Opponents of physician-assisted suicide want people in the pews to understand a very simple point: in regard to this issue, precise language is extremely important.
It is especially crucial when dealing with the messaging put forth by the national nonprofit group that is pushing assisted-suicide bills onto state legislatures – the misleadingly named “Compassion and Choices.”
“We are battling the same challenge in framing the issue as people were when they faced the abortion issue in 1973,” said Jennifer Briemann, executive director of the Maryland Catholic Conference. “Instead of talking about ‘suicide’ now or the killing of a child then, we are confronting a conversation about assisted suicide that falsely couches the issue in terms of ‘compassion’ and ‘choices.’ We are now in the pre-Roe v. Wade days of assisted suicide. We must be careful not to repeat history — and should craft our words accordingly.”
For three years, Briemann’s office was a key player in defeating assisted-suicide bills in the left-leaning state of Maryland. Then, during the 2017 general assembly, the bill was pulled by its co-sponsor before it even had a committee hearing, thanks to the efforts of the coalition Maryland Against Physician Assisted Suicide (MAPAS).
“It was very important that the voices protesting this issue represented a broad swath of our secular culture,” explained Briemann, whose office is part of MAPAS. “That includes disability groups, anti-suicide groups, the autism community, doctors, nurses, hospice workers, EMTs, pharmacists — the list could go on.”
This need for awareness was highlighted by the recent activity of the American Medical Association (AMA).
Two years ago, their house of delegates charged their Council on Ethical and Judicial Affairs (CEJA) to research two questions regarding physician-assisted suicide: Should the AMA move their position of opposition to a position of neutrality, and should they change the official phrasing from “suicide” to “aid in dying”?
The ethics committee came back in June 2018 to the entire body of delegates in the AMA, saying that after exhaustive research they concluded that the organization should remain opposed to the practice, and that the name “physician-assisted suicide” was, indeed, the correct phrase.
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While there are myriad reasons to be morally opposed to physician-assisted suicide, the bills themselves have plenty of points that raise practical red flags.
1. No mental health evaluation is required before the patient receives a life-ending prescription.
2. No education is given by the pharmacist to the patient on proper use or disposal of the highly addictive drugs used in assisted suicide. There is also no takeback plan if the patient ends up not using the drug.
3. The bills allow for insurance fraud, mandating the patient’s cause of death not be listed as suicide.
4. No witnesses are required at the time of death. Patients may be coerced into ingesting the drug, or another person may administer the drug, leaving serious potential for abuse.
5. There is no way to predict an accurate prognosis. Patients can request assisted suicide if diagnosed with a terminal illness and given six months or less to live. But, medical prognoses are based on often-incorrect averages, and patients frequently outlive them.
6. There are no safeguards for the disabled. The bills pose many dangers to those with intellectual and developmental disabilities, such as falling prey to undue influence from doctors or family members, resulting in a lack of true informed consent.
7. The doctor is not required to notify the family of the patient’s decision.
8. No doctor, nurse or independently licensed aid worker is present when the patient ingests the lethal dose. If something goes wrong, any physical or emotional complications must be handled solely by the patient and those witnessing the death, if any are present.
Rita Marker, executive director of the Patients Rights Council in Steubenville, Ohio, agrees with their decisions. “There are many words that we think mean one thing but they mean another,” she said. “‘Aid in dying’ could mean plumping the pillow or wiping the brow. These words mask the reality. The AMA recognizes that and uses the correct term ‘assisted suicide’ — because that’s what it is.”
However, the council’s findings went to the entire house of delegates, who voted to not approve the findings. They sent the council back to the drawing board.
Dr. Joseph Marine, a cardiologist at Johns Hopkins University and a member of the AMA, emphasized that the official position has not changed, although the house of delegates is showing that they feel the pressure of groups such as Compassion and Choices.
“[Those groups] actually have a published game plan for how to infiltrate and turn the opinion of state medical societies away from opposition to assisted suicide to ‘neutrality,’ which is being interpreted by state legislators as a green light,” explained Marine. “Unfortunately, it creates the appearance of using political force or political pressure to produce a result that should be based on study and ethical considerations.”
State legislative battles
It’s also important for people in the pews to realize that these laws are playing out in the state government.
“You need to get to know your state delegates or representatives or senator and make your opinion known. A small group of opinionated people can have a big impact at the state level,” said Marine. “Those politicians really want to make their constituents happy so they will listen.”
There’s more good news. First, Compassion and Choices is pushing nearly the same version of the bill in each state. That means opponents can anticipate the best strategies to defeat the bills as they go through legislatures. Second, in the last two years, an assisted-suicide bill has been introduced in at least 30 states and was only passed in two, signaling that legislators’ constituents do not want the bill.
“It’s important, as difficult as it may be, to not make assisted suicide a religious issue,” said Briemann. “Polling in our state showed that people’s opposition to assisted suicide dwindles when it is posed as a religious issue versus an issue that is a violation of basic legal and human rights.”
And similar to the abortion debate, the “choices” aren’t really there. “When people talk about this being a choice, it may be a choice for the comfortably well-off. But it could be the only medical treatment the poor can afford,” said Marker. “The laws say you have to tell someone about all feasible alternatives. Well, you can tell them about feasible alternatives, but that doesn’t mean they can afford them.”
Abuses stemming from this scenario are already happening, according to MAPAS. In 2008, a woman named Barbara Wagner asked the Oregon Health Plan to cover treatment for her cancer. The insurance denied her claim but offered to pay for the $50 assisted-suicide drugs.
And, added Marine, the assisted-suicide bills are highly discriminatory and rightly protested by disability groups, who he says are among the strongest forces keeping the bills at bay.
“For everybody else in our society who presents with the desire to take their own life, we offer those patients suicide prevention. We just had some high profile suicides with Anthony Bourdain and Kate Spade. There was all this information put out in the public domain about suicide prevention and suicide hotlines,” he said. “But now with these assisted-suicide laws there’s a big ‘except.’ ‘Except’ if you have a disability or a terminal illness. You’re really creating a special class of people who have lost all of these protections of the law and the medical profession from suicide and self-harm.”
Mariann Hughes writes from Florida.