09 Mar Death With Dignity: Insights From Health Professionals Around the World
“Death with dignity” has become a topic of controversy within the last year, gaining attention from the media and now—state lawmakers. Last year, Brittany Maynard, a 29-year-old from San Francisco, California became the face of the “right-to-die” movement, when she moved to Oregon after learning of a brain tumor, and legally sought the help of a physician to end her life. This sparked a hot debate about a patient’s rights, suffering, and morals, and now it’s a conversation some lawmakers feel they’re ready to have.
Last week, HB 391 Utah Death With Dignity Act was heard in the House Health and Human Services Committee Meeting. On behalf of United Families International, I testified against the bill and its content. Along the lines of Oregon’s law, this bill would not only allow a patient with a terminal illness to request medication to end their life, but would also allow a person to potentially end their life if they were “suffering from…an intractable and unbearable illness.” The bill defines intractable and unbearable as “a bodily disorder that cannot be cured or successfully [relieved] and that causes such severe suffering that a patient prefers death.” Under that description, individuals with diseases such as multiple sclerosis and lupus could potentially be allowed to end their lives, if their condition was severe enough.
The principle that must be incorporated into this discussion is this: the law is a teacher. This bill, if made into law, speaks volumes about the worth of a life. I personally have close family and friends who suffer from lupus and MS—both of which are incurable and have symptoms that often go unrelieved. Not only is this bill harmful because of the experiences of my loved ones, but as a young patient, myself, who is being considered for a disease such as MS or lupus. Are our lives less valuable because we aren’t healthy?
Aside from allowing those who are not currently going to die choice to do so, there are several other factors surrounding the “death with dignity” debate that need to be taken into consideration regarding Euthanasia and Assisted Suicide (EAS). Medical experts from countries where assisted suicide has been legalized provide valuable insight on the issue:
- Some may choose to end their life because they feel it would be easier on their family. While this reasoning is understandable, it is not necessarily accurate.
- “…the psychological outcomes of bereaved family members are better for those who access [hospice] care services,” while “higher instances of posttraumatic distress disorder and depression in families who have witnessed EAS have been reported.”
- Misdiagnosis is common in life expectancy and illness.
- “Recognition of the final phase of life is…difficult to diagnose, and errors in prognostication are common…In some instances where EAS is legalized, there is a requirement that the patient be expected to die within six months…however, estimations of life expectancy are typically erroneous…particularly in the context of such chronic diseases…”
- “[Physician Assisted Suicide] poses considerable danger to people with new or progressive disabilities or diseases, who may often be misdiagnosed as terminally ill but who, in many cases, outlive these prognoses by years or even decades.”
- Death with Dignity has little to do with pain.
- “Supporters advocate its legalization by suggesting that it is needed for unrelievable pain and discomfort at the end of life. But the overwhelming majority of the people in Oregon who have reportedly used that state’s assisted suicide law wanted to die not because of pain, but for reasons associated with disability, including the loss of dignity and the loss of control of bodily functions.”
Again, lawmakers and citizens must consider what lesson the law would be teaching if a patient is not in pain, but is allowed to end their life because they don’t want to endure the humiliation of needing help to go to the bathroom. This sort of decision has negative implications for those who are not terminally ill, but have other disabilities that necessitate a great amount of caregiving from others. They are not less dignified because they are dependent on others to help them function.
- Patients with Psychological Disorders and Depression will be allowed to end their life.
In most “death with dignity” laws, a physician must refer a patient to a counselor, only if he/she believes the patient is “suffering from a psychiatric or psychological disorder or depression causing impaired judgment,” including the proposed law in Utah. This means that the patient who has depression or another mental illness that may be affecting them may have assisted suicide, as long as a physician perceives the illness is not affecting their judgment.
- One hematologist-oncologist explained that patients “consistently reported NOT to be in pain or disabled by their allegedly terminal illness but request [assisted suicide] because of fears of …helplessness, dependency, [and] becoming a burden. Oregon in fact has proven that the only symptom driving requests for [assisted suicide] is psychological distress.”
Symptoms of depression can often go unnoticed by doctors or may be easily hidden by patients.
- “An Oregon woman[‘s]…evaluating psychologist decided she was competent “on the basis of a single questionnaire administered by her family…” …when a psychiatric evaluation occurs, it tends to be used to protect clinicians rather than patients.”
- Fifteen days is not long enough. Assisted suicide may cut short a person’s time whose decision is based on the natural emotions associated with illness.
- “People with new disabilities frequently go through initial despondency and suicidal feelings but later adapt well and find great satisfaction in their lives…However, the adaptation usually takes longer than the mere 15-day waiting period required by…assisted suicide laws”
When it comes to something as valuable as a human life, it is crucial to consider the information provided by those countries that have legalized EAS. Health professionals have seen the negative impact it has on the surviving family members, and assert that many patients who are expected to die live much longer than the initially projected time frame. Accredited health professionals around the world who have dealt with physician-assisted suicide are warning us:
“The overwhelming majority of justifications for [Euthanasia and Assisted Suicide] focus on the individual who desires this pathway, while the potential impact on society, institutions, and healthcare delivery have received far less attention…most discussion around EAS and its place in the care of those with advanced illness is conducted in an environment far from the bedside, and removed from the experiences of those with the illness, their [care-givers], and the palliative care health professionals who deliver end-of-life care on a daily basis.”
Before we pass laws such as “Death With Dignity,” we must consider the effect it will have on individuals, families, and most importantly, what it says about the worth of a life.
Kristina Eberle is a Senior at BYU–Idaho, earning an undergraduate degree in Marriage and Family Studies. She is currently doing an internship with the Utah Chapter of United Families International at the State Capitol building. She looks forward to continue engaging in political issues and contributing to the process of collaboration between the two things she loves most—law and family.