Public Discourse blog has a new posting by Adam MacLeod, Assisted Suicide: the Forgotten Front in the Fight for Life. He mentions the Massachusetts ballot initiative that was certified for the ballot by the state attorney general last week. Marcia Angell, former editor of the New England Journal of Medicine is among the initiative supporters. During her tenure as editor she authored an editorial arguing in favor of such laws. Dignity 2012 is the organization coordinating supporters. The Massachusetts Catholic Conference is among the many opponents of the initiative.
In his blog post at Public Discourse, Professor MacLeod argues that there is little evidence from the Oregon experience that physician assisted suicide is requested by parties due to “inadequate pain control or concern about it.” Even strong proponents of assisted suicide have conceded this point. “Unrelieved or unrelievable pain is not often the major or sole reason for requests for physician-assisted death. Physicians report that unrelieved pain is infrequently the only reason cited by patients who request or receive physician-assisted suicide or voluntary active euthanasia.” Timothy E. Quill et al., The Debate over Physician-Assisted Suicide: Empirical Data and Convergent Views, 128 Annals of Internal Medicine 552 (1998). Professor MacLeod fails to mention reports that pain management has deteriorated in Oregon resulting in more people dying in pain. According to one report, there were almost twice as many dying patients in moderate or severe pain or distress, as there had been prior to Oregon’s assisted suicide law being used. Fromme et al. Increased family reports of pain or distress in dying Oregonians: 1996 to 2002, 7 J.Palliative Medicine 431(2004). There is a large number of Oregonian doctors opposed to this practice.
The second argument that Professor MacLeod makes is that “prohibiting suicide is not the same as forcing people to live beyond their time.” The entire area of over-treatment or futile care is one that is receiving significant attention, in part due to healthcare cost and in part due to concerns that such care is not in the best interest of the patient. That said, we must be very careful as Professor MacLeod warns, that we not confuse avoiding overtreatment with denial of proper treatment.
His final argument against assisted suicide initiatives rests on the communal nature of human beings and that fact that the death of any individual has significance to others. It is false to claim that the decision to take your own life (or to assist another in doing so) is purely a private matter, and the law should not treat it as one.
Professor MacLeod’s post is a helpful review of the arguments of both sides and well worth the time to read.