In less than four months, our Canadian neighbors will become the fifth western country to legalize physician-assisted suicide.
Such legalization creates a pseudo-autonomy that burdens the terminally-ill and elderly to face to their “duty to die.”
Ideally, physician-assisted suicide grants greater patient control over end-of-life decisions; however, serious flaws emerge within its paradigm. First it suggests to the terminally-ill and elderly that they’re lives are not worth-living anymore, morphing into an insidious, sacrificial morality which many proponents advocate as their “duty to die” and save resources for the next generation.
Secondly, physician-assisted suicide inherently endangers the vulnerable by sharing decision-making power with a physician who renounced his oath to “do no harm.” Ultimately, autonomy rests in the pen of physician to prescribe the lethal dose of barbiturates. In America, Medicare funding is expected to rise 72 percent over the next eight years and physicians are already making tough decisions to ration medicine. How many think the elderly and terminally-ill have a duty to die?
In 1984, Colorado governor Richard Lamm famously said that the elderly have a “duty to die and make way for the next generation.” Referencing Lamm’s statement in the opening sentence of his infamous Hastings Report, philosopher John Hartwig says that people are “victims of twisted moral reasoning or vicious social pressure,” if they think legalizing physician-assisted suicide obligates a duty to die.
If you keep reading, however, Hartwig asserts that “to have reached the age of, say, seventy-five or eighty years without being ready to die is itself a moral failing, the sign of a life out of touch with life’s basic realities.”
Proponents of assisted-suicide claim that the patient’s consent protects them from Hartwig’s credo. Those over eighty years old may have a supportive family who do not see grandpa or grandma as a moral failing, but their physician or insurance company may decide otherwise.
The perilously slippery slope of assisted-suicide has been well-documented in the Netherlands, where it has been legal since 1981 and displays a frightening trajectory.
In 2013, the number of deaths by assisted-suicide rose by 15 percent and another 10 percent in 2014. These numbers do not include the projected 23 percent of unrecorded additional assisted-suicide deaths, as reported in a 2010 Lancet study.
The most shocking statistics come from the Remmlieck Report, the most comprehensive study on end-of-life deaths in the Netherlands. A 1996 study documented that beyond the roughly 3,600 cases of physician-assisted suicide and euthanasia reported in that year, approximately 1,000 cases of involuntary euthanasia were reported.
Is this what patient autonomy looks like?
Responding to a survey spanning from 1998 to 2014, of the 857 terminally-ill patients who died by ingesting a lethal prescription dose under Oregon’s Death with Dignity Act, 96 percent said an end-of-life concern was loss of autonomy, compared to 33 percent who listed uncontrollable pain.
The number of deaths by physician-assisted suicide has been steadily rising since its legalization in 1997.
Legalizing physician-assisted death has been slow-moving in the U.S., but as presidential candidate Hillary Clinton expressed her desire to “catalyze the debate,” Americans should expect to see legislation on assisted suicide reach the federal level in the near future, regardless of which president is elected.
Instead of privileging patient’s wishes, assisted suicide damages the integrity of the medical profession and leads to uncontrollable consequences. Americans need only look across the Atlantic for proof.
