Frequently Asked Questions: Assisted Suicide

 

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What is state sponsored assisted suicide as defined by legislative efforts in Connecticut?

Assisted suicide occurs when a doctor writes a prescription for a patient who has a terminal illness with a prognosis of death within six months. 

Medical oversight ends at the time of prescription.  A pharmacy fulfills the prescription for the patient, who must self-administer the life-ending medications. Patients usually ingest the dozens of pills alone without a doctor or nurse present and without medical oversight after ingestion.  A physician or another health care professional cannot administer the drugs. 

Assisted suicide is not related to the withdrawal of feeding tubes, intravenous fluids, breathing tubes, etc. The withdrawal of these devices is already allowed under law and under Catholic medical directives. 

Is there any difference among “aid in dying,” “death with dignity,” and assisted suicide?

No. “Aid in dying” or “death with dignity” are euphemisms for 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. These terms mean nothing more than a physician making lethal medication available to a patient who wishes to commit suicide.

Does the State of Connecticut have a suicide prevention program? Would legalization of assisted suicide create an inconsistency in the State’s moral/ethical judgment that would undermine the goal of such a program?

Yes, and yes.

The Connecticut Suicide Advisory Board (CTSAB) was established January 2012 through the merger of the 1989 legislatively mandated CT Youth Suicide Advisory Board under the CT Department of Children and Families, and the CT Department of Public Health’s Interagency Suicide Prevention Network to create one state-level Suicide Advisory Board to address suicide across the lifespan. 

The Advisory Board, in its 2020 – 2025 report, does not specifically endorse or reject assisted suicide, but make many recommendations that run counter to the premises driving the assisted suicide movement.

Is uncontrollable pain the biggest concern of patients who participate in assisted suicide?

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. The Oregon Health Authority reported that physician-assisted suicides in 2019 were requested due to “decreasing ability to participate in activities that made life enjoyable (90%), loss of autonomy (87%) and loss of dignity (72%).”  Fear of pain was listed as a concern for 33% of patients.

Does every patient consume the lethal medication? Are there difficulties in determining cause of death of patients who had prescriptions fulfilled?

No and yes. The Oregon Death With Dignity Act 2019 Data Summary provides the information in the chart below.

If the deadly medication is unused there is no requirement to return it. In the chart below, it is very likely the medication, which was given to the 62 people who eventually died from natural causes, is still in circulation.  

 

Is opposition to assisted suicide laws primarily religiously motivated?

No. While assisted suicide advocates argue that religious groups are its strongest opponents, they are mischaracterizing the diversity of those in opposition. Although religious denominations, such as the Catholic Church, strongly oppose this type of legislation and have been known to actively fund efforts to defeat it, many other interested parties have spoken out loudly in state after state. The medical, hospice, disability, and elderly communities are all strong opponents of this type of legislation. The American Medical Association also strongly opposes it. Any effort to label this a religious issue is clearly an attempt to detract from the serious problems concerning the legalization of physician-assisted suicide.

Is assisted suicide a recipe for abuse of the elderly?

The laws of Washington and Oregon laws are a recipe for elder abuse with their complete lack of oversight of the administration of lethal medications and the subsequent hours leading to death.  No witnesses are required at the time of death, and the death can occur in a private place.  An opportunistic heir or beneficiary of the patient’s death could administer the lethal dose to the patient without their consent.  Even if the patient struggled, no one would know. We note that the state health departments in Oregon and Washington neither ask about abuse, monitor for abuse, nor issue any reports on abuse.

Is assisted suicide good public policy?

Once a legislature enacts an assisted suicide law, it impacts everyone. It 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 the disabled to be manipulated by those around them who would benefit from their death.  In Oregon, the state’s Public Health Plan informed patients that the insurance will cover the costs of medication for assisted suicide, but not the cancer treatment they requested.

The rights of an individual are often balanced by the potential negative impacts on the public. The right to die may soon become the responsibility to die for the sick, the elderly and the disabled. By the very act of legalizing assisted suicide, the state would be passing judgment on the quality of life worth living and not worth living.  Anyone who meets the criteria for assisted suicide would be part of the group of lives not worth living, and thus would be exposed to potential unequal treatment under the laws of the state.

Therefore, the legalization of assisted suicide is terrible public policy. 


How prevalent are assisted suicide laws?

  Eight 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)

In Montana, Baxter v. Montana (2009) 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. 

Since Oregon legalized assisted suicide in 1994, there have been hundreds of legislative proposals in a multitude of states.  Yet, most of these efforts failed.  Efforts have failed repeatedly in Connecticut.



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 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 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.”


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