There are currently six states in our country that have “death with dignity” or “aid in dying” laws on their books; an additional five will consider assisted suicide bills in 2018. Minnesota does not currently have laws allowing assisted suicide, but we are likely to see a bill presented soon. Therefore, now is the time for us to critically examine these laws, especially the ways in which they fail to protect patients and undermine ethical health care.
Here are four things you need to know about assisted suicide legislation:
1. Anyone can Seek Assisted Suicide even if the “Incurable” Disease is Treatable
In practice, these laws operate with a much broader definition of “terminally ill” than the laws seem to indicate. In fact, people who are chronically ill can be approved for assisted suicide in Oregon if they refuse effective treatment. In other words, patients do not have to be actually terminally ill to be considered “terminally ill” by their attending physician, and thus eligible for assisted suicide. For example, a person with cancer that is completely curable could qualify for lethal drugs, since that cancer, if left untreated would kill them. This leaves the door open to myriads of abuses and over-prescription of lethal drugs to people who should be receiving the best treatments available.
2. Under current legislation, there is no requirement for a psychological examination for those considering assisted suicide
Considering that assisted suicide is an irreversible decision, it would seem natural that if a person expresses a desire to end their own life, their attending physician would refer them for psychological examination before proceeding. Strangely, in states where assisted suicide is legal, such an examination is only required if the attending physician judges that the patient may have impaired capacity for full consent. This completely ignores the fact that a person may desire assisted suicide because they are depressed or overwhelmed by fear—what they need in this case is precisely psychological help, not a quick-fix to end their life.
3. Death certificates will not reflect assisted suicide as the cause of death
According to the Oregon Death With Dignity Act, for “patient privacy reasons”, the cause of death must be listed as death from an underlying condition rather than assisted suicide. This not only hides the true cause of death but also skews record-keeping. It is a dishonest practice that is worked right into assisted suicide legislation—one which will also make data collection and research regarding assisted suicide extremely difficult.
4. There is little recourse if the law is abused
Advocates of medical aid-in-dying give the impression that there are safeguards in place to protect the patient in case of abuse or coercion. In reality, these laws protect the physician more than the patient. Currently, there is no requirement for record-keeping regarding many significant factors, including whether lack of adequate health care coverage may have been a coercive influence, the underlying diagnosis, demographic information, and whether the patient was enrolled in hospice. Clearly, this leaves room for a lot of unanswered questions in potential cases of abuse, and places the burden of proof on the patient, instead of where it belongs: on the attending physician.
Assisted suicide laws are tragically flawed and will put Minnesotans at great risk if passed in our state. They do not protect the patients, nor do they offer the care that patients need and deserve.
Minnesota, we can do better to care for our elderly and terminally ill!