‘Death with Dignity’ Ballot Question Stirs Debate

By Kelia Cowan, Paige Moulton, and Hillary Weiss
Boston University News Service

Doctors spend their lives trying to save people, but Question 2 on the upcoming Massachusetts ballot would create an immunity statute for doctors so they can provide patients with a relatively humane method to end life without facing retribution.

A similar law was passed in Oregon in 1997, and the number of people taking advantage of it has slowly grown.  In 2011, 114 patients received a prescription for the life-ending medication, according to the Oregon Public Health Division.   Now, other states, along with Massachusetts, are considering what has come to be called “physician assisted-suicide.”

A recent Public Policy Poll in Massachusetts showed 56 percent were in favor of the act and 30 percent opposed.

The question of assisted suicide is an emotional one by nature, but many opponents of the idea say they are rejecting the idea for practical reasons.

“It’s not even about how a person feels philosophically about physician-assisted suicide,” said Andrew Hoglund, spokesperson for The Committee Against Physician Assisted Suicide.  “It’s about what’s in Question 2 and what isn’t.”

Safeguards are missing, contends Hoglund.  The proposal, for example, lacks a requirement for a psychiatric evaluation.  Last year in Oregon, only one person who received the prescription had been evaluated.  After the prescription is provided, there is no oversight; it is self-administered at the patient’s discretion.

The reports coming from Oregon are not thorough, according to Diane Coleman, and they leave out significant facts.

“They don’t investigate. They don’t enforce,” said Coleman, president and CEO of Not Dead Yet, an organization based in New York that advises a Massachusetts group, Second Thoughts.  Both groups represent people with disabilities.

“Basically, it sets up a double standard for how doctors and other people respond to someone who says they want to die,” said Coleman.  She said this act will carve out a specific portion of the population who, unlike most people, will not get suicide prevention when they talk about death.  “We call that discrimination,” said Coleman.

Proponents of the act, formally called “An Act Relative to Death with Dignity,” say the proposal includes safeguards.  Terminally ill patients are only eligible for the life-ending medication, such as a short-acting barbiturate, if doctors have given them a prognosis of six months or less to live.  In addition, two doctors must verify that the patient is mentally competent to make this decision.  Patients must request the drug several times, both verbally and in writing.  Doctors also have the option of rejecting the request if they do not think the prescription is in the best interest of the patient.

Those faced with such a decision often do not want to die; it’s simply the best means to the end.

Dr. Peter Goodwin, an Oregon physician who was diagnosed with a progressive neurological diseases called corticobasal degeneration, decided to take advantage of the Death with Dignity Act in his state while he still had the opportunity to die as he wished.

“I don’t want to die. No way do I want to die. I enjoy life; I enjoy company; I enjoy my friends,” he said in an interview with NPR in September 2011 before his death in January. “I’m going to try and have a six-month prognosis, making me eligible to use the law before I lose my marbles.”

Advocates for the Death with Dignity Act contend that the misperceptions about the act are the primary reason voters disagree with it.  Some see problems with the term “physician assisted suicide,” which has become synonymous with the act.

Doctors will have the option of helping patients,” said Dr. Marcia Angell, a senior lecturer at Harvard Medical School.  Doctors are not leading patients to the end.  “About one-third of the patients who receive the prescription never take it.”

Dr. Angell was the first person in Massachusetts to sign the petition for the Death with Dignity Act.  The act has personal meaning: her father used a gun to take his own life rather than eventually succumbing to his cancer.

“Dying by inches and knowing your course is inevitably downhill is terrible,” she said. “It’s not only about compassionate and humane options but it’s also a matter of choice. Giving that right to choice gives the right to self-determination. It gives patients a peace of mind and a sense of control.”

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