Focus on the Family (USA)
Q: What is physician-assisted suicide?
A: Physician-assisted suicide (PAS) is much different than refusing treatment. PAS involves a medical doctor who gives a terminally ill patient the means to commit suicide, usually by an overdose of prescription medication.
Q: Is physician-assisted suicide legal?
A: Physician-assisted suicide is illegal and a crime in most states. It’s only legal in Oregon, Washington State and Vermont. The law is less clear in Montana. The issue is the topic of an ongoing court case in New Mexico.
Q: Can patients refuse to have treatment and decide they want to die?
A: Yes, mentally competent adults can refuse or stop treatment at any time. The medical decision-maker for a non-competent adult can also make that decision. So fears that technology will keep you alive past the time of natural death are generally unwarranted. It’s also important to recognize that today’s health- care climate lends itself more to under treatment than overtreatment.
It’s one thing to say, “I don’t want any more treatment. I want to allow the natural dying process to take its course.” It’s something quite different to ask a physician to violate the Hippocratic Oath of “Do No Harm” by prescribing drugs for suicide (physician-assisted suicide). That crosses a bright moral line that protects patients, especially when they are vulnerable due to a terminal diagnosis.
Q: Why do people commit suicide using drugs from a physician?
A: You might think most people want to commit suicide to avoid pain at the end of life. However, the most common concern cited in Oregon and Washington State is the loss of autonomy, followed by being less able to engage in enjoyable activities and loss of dignity. While these concerns are important, the premature death of the patient by suicide is not the only way to address these needs.
Q: What about someone who doesn’t want to be a burden to his family and friends?
A: The notion of being a burden is most often the perspective of the person who is receiving care, not the one providing the support. A parent doesn’t think twice about caring for a newborn or toddler that needs help. The same holds true for most family members when it comes to their loved ones: It’s not a burden to care for those we love!
Our culture prides itself on being independent and having autonomy. Some people may think, “I’d rather be dead than dependent.” This speaks volumes to how we value independence, even above the value of human life. The attitude that, “I’d rather die than be dependent on someone else” sends a larger message that life only has value if it’s independent of others. It’s a message that is heard often loud and clear by the elderly, infirm and disabled who need and deserve our care, and do not want assisted suicide. Physician-assisted suicide sends the message that some lives are not worth living.
Q: What’s wrong with a patient committing suicide if they are dying anyway and don’t want to suffer?
A: The desire for death by suicide (physician-involved or otherwise) speaks to larger issues for the patient, and for society.
Suicide is a moral issue: Do we have moral authority to end our own life? Western civilization has long considered suicide morally wrong based on the belief that human life is a gift from God — regardless of its circumstances. Life itself has purpose and value.
Patients facing a terminal illness often experience a wide range of emotions, including hopelessness, depression and fear. The desire for suicide before a natural death likely indicates the patient is afraid of what is to come or doesn’t view his life as having value.
Every human being is terminal; at some point all of us will die. Suicide eliminates the “what if” possibilities that may occur: The discovery of a new treatment or cure, the realization of an incorrect diagnosis, or the opportunity to have one last kiss or touch from a loved one.
It may seem ironic but laws, such as in Oregon, encouraging physician-assisted suicide actually work to deny terminally ill patients death with dignity. That’s because human dignity comes from God and is affirmed by those around us, especially when others care for us in our last days. There are incredible life-giving experiences that happen in this difficult journey for both the patient and their loved ones, but physician-assisted suicide piles sorrow upon sorrow.
Q: What about expensive medical bills for treating disease?
A: Remember patients can decide how much or how little treatment they want. By the time a patient is in hospice care (with a diagnosis of six months to live), the care is focused on making the patient comfortable, not treatment.
Suicide is much less expensive than treatment and care and that fact raises red flags for many in light of today’s demands to “manage” health care costs— even by rationing care for patients whose lives are deemed less valuable. In a dollar driven health care environment, the inexpensive cost of assisted suicide is a great concern, as it can be used as a way to reduce the amount of health-care dollars spent per patient.
Do we want patients being pressured to end their lives with suicide as a “duty” to die in order to save money?
Q: What about pain and other physical symptoms at the end of life?
A: Pain- and symptom-management has improved greatly in recent years, thanks in part to the expansion of hospice (palliative) care. For most patients, pain can be controlled along with other physical symptoms of disease and the dying process. Palliative care addresses the physical, psychological, emotional and spiritual needs of the patient and the patient’s family.
As mentioned previously, fear of not controlling pain is not a primary reason for physician-prescribed death.
Q: Can doctors be wrong about the diagnosis and prognosis?
A: Yes, there are many stories of incorrect diagnoses and predictions, as well as numerous cases where people have lived far beyond their doctor’s predictions, and some people who have been cured from their terminal disease.
People living with terminal illness deserve more than the offer of a physician to facilitate their death. They merit true compassion and that’s not found in a bottle of pills. True compassion is when people come along side you in this journey.