The national advocates for physician assisted suicide were in Annapolis last week advocating for doctor assisted suicide (“Supporters of medically assisted suicide in Maryland say new legislators, sponsor increase bill's chances this year,” Jan. 29). Maryland law currently allows doctors to administer potentially lethal doses of pain medication to terminally ill patients, even where that medication might result in the patient’s death, provided that the doctor’s intent is pain relief and not to cause the patient’s immediate death. The same protections apply to family members administering pain medication under the doctor’s direction. That standard obviously leaves doctors and family members with considerable discretion to lawfully ease a terminally ill patient towards death. It is a standard that has proved workable since its adoption in 1999 and is consistent with the physicians’ 2,300-year-old oath to “first do no harm.”
Maryland is now poised to take a major leap beyond this carefully crafted balance. Senate Bill 311 and House Bill 399 would allow a doctor to provide lethal doses of pills to a patient if the doctor believes in his subjective good faith that the patient has less than six months to live. Never mind that medical doctors from nearly every major medical institution in Maryland and Washington D.C. testified before the Senate that a doctor cannot accurately make such a diagnosis and that patients told they have six months to live often lead productive lives for years. Under the legislation, Maryland will move from a standard that restricts the administration of potentially lethal doses of medication to alleviate pain and suffering during the final stage of life to a new standard that allows the health care industry to facilitate suicide when it is consistent with the medical industry’s desire to avoid the expenses and inconveniences of natural death.
It is interesting that we arrive at this debate at the same time that suicide rates are rising at alarming rates. A Centers for Disease Control study shows that 25 states have increased suicide rates of more than 30 percent over the past 17 years. We are faced on the one hand with legislation that seeks a clear public acknowledgement that suicide is morally acceptable for people with months and even years of life ahead. At the same time, we are called on to send a strong, rational message to an increasingly troubled population of young people that suicide is a terrible tragedy, a line that must not be crossed. As much as legislators love to “split the proverbial baby” and give both sides a win, such a compromise will not work in this case. We must fully embrace one or the other of these issues fully with the recognition that studies demonstrate that suicide rates among the physically healthy rise when states legalize doctor assisted suicide.
Adding to the seriousness of the doctor assisted suicide debate is the fact that the bill being pushed by well-funded national advocates in Maryland and across the country is carefully crafted to stifle opposition, hide the facts and aggressively push a pro-suicide agenda. It shrouds the entire process with an impenetrable bubble of non-disclosure, gives undue influence to the health care industry and prevents even close family members from uncovering the facts or taking any action to protect a loved one’s interests.
Consider a possible scenario of a brother, George, who wants to find out why his sister, June, recently diagnosed with cancer, was unexpectedly found dead on her kitchen floor only days after her diagnosis. June’s death certificate would simply indicate that she died of her illness many months earlier than doctors had first advised, making no mention of the poison she ingested. George would have no access to any records of the conversations June had with the doctor provided by June’s insurance company. George would never know that June’s doctor told her that she could elect expensive treatment, paid in part by her insurer, to extend June’s life but that in doing so June would likely become a considerable burden on her family and friends. George would never know that in June’s distraught mental state her doctor advised that she could avoid becoming a burden by taking a very inexpensive pill, paid for by her insurance company, to end her life. George would never know that, despite June’s considerable mental anguish over the decision to take her own life, she was never provided access to a mental health counselor nor did any outside doctor review the terminal diagnosis. George would also never know that all of those who influenced June’s decision to end her life were employed by the same health care provider who stood to gain financially from June’s quick death: the advising doctor, the doctor tasked to prescribe the poison and two hospital staff who witnessed June sign the written consent. If George was sufficiently alarmed and tried to file a lawsuit, he would find that he could not obtain any of the relevant medical records and that the hospital and doctors are immune from suit so long as George cannot prove they acted in bad faith, an impossible burden given that all of the facts rest with June and the records George cannot obtain.
Proponents of the legislation tell us they are supporting a “right to die,” but this legislation threatens to impose a “duty to die.” In the Netherlands, where doctor assisted suicide has been in effect for years, hospice facilities are few and less than 1 percent of deaths are in hospice. This contrasts sharply with the U.S. where 45 percent of deaths take place in hospice. These bills will create an expectation that seniors not become a burden on the next generation That is not a public policy that I can support.
Sen. Bob Cassilly
The writer, a Republican, represents district 34 in Harford County.