A bill to legalize doctor-prescribed suicide in Alaska has been reintroduced in the State Legislature. House Bill 54, sponsored by Anchorage Democrat Rep. Harriet Drummond would permit doctors to prescribe lethal drugs to patients for the purpose of suicide. Drummond proposed a similar bill in 2015.
Opponents of the practice include physicians and faith leaders who believe that patients with terminal illness need proper care, not destruction.
Alaska’s highest ranking Catholic prelate who leads 30,000 Catholics in Southcentral Alaska — Anchorage Archbishop Paul Etienne — has called doctor-prescribed suicide “a violation of principles of good medicine.”
“Many sick people came to Jesus, and what he gave them was his care and his understanding, his touch and his healing. And that’s what good medicine is to provide, and that’s what families want to provide for people, members of their own family that are suffering, that are ill, terminally or otherwise,” Archbishop Etienne explained in an interview with the Catholic Anchor. “We want to offer them our gaze of love, we want to offer them our compassion, our accompanying presence. But leave the life choices up to God.”
The Catholic Church opposes suicide — doctor-prescribed or otherwise.
“We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of,” observes the Catechism of the Catholic Church.
Archbishop Etienne added that, in the face of suffering health care should strive for the “elimination of as much suffering as we possibly can through moral practices that respect that dignity and sanctity of human life, but to help people to take their own life is a violation of principles of good medicine.”
The U.S. Conference of Catholic Bishops (USCCB) teaches that suicide “breaks the bonds of love and solidarity with family, friends, and God.”
“Most people, regardless of religious affiliation, know that suicide is a terrible tragedy, one that a compassionate society should work to prevent,” the Catholic bishops observe.
The Alaska bill is part of a national push by an outside, multi-million-dollar operation called Compassion & Choices, formerly the Hemlock Society. To date, doctor-prescribed suicide — euphemistically called “medical aid in dying” and “death with dignity” — is legal in six states, Oregon, Washington, Vermont, California, Montana and Colorado, and the District of Columbia.
In a press release in 2015, Rep. Drummond lauded the Oregon law in particular. Since 1998, that law has resulted in 1,545 lethal prescriptions and more than 991 deaths. In 2015 alone, 132 people died by doctor-prescribed suicide in Oregon — almost eight times the number of deaths during the law’s first year.
PRESSURE TO DIE
Many patient and disability advocacy organizations — such as Access Alaska — oppose doctor-prescribed suicide because it targets vulnerable citizens who need care but are pushed to die.
“When people with disabilities see themselves as a burden, without worth or dignity, as taught or experienced in society, the option for assisted suicide becomes more of an attractive option,” Doug White, executive director of Access Alaska told the Catholic Anchor. “We teach, advocate, support and foster the belief that all people have intrinsic value to themselves, their family and their community.”
LAW OF THE LAND
In 1997, the U.S. Supreme Court upheld state laws prohibiting assisted suicide, recognizing “the real risk of subtle coercion and undue influence in end-of-life situations.” The Court observed that “legalizing physician-assisted suicide would pose profound risks to many individuals who are ill and vulnerable … The risk of harm is greatest for the many individuals in our society whose autonomy and well-being are already compromised by poverty, lack of access to good medical care, advanced age, or membership in a stigmatized social group.”
In 2001, the Alaska Supreme Court unanimously ruled that there is no state constitutional right to doctor-prescribed suicide. One of the primary reasons noted by Justice Alex Bryner who wrote the opinion, was that the “terminally ill are a class of persons who need protection from family, social, and economic pressures, and who are often particularly vulnerable to such pressures because of chronic pain, depression, and the effects of medication.”
DEATH FOR DEPRESSED AND DISENFRANCHISED
Drummond has argued that doctor-prescribed suicide should be available to Alaskans with a “terminal” condition or who are expected to die within six months — though such predictions are notoriously unreliable and could include people with chronic illness or disabilities not receiving appropriate treatment — and who are “experiencing so much pain that their quality of life is completely degraded,” though the bill does not specify that a person must be in pain to request lethal drugs.
But pain is not among the top reasons for taking lethal drugs. According to the Oregon Health Authority’s “Death with Dignity Act Annual Reports,” in 2015, over 90 percent of patients cited “losing the ability to engage in activities making life enjoyable” and “losing autonomy,” and 48 percent cited being a “burden” on family, friends or caregivers.
Most victims are vulnerable elders. “It seems solitary, dependent and chronically ill seniors are prime candidates for assisted suicide in Oregon,” the U.S. bishops’ conference notes. In 2015, 78 percent of those obtaining lethal drugs were aged 65 and over. Most were women; most had no health insurance, or only government insurance; and most had no living spouse. More than 96 percent received no psychological evaluation for suicidal thoughts.
Physical and psychological pain are treatable. According to a report by the National Institutes of Health: “…if all patients had access to careful assessment and optimal symptom control and supportive care, the suffering of most patients with life-threatening illnesses could be reduced sufficiently to eliminate their desire for hastened death.”
NO PROTECTIONS AGAINST ABUSE
Drummond’s bill does nothing to protect vulnerable elderly, disabled and depressed persons from abuse, according to opponents of doctor-prescribed suicide.
For instance, there is no requirement that all patients requesting lethal drugs be screened for depression or other mental illness before receiving those drugs. It’s up to the discretion of the prescribing doctor even though studies show depression is a normal response to terminal illness.
Moreover, there is nothing to protect patients from pressure that family members, caregivers or social stress might exert on a patient to request doctor-prescribe suicide.
Additionally, Drummond’s bill only requires after-the-fact self-reporting by the doctors prescribing the lethal drugs. And that information may not be made available for inspection by the public.
SUICIDE LIMITS CARE
Opponents of doctor-prescribed suicide also warn the practice limits health care options when patients need them most. Patient and disability organizations point to several cases in which cancer patients in Oregon and California, for instance, received letters from state Medicaid or other insurer denying coverage for expensive chemotherapy treatment while offering to cover cheap lethal drugs — which typically cost no more than $300.
Jan McCoy, a member of the Respect Life Committee at St. Elizabeth Ann Seton Church in Anchorage and former lobbyist for the National Right to Life Committee, says vulnerable patients are being “incentivized” to die. Saving money by ending life will become “the ultimate form of social responsibility,” McCoy told the Anchor.
“We just need to offer better things than death to people who are already in difficult circumstances,” she said.
MEDICAL ASSOCIATION OPPOSES PRACTICE
The American Medical Association opposes doctor-prescribed suicide. In its June 2016 updated Code of Medical Ethics, the AMA states: Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks. Instead of engaging in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life.”