The story of Brittany Maynard has revived the debate over Oregon’s Death with Dignity Act. The law lets terminally ill patients end their lives with the aid of a doctor.
That Maynard is a pretty 29-year-old newlywed using her personal tragedy to broaden support for such laws provokes and rankles foes of physician-assisted suicide. She also rejects the term “suicide.”
Maynard suffers from a malignant brain tumor, which extensive surgery failed to contain. Given six months to live about six months ago, she and her family moved from California to Oregon specifically to obtain the right to shorten her suffering without resorting to deception. Washington state, Montana, New Mexico and Vermont now permit doctor-assisted suicide, as well.
Foes of such laws make a “slippery slope” argument. The existence of this option, they say, would pressure sick people to kill themselves.
But if you think about it, these laws can do the opposite. They can lessen a pressure that already exists.
It’s no secret that very sick people often shorten their painful lives with doctors helping them. And it’s no secret that, as these laws’ critics say, dying people sometimes feel pushed by heirs and exhausted caretakers to end their ordeal with a bottle of pills.
But by bringing dying patients’ desire to end their lives into a legal framework full of safeguards, such decisions can be made — or not made — with greater compassion and less deception. The Oregon law insists that two physicians determine that the person will probably die in six months or less. Patients must be screened for depression and told of alternatives, such as hospice care. And the patients must take the lethal prescription themselves.
“The patient can change their mind right up to the last minute,” Maynard has said. “I feel very protected here in Oregon.”
Making a different case, social conservative Michael Gerson writes that a “right” to die “begins to look more and more like an expectation.” But laws such as Oregon’s move any expectation into the open.
Terminally ill people are often very depressed and socially isolated. And if they are surrounded by “loved ones” who, for personal reasons or by their own notion of mercy, think an earlier death would be for the best, death-with-dignity laws can bring in outside guidance. If depression is making them feel life is not worth continuing, that can be treated. And the patients can learn about other approaches to deal with pain — that is, palliative care.
This is a very uncomfortable conversation but one that must be held. Terminal illness does not come with simplistic guidelines. That is doubly so in an era when medical technology can prolong a life in agonizing ways — ways that would have been unrecognizable in the world of the Victorian deathbed. For example, is rejecting another round of chemo a decision to die?
Nor are there easy political divisions between supporters and opponents of such laws. Libertarian conservatives support them as an expression of autonomy over one’s body.
A Gallup poll found a slim majority of Americans now regarding “doctor-assisted suicide” as morally acceptable. The percentage rises when “suicide” is replaced by a less emotional term. In another Gallup poll, 70 percent agreed that doctors should be allowed to end patients’ lives “by some painless means” if that’s the wish of the patients and their families.
Caring for the terminally ill creates ethical slopes going in all directions. What death-with-dignity laws can do, ironically, is apply some brakes to making such decisions. As such, they may offer the least slippery slope of them all.
Froma Harrop’s email address is fharrop@gmail.com.
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