Open Letter: HB 54 Opposition
By Jim Minnery
April 18, 2018
We are writing to express our opposition to CS for Sponsor Substitute for House Bill 54(HSS):
“An act providing an end-of-life option for terminally ill individuals; and providing for an effective date.”
HB 54 would authorize physicians to intentionally prescribe a lethal dose of drugs for the purpose of helping facilitate a person’s decision to take his or her own life.
Alaska Family Action opposes the practice of physician-assisted suicide (PAS) for the following reasons:
1. Legalization of physician-assisted suicide jeopardizes the vulnerable.
Similar to PAS laws in other states, HB 54 contains no mandatory requirement that individuals seeking to end their own lives be referred for a psychiatric consultation.
Dr. Aaron Kheriaty, a psychiatrist and Director of the Medical Ethics Program at the University of California Irvine School of Medicine, has described how the legalization of assisted suicide can exploit vulnerable people:
“Many Americans already lack necessary access to mental health services, and [legalizing assisted suicide] places these and other vulnerable individuals at risk. The desire to end one’s life, or the request for assisted suicide, is nearly always a cry for help. It is a distress signal, a kind of ‘canary in the coal mine,’ indicating that something in the patient’s situation (medical, psychological, or social) is not adequately being attended to – an untreated clinical depression, fear or anxiety about the future or about one’s medical condition, untreated or undertreated pain, family or relationship strain or conflict, and so on. Well-replicated research demonstrates that 80 – 90% of suicides are associated with clinical depression or other treatable mental disorders, including for individuals at the end-of-life and individuals with a terminal condition.... Yet alarmingly, according to the Oregon Health Department’s annual report, only 5% of the individuals who have died by assisted suicide under Oregon’s law were referred for psychiatric evaluation – and this number is decreasing every year. Considering what we know about suicide risk factors, this constitutes medical negligence.” (Letter from Aaron Kheriaty, M.D. to Andrew Gurman, M.D., President of the American Medical Association, November 9, 2015. Emphasis in original)
2. Physician-assisted suicide corrupts the practice of medicine.
Physicians have taken the Hippocratic Oath for many centuries. It states in part: “I will keep [the sick] from harm and injustice. I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect.”
Bills such as HB 54 tend to blur a very important ethical distinction: patients and their health care providers are not obligated to preserve or extend life at any cost, but a decision to forego treatment is not the same as purposefully ingesting a massive dose of lethal drugs that is designed to kill.
Ryan Anderson, Senior Research Fellow at the Heritage Foundation, writes:
“Human life need not be extended by every medical means possible, but a person should never be intentionally killed. Doctors may help their patients to die a dignified death from natural causes, but they should not kill their patients or help them to kill themselves. This is the reality that such euphemisms as ‘death with dignity’ and ‘aid in dying’ seek to conceal.” (“Always Care, Never Kill: How Physician-Assisted Suicide Endangers the Weak, Corrupts Medicine, Compromises the Family, and Violates Human Dignity and Equality,” by Ryan Anderson, March 24, 2015, available at www.heritage.org)
3. Physician-assisted suicide will lead to worse violations of human dignity.
Advocates of physician-assisted suicide argue in soothing language that there is no “slippery slope” whereby PAS will eventually lead to voluntary euthanasia, and then to involuntary euthanasia. Unfortunately, ideas have consequences – whether we choose to face them honestly or not. The consequential “idea” that is inherent in laws allowing physician-assisted suicide is that some lives are not worth living.
The logic of the “right to die” movement is inexorable: if those deemed to be “terminally ill” have a personal autonomy right to receive lethal drugs to take their lives, then why not the chronically ill? Why not the profoundly disabled? The experience of assisted suicide and euthanasia in Europe shows that these ethical landmines are real, not imaginary.
In 2012, twin brothers Marc and Eddy Verbessem were euthanized in Belgium, at their own request, when they discovered they had a condition that would eventually cause them to be blind. The brothers decided they would rather be killed than live their lives without vision. In 2013, Nancy Verhelst was euthanized in Belgium. She requested euthanasia based on “unbearable psychological suffering” resulting from a “sex change” operation that had yielded unsatisfactory results.
Dr. Ezekiel Emanuel, noted oncologist and bioethicist, acknowledged the reality of the “slippery slope” dynamic in an article for The Atlantic:
“The Netherlands studies fail to demonstrate that permitting physician-assisted suicide and euthanasia will not lead to the nonvoluntary euthanasia of children, the demented, the mentally ill, the old, and others. Indeed, the persistence of abuse and the violation of safeguards, despite publicity and condemnation, suggest that the feared consequences of legalization are exactly its inherent consequences.” (“Whose Right to Die?,” Dr. Ezekiel Emanuel, The Atlantic, March 1997; emphasis added)
HB 54 proposes a dangerous public policy for Alaska, and it diverts attention away from real solutions – such as promoting better palliative and hospice care – that can yield real benefits for enhancing the dignity of vulnerable people at the end of life. We respectfully urge you to oppose this legislation.
Standing for Families,
Received April 16, 2018 - Published April 18, 2018
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