more important that many people know. Turning this into an discussion about the Catholic Church is deceptive. The overwhelming majority of the medical community opposing Physician Asisted Suicide. Death with dignity is merely a euphemism for killing the sick. It is utilitarian evil, not dignified. Letting nature takes it’s course with modern science to help ease the pain is dignified. Murder and suicide are not.

    We can see where this has led to after years of practice in Sweden for example. The elderly are routinely euthenized by doctors without actual consent. One door easily opens to another.

    A society that encourages the depressed and ill to commit suicide is a society that itself is undignified.

    • Emily on 10.15.2012 at 12:28 pm

      Zach had clearly never had to watch their loved ones dying from a terrible disease like cancer, or he would know that there are many people who would definitely not want to persevere through the last, excrutiating weeks of dying that these patients often endure. It should be a person’s decision, not doctors, clergy, lawyers and not even their families. We all don’t want our loved ones to go sooner than inevitable. But do these loved ones want to exist on pain medication? That should be their choice and there should be a legal way for them to pursue their decision. It’s not about physicians feeling good.

    • BU student on 10.15.2012 at 12:55 pm

      I AGREE! Very well said.

      • BU student on 10.15.2012 at 12:57 pm

        —@ David

  • Mo on 10.15.2012 at 10:46 am

    Well said David. A good resource for those looking for more information on this ballot question could go to http://www.suicideisalwaysatragedy.org .

  • George on 10.15.2012 at 10:49 am

    So, this is a whole article about physician assisted suicide, a contested issue in an election year, and yet an entire page is devoted to the pro position, with only one quote from an opponent? And you didn’t even post the whole quote.

    Great unbiased reporting here…

  • Li on 10.15.2012 at 11:58 am

    The problem here is not the ethics of human euthanasia as much as the fact that the bill has MANY flaws. So regardless of what you may believe about “physician assisted suicide” (I’m with Zach here, this contradict the hippocratic oath–it is a doctor’s responsibility to preserve life, not end it. That’s just adding a lot of negative weight on doctors’ shoulders who already do so much to save lives). This particular bill is just not the right one. (For specific reasons, because I honestly have no time for a rant right now, visit NoOnQuestion2.org, go to the about tab, or the ‘what people are saying’ tab)

    • BU Grad Student on 10.15.2012 at 12:10 pm

      What exactly are the flaws? Besides the “no” side just insisting that there are flaws that are actually, more than covered by the bill’s language.

  • BU Grad Student on 10.15.2012 at 12:07 pm

    My only worry about assisted suicide laws is that they ensure that the patient cannot be coerced by another party, especially someone who might benefit from their life insurance policy, will, etc. upon their death. But if you read the language in the proposed MA law, this concern is more than addressed – there are multiple safeguards against someone being pressured into assisted suicide. So the fear-mongering about this issue is silly. People should make sure to vote YES on this, because you never know whether or not you might one day be a terminally ill patient who does not want to go on suffering any longer.

  • Anonymous on 10.15.2012 at 12:33 pm

    I hope I’m never in a position where I would consider this as a viable option, but I’m not going to tell someone that they don’t have control over their own life. Leave religious arguments aside; they have no place in public law. And as the mantra goes for certain other polarizing issues, “if you don’t want it, don’t have it.” I cannot justify restricting someone’s decisions as an individual as long as they are mentally fit to make such a decision. Sometimes we have to stop thinking we know what’s best for other people. Just my 2 cents.

    • yes on 10.15.2012 at 4:45 pm

      I WISH MORE PEOPLE THOUGHT LIKE YOU.

      • Caroline on 10.17.2012 at 2:00 am

        ditto!

    • ThatGirlwhoPostedAComment on 10.20.2012 at 9:50 am

      So if your teenage son wanted to kill himself, then you would just let him do it? If he came to the conclusion that his life wasn’t worth living, then that would be perfectly okay with you?

      • Anonymous on 10.22.2012 at 12:50 pm

        It’s not about being “okay” with it. It’s about respecting a person’s independent sovereignty. If you want to get into the issue of minors, sure, you can stop it. Society has deemed that minors don’t have the ability or the right to make life-altering decisions. Adults, on the other hand, are independent actors. And like I said, someone of sound mind and judgment should have absolute autonomy over their own life. If you don’t control that, you control nothing.

      • Cheryl on 10.23.2012 at 3:35 pm

        You obviously have only one opinion and not matter what would not change it. This isnt about my son saying he wants to kill himself and letting him do it. It is about my terminally ill husband that cannot stand waking as he is in such pain and cannot stand it. It is about him losing control over everything he has. It is about his constant vomiting due to medication to make him be more comfortable. If he choose to leave this world as it has become unbearable it is his choice. If my son stated that he wanted to kill himself, I would move heaven and earth to stop him. You are just very narrow minded and cannot see beyond yourself

  • opposite opinion on 10.15.2012 at 1:31 pm

    Very briefly, I agree with George about biased reporting. I am looking forward to a speaker against physician-assisted suicide receiving coverage in the BU Today online newspaper BEFORE the election.

    I wish to contest certain points…
    • Angell says that only .2 percent of Oregon deaths, or 1 in 500, have been physician-assisted since that state’s law was passed.

    I am wondering where Dr. Angell is getting this .2 percent number. I am assuming that these are REPORTED deaths by doctor assisted suicide. How about unreported deaths? Are doctors required by law to report these doctor-assisted suicides. Can these physician-assisted deaths be covered up under another diagnosis? Does anyone go after doctors prescribing physician assisted suicides to patients against their will? What laws are in place to assume this does not happen?

    For more on this, please see http://dredf.org/assisted_suicide/practice_vs_theory.pdf.

    • First, assisted dying is specifically limited to patients for whom “healing” is no longer possible because they are dying of an incurable illness…

    Diabetes is an incurable illness. Are there safeguards in place to keep this measure contained to those with terminal illnesses? What is to keep this legislation from expanding to people with other handicaps?

    • The notion that doctors can’t tell whether a patient is dying from a terminal illness is simply wrong, although it’s true that a life expectancy of six months is a statistical average. Such a patient could live for four or five months or for seven or eight. The point is that the patient faces an imminent death and is suffering unbearably.

    According to the link above, “Not one of the 208 suicides in the first 7 years was due to pain; ~20% were because patients feared future pain Neither Oregon law nor VT proposal (H-44) has any requirement that the patient have any pain or suffering, only “terminal illness.”

  • Anonymous on 10.15.2012 at 1:59 pm

    My siblings and I watched for 7 years as our mother became trapped inside her own body from Parkinson’s Disease. At the very end of her life, the only thing she was able to do was blink her eyes, but her mind was as sharp as the rest ours. She suffered not only the indignity of having her children (and son-in-law) assist her to the bedpan and clean her when we didn’t get there in time, but to be fed through a tube in her abdomen so as not to experience the agony of starvation. I remember sitting next to her on her bed and looking into her eyes and wondering if she had been able to speak, would she have asked one of us to somehow put an end to her suffering. 2012 will mark the 32nd year anniversary of her death (at the age of 59) and all these years later the most vivid memories of the wonderful woman who brought me into this world are of her suffering and the helplessness of never being able to help her pass with the dignity equal to her first 52 years.

  • David on 10.15.2012 at 2:25 pm

    Dear Anonymous,

    I am very sorry for your loss. I relate to it.

    Thankfully, we have come very far with palliative care since your mother’s passing 32 years ago. In fact we have come far since my mother’s passing six years ago. No one in the State with the the best hospitals in the world need have to suffer in this way anymore. So we need not give in to the fear of a false dilemma. We no longer live in an age where pain cannot be managed with dignity and compassion.

    There is no dignity in suicide.

    • Nathan on 10.15.2012 at 3:29 pm

      My Grandfather took many years to die of Parkinson’s, unable to make major movements, unable to form words, trapped behind his eyes with no way to communicate. This was a very real, non-physical pain for everyone in the family.

      The limitation of the proposed law is that he would have to make the request while he could still talk. The years he could talk were his best years, and very, very frustrating for him.

      This is voluntary by the patient, and voluntary for the physician. Noone is trying to force anyone into an early death. Those opposed are trying to force others to fit their ideas of dignity and morality. This is, in many ways, similar to the debate about whether a woman has a right to choose an abortion.

      The world divides between people who have compassion and empathy and those who do not. Anyone with the empathy to imagine their suffering, and the compassion to want the best for the patient, would be in support of the patients right to choose death.

      • David on 10.16.2012 at 9:31 am

        Call me old fashioned but I do not think killing someone or oneself is compassionate. Life is precious because it is life not because of some cultural definition of “quality of life”. Most would say Stephen Hawking has a terrible quality of life. But look what he has accomplished.

        I take great exception to your suggesting I do not have compassion bacause I happen to believe life is precious not because of ability but because it is intrinsically. I am sorry you suffered a loss. I watched both my parents die when I was young. My mother died in my arms of a horrible lung disease, essentially suffocating to death – and she had the courage to fight. All my grandparents died and my mother in law passed 6 months ago from a horrible cancer. Every moment with her was precious. Suicide is not rational. It is not care. It is death. We have plenty of time to be dead. There is never a need to rush it.

        This is about a false sense of controlling ones personal destiny. It is nonsense. This is not 1712. It is 2012. People are not animals to be done away with when they lose their sense of self worth.

    • Anonymous on 10.16.2012 at 12:06 am

      Dear David,

      Thank you for your kind words and I am sorry for your loss. I guess the issue with people like my mom isn’t physical pain. I agree that much has changed in 32 years….it was the humiliation she suffered. I still see the tears stream down her face as my father, brother, sister, husband and I had to change her after soiling and wetting herself because of her inability to even tell one of us she needed to use the bathroom. She couldn’t even scratch an itch, certainly something I can’t imagine.

      I reply to you not as attempt to initiate an argument and to be honest, as a God-fearing Christian, I don’t know if I could have agreed to assist with ending her life. I have 52 years of wonderful memories and am still working on not focusing on those last 7

      Best wishes to you and thank you for taking the time to sharing your thoughts.

  • Liz on 10.15.2012 at 7:32 pm

    The law now proposed in Massachusetts is an exact replica of the original law passed in Oregon. We voting on this measure are in the unique position of knowing that many of the fears expressed above have not been borne out in Oregon. I was fortunate enough to attend Dr. Angell’s short panel at the School of Public Health this past Wednesday. The discussion kept returning to one raised here: palliative care vs. ‘right-to-die’. Why are these presented as options exclusive of each other?
    Cardinal O’Malley and Dr. Angell actually both note that pain management is sufficient for most and that very few cite pain the main reason for choosing a physician assisted death. In fact, pain is at the bottom of the list of reasons people may choose to go this route, far eclipsed by dignity and autonomy. Furthermore, 1/3 of those who chose to obtain the medication never even took it, but kept it on hand and said they felt much greater piece of mind. As there are claims of cases where terminal diagnoses have been reversed, so there are cases where palliative treatment has not been sufficient. A caring society would offer both palliative care and right-to-die because circumstances of death vary as much as those who approach it, and these individuals should have the option to die by whatever manner of dignity they choose.
    It is indescribably courageous and amazing to choose to fight for each moment with one’s family and it is an equally amazing act of will for someone to choose their own manner of death. Even if our health care system can’t be, shouldn’t death still be ultimately about the patient, not the physician or the ethical notions of strangers?

  • Lee on 10.15.2012 at 8:49 pm

    I had a family member who was given 6 months to live. He was told that the 6 months ahead of him would be painful and that he would suffer greatly. If this bill was law when he was here, he might have opted for the lethal drugs to end his life. What a tragedy it would have been if he did end his life, because he ended up living for 7 more years after his cancer diagnosis. Doctors aren’t God, and should not play God when it comes when a human life should end.

    • Not the point... on 10.16.2012 at 11:16 am

      This will not be used by people given a 6 month diagnosis, it would not even be used in a 6 weeks to live diagnosis. This is for those last few days, that time where pain is so overwhelming and the quality of life is so dehumanized and unnatural that to the sufferer, death is the only release and is inevitable regardless of how much positive intervention will be given. PAS is not for those who have limited time left but can live it out, even though in pain, but in good cognition and mental ability; rather it is for those with such trouble and such pains that to live would cause more depression and suffering than to die…It is a sad truth. Religion plays no part of it, if you (i speak to “you” as a general term) are religious, you can let whatever god is out there cure you and pray until you are either cured or dead, but for those who dont believe a higher intervention is logical/existing, PAS functions as a way out of pain.

  • Brad Agostinelli on 10.16.2012 at 12:18 am

    Several points here about the actual flaws of this ballot Question 2. Even if you believe physician assisted suicide is okay, which I don’t, there are still reasons we can’t vote yes on Question 2 here in Massachusetts.

    -It doesn’t require any psychiatric counseling so, unless the doctor refers the patient to one, there’s no way to know if the patient is making this decision because they’re depressed, which is not a legitimate reason because we treat people for depression all the time. In short, they may not be in their right mind when making this decision.

    -There is no way of tracking the prescription after the patient gains access to it, therefore if they don’t take it immediately it’s easy for someone else to get access, leading to the possibility of the development of a black market of lethal pills.

    -Patients can “doctor shop”, meaning they can go to doctor after doctor after doctor until they get someone to sign off on the prescription, even if all the other doctors have denied them the prescriptions.

    -The patient doesn’t have to take the pills in the hospital or even with someone watching, so there’s no way to know if they actually took the pill willingly or someone killed them with it.

    -Of the two witnesses that have to sign off for the patient to get access to the pills, one can be an heir to the patient, awaiting something of value to pass onto them from the patient after they’re dead. So there’s no way to know if their signature is actually motivated by compassion or ill will.

    And then there are more philosophical reasons for voting no, such as:

    -Whether the government or private companies are providing health care insurance, everyone wants to save money and make the cheaper decision. If PAS is legalized here, we run the risk of insurance denying actual treatment for medical conditions (say chemotherapy for cancer for example) because they now recognize PAS as a “treatment” and is much cheaper. (REGARDLESS OF THE FACT THAT DEATH IS NOT A TREATMENT)

    -Finally, by let our loved ones choose suicide, the elders and sick of our culture may begin to feel like a burden, instead of the purposeful and dignified life that they truly hold, no matter the condition. If they merely feel like a responsibility to their family and friends, they may convince themselves to ask for PAS sooner and more often. And on either side, this decision is not motivated by actual love.

    As I said before, I think physician assisted suicide is completely wrong always, but regardless of whether you think PAS is okay, we can’t vote for Question 2.

    • Liz on 10.16.2012 at 3:41 pm

      This safeguards in this law have shown in Oregon that for the few people who take this option, there is little room for abuse.
      -First of all, doctor’s will never be required to provide this service so any doctor can deny the request for any reason, not just those outlined in the law.
      -doctors must refer a patient for psychiatric counseling if any evidence of mental impairment, from depression or otherwise, exists
      -It is highly unlikely, given how doctors seek to protect themselves from liability, that it will be simple for a terminally ill patient battling pain and fatigue and who knows what else, to shop around until they find a doctor who has never seen them before and who is willing to sign off on this prescription
      -doctors already do prescribe terminal doses of medications, although it is hard to quantify this because it is illegal and not reported. What we do know are stories of patients who carefully collect prescriptions from doctors (here is where doctor shopping may come in) until they believe they have enough to constitute a lethal dose. It’s much more likely that these drugs will fall into the wrong hands, be they children, teenagers, or a black market scenario, than one prescription that is carefully dispensed to the patient in appropriate packaging
      -the medication must be taken in a full glass of water, leaving little room for force-able ingestion
      -the other person signing the act must not be an heir of the patient, a beneficiary, or an employee of the health facility in question
      -furthermore the patient must verbally make this request twice and in writing once
      So realistically, the abuses that could occur are a tiny fraction of the already tiny 0.2% of all deaths (I think something like 78 in Oregon last year) and there is no evidence that any of these fears have come to pass in Oregon. Are we going to let conjecture get in the way of compassion?

  • Mo on 10.16.2012 at 9:25 am

    Well said Lee. Sad that society has deemed human life so easily disposable when things get inconvenient or uncomfortable. For myself, I feel if the the son of God suffered and died, why would I think my life may be without? I’m ready for anything that He throws at me and trust that He knows best when it’s time to call me home.

    • No on 10.16.2012 at 11:22 am

      Society does not deem anything here…People aren’t gonna be forcibly killed because they lack quality of life, it is a personal choice. I fail to see why this god you speak of needs to be brought in. It is a personal choice, and believers can choose to suffer through the pain in hopes of healing by god but for those who believe in the logic of science and medicine, and know that they have no chance of surviving and see no point in living an extra few hours or days in severe pain and discomfort, this is a solution. You dont have to agree with it, but just because you believe in a higher power doesn’t mean others should suffer… separation of church and state is long gone unfortunately…

  • ThatGirlwhoPostedAComment on 10.20.2012 at 9:48 am

    It’s odd to me that people can be in support of something like this but then have all of these campaigns to stop teenage suicide. Is suicide okay or isn’t it? Are we just okay with this type of suicide because it often involves the elderly? Do we get to pick and choose who dies?

    • Cheryl on 10.23.2012 at 3:43 pm

      You keep mentioning teen suicide. They are 2 very different things. A teen committing suicide isnt terminally ill and assisted suicide doesnt just involve the elderly. You dont get to pick who lives or dies the person does. Hanging yourself, shooting yourself is not the same as taking a prescribed amount of a drugs to end your life. Quite a few terminally ill patients resort to those drastic measures when they cannot cope anylonger. I think the word suicide should not be used. there has to be a different term that can be associated with this process.

  • Cheryl on 10.23.2012 at 3:23 pm

    I am very disheartened with the people that are trying to say that assisted suicide should be allowed. If they disagree with the way the current question is written, work with the people presenting it to make it workable. My husband has terminal cancer. At this moment we have no idea how long his life expectancy is. He has had 3 surgeries to remove organs that were infected with cancer. He is on his 3rd prescription of oral chemo trying to find one that will help. He is in constant pain and take pain meds daily. we are preparing for his 4th surgery, this time the cancer has invaded his bones. He is slowly losing his battle and I see it in his face everyday the pain and suffering. He is hoping that this bill passes it the time comes that he would welcome such a thing to end his suffering. He has gone from 230 to 142 lbs and cannot walk without pain. No one should have the right to tell someone that they should remain alive and in constant pain and suffering. IT should be up to the individual. Someone that has 6 months to live is at their most painful and depressing stage and if they choose to stop the suffering, all you dogooders, leave them alone and let them leave this earth with whatever dignity that they have left. I see the pain daily that he goes though and I cannot imagine having to watch when he gets towards the end. I do not want him to go, but I also dont want him to have to be in constant pain with it worsening daily. I am voting yes for this to be allowed and my kids and his family are also voting to allow this. We all go to church and are good people. I do not want to have him lying there suffering as we watching his brother and it was horrible. He was at the stage where he couldnt talk, his jawbone was through his skin and his feeding tube no longer could be held in due to the weakness of his skin. They finally gave him morphine to end his suffering and it was the most horrible way to die. Vote for this to happen.

  • Howard on 10.24.2012 at 10:28 am

    The answer to this legal issue is to take the decision making part of the problem out of medical hands, and place it into the realm of the court. With medical information to be provided, the court is in the position to evaluate, and direct interventions, which should include the authority to direct the issuance of any appropriate substance, or device that would humanely assist with the process of ending life. The courts do it now in reference to Capital punishment. The moral burdens placed on the medical community needs to be reduced, where appropriate. Religious values, philosophic positions should be cleaved from controlling the American people. A person’s life is theirs, not the property of any institution .The range of natural life expectancy has remained Constance over time. The mean has increased ,thanks to public health measures, and disease treatments. What is a “normal” life span is variable, and man’s intervention has effected it. Why should there be prohibitions on individuals interventions that shorten it?

Post Your Comment

(never shown)