- What is physician-assisted suicide?
- Are “aid in dying," death with dignity,” and physician-assisted suicide different?
- Is uncontrollable pain the biggest concern of patients who participate in physician-assisted suicide?
- What states have physician-assisted suicide?
- Does opposition to physician-assisted suicide laws come primarily from religious groups?
- Is physician-assisted suicide good public policy?
- What is the solution to difficult end-of-life situations?
- Will I have to go to a new doctor to take advantage of PAS?
- Has the medication used in PAS been tested and approved by the FDA?
- Is death immediate with assisted suicide?
- How are the body and brain affected by the lethal medications- does a person experience pain, pressure, emotions?
- Is assisted suicide medical treatment?
What is physician-assisted suicide?
Physician-assisted suicide occurs when a doctor writes a prescription for a patient, who has a terminal illness and is told they have only six months to live. The patient then must have the prescription filled at a local pharmacy and self-administer the drug, which in most cases occurs at home. The physician is almost never present at the patient’s suicide. The physician or another health care professional cannot administer the drug. The patient must consume the medication by themselves. The physician’s role basically ends once they provide the prescription to the patient.
Terminal Illness is not clearly defined, and can be open to interpretation, such as removal of breathing and feeding support (applies to the disabled), voluntary refusal of food and drink, and anorexia.
Pain and suffering is not mentioned at all in SB 1076, and the state is declaring that EVERY person with a terminal illness and 6 month prognosis has such a low quality of life that it will remove statutory protections for all of these people, including nearly eliminating the standard of care for doctors prescribing lethal suicide drugs.
Are “aid in dying," death with dignity,” and physician-assisted suicide different?
No. “aid in dying” or “death with dignity” are more socially tolerable terms for physician-assisted suicide. These terms are used by advocates of physician-assisted suicide in order to avoid the use of the word “suicide”, which most people find objectionable. Webster’s Dictionary defines suicide as the “act or an instance of taking one’s own life voluntarily and intentionally especially by a person of years of discretion and of sound mind”. Therefore, these terms mean nothing more than having a physician provide lethal medication to a patient who wishes to commit suicide. "Sui" is the reflexive Latin root word that means "self," and "cide" is the Latin root that means "kill." Motivation and intention are not included in the definition of this basic term.
Is uncontrollable pain the biggest concern of patients who participate in physician-assisted suicide?
Again the answer is “no." Actual pain, combined with concern about possible pain in the future, is only a motivating factor in the minority of cases. Although advocates for physician-assisted suicide would like one to believe that uncontrollable pain is the primary reason that individuals seek to end their lives; this is simply not supported by the facts. In the words of the Oregon Public Health Division concerning physician-assisted suicides in 2020, “ as in previous years, the three most frequently reported end-of-life concerns were: loss of autonomy (93%), decreasing ability to participate in activities that made life enjoyable (94%), and loss of dignity (72%).” Fear of being a burden on family and friends was a concern in 53% of the cases, while fear of pain was a concern in only 33%. (“State of Oregon Death with Dignity Report 2020”, Oregon Public Health Division). Note well that SB 1076 makes no mention of suffering or pain. The state would be declaring that everyone who is terminally ill with 6 months to live has such a poor quality of iife that the state will allow doctors to help kill them. The focus of legislators should be to improve quality of care, and objective goal.
What states have physician-assisted suicide?
Current Status Nationwide:
Nine states and Washington, D.C., have death with dignity statutes (in order by year of enactment)
- Oregon (Death with Dignity Act; 1994)
- Washington (Death with Dignity Act; 2008)
- Vermont (Patient Choice and Control at the End of Life Act; 2013)
- California (End of Life Option Act; approved in 2015, in effect from 2016)
- Colorado (End of Life Options Act; 2016)
- District of Columbia (D.C. Death with Dignity Act; 2016)
- Hawaii (Our Care, Our Choice Act; 2018)
- Maine (Death with Dignity Act; 2019)
- New Jersey (Aid in Dying for the Terminally Ill Act; 2019)
- New Mexico (Elizabeth Whitefield End of Life Options Act; 2021)
In Montana, the Baxter v. Montana (2009) court decision created a defense for a physician who is prosecuted should the physician be charged in assisting a suicide, although prosecutions and convictions for assisted suicide remain possible in Montana.
Does opposition to physician-assisted suicide laws come primarily from religious groups?
No. Supporters of physician-assisted suicide argue that religious groups are its strongest opponents. This also is not true. Although religious groups, such as the Catholic Church and other denominations strongly oppose this type of legislation, and have been known to actively fund efforts to defeat it, many other groups have spoken out loudly against physician-assisted suicide in state after state. Organizations representing the medical, hospice, disability and elderly communities are all strong opponents of this type of legislation. Physician-assisted suicide legislation is also strongly opposed by the American Medical Association. Any effort to call this a religious issue is clearly an attempt to detract from the serious problems relating to the legalization of physician-assisted suicide.
Is physician-assisted suicide good public policy?
Many proponents of physician-assisted suicide believe that this procedure is a private personal matter and the state should allow individuals to end their lives if they so desire. The only problem with this thought process is that once a legislature enacts a physician-assisted suicide law, it impacts everyone. It now places the option of suicide on the “table of options” to be considered when a person is facing a serious illness. It presents opportunities for the ill, the elderly, and those with disabilities to be manipulated by those around them who would benefit from their death. It may even effect the options for medical care that people will be provided. In Oregon, the state’s Public Health Plan informed patients that the insurance will cover the costs of medication for physician-assisted suicide, but not the cancer treatment they requested. The right of an individual is far overshadowed by the potential negative impact on our society. The right to die may soon become the responsibility to die for the sick, the elderly and the disabled. The passage of physician-assisted suicide would create a terrible public policy.
What is the solution to difficult end-of-life situations?
Most people facing a devastating illness are usually seeking true compassion, loving care, family support and quality pain control. Instead of enacting a law that opens up a Pandora’s box of possible abuses, we as a society should work on refining the existing system of medical care to reflect the 1993 statement of the American Medical Association when they took a position against physician-assisted suicide. The AMA reaffirmed this position in 2019.
“Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks. Instead of participating in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life. Patients should not be abandoned once it is determined that cure is impossible. Multidisciplinary interventions should be sought including specialty consultation, hospice care, pastoral support, family counseling, and other modalities. Patients near the end of life must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication.”
Will I have to go to a new doctor to take advantage of PAS?
Their is a very strong possibility a patient will have to seek out a new doctor to receive PAS services. In states where physician-assisted suicide is legal, very few doctors actual offer the service. It is estimated that in Oregon, the state where it all started, only 2 -3 % of the physicians offer the service. Most patients seeking physician-assisted suicide usually contact contact the advocacy group Compassion and Choices to locate a physician. There is also no formal training or medical certification offered to doctors. Those that participate in providing this service usually learn from other doctors who have done it. There has been no large scale study of the effects of the lethal drugs on the body to determine if a patient's pain and suffering is masked.
Has the medication used in PAS been tested and approved by the FDA?
The answer is "No." While the individual medications are FDA approved, the medication consumed by a patient is a "cocktail" of various drugs, which has been developed by physicians that participate with physician-assisted suicides. The information about the drug mixture in the "cocktail" is shared by physician to physician. If a physician decides to modify the "cocktail," probably to make it work more efficiently, they are free to do so. This has occurred in the past, sometimes with bad results. In the physician-assisted suicide world the patient is also the test subject. The "cocktail" is not FDA approved.
Is death immediate with assisted suicide?
Does the person have to tell her family members? Can the drugs be taken in a public place? Will first responders let a person die if there are complications? Will they help the person live?
No, it can take hours or even days to die.
No, contact and discussion with family are not required.
Yes, the drugs can be taken in a public place.
Ethical questions to be answered.
How are the body and brain affected by the lethal medications- does a person experience pain, pressure, emotions?
There have not been large scale studies of the effect of lethal medications on the body. The physical reaction manifested may mask internal disturbance and suffering.
Its effects have been compared to lethal injections that are used in executions, with calls for further research.
Medical aid in dying: a peaceful or painful experience?
Is assisted suicide medical treatment?
Assisted Suicide is not medical care. It is the failure of medicine. It is not relief of pain or suffering, because the person will not be alive to experience the relief.