The Globalization of Assisted Suicide

Courtesy of Desiring God

By Lara Cornelius, Staff Writer

Last November, Colorado approved a medical aid in dying ballot by two-thirds majority that allows those who suffer form a terminal illness to take doctor-prescribed sleeping medication that is life-ending. Aid in dying, or Proposition 106 (known as the End of Life Options Act), is a widely debated issue that involves thousands of individuals and millions of dollars but affects only a small number of people.

In the United States, Oregon’s “Death with Dignity” law, passed 22 years ago, has been followed with similar laws by the four other states of Washington, Vermont, Montana and now Colorado. The requirement for this decision is that two physicians have to approve and agree the person has fewer than 6 months to live and has the mental capacity to make medical decisions. This person would have to self-administer the dosage of the lethal prescription drug. Although this bill has been passed, aid in dying still is not necessarily broadly available to patients. Patients and families are feeling frustrated that the process is not as seamless as they expect it to be and it is difficult to find doctors willing to prescribe lethal drugs and for pharmacies to fill prescriptions.

There has been strong opposition to aid in dying or assisted suicide from many different angles. The Catholic Church has been extremely resistant to the idea of aid in dying on the basis of religion and morality. The Church states that “The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded.” Individuals who do not support the law state that there is a lack of safeguards, such as no requirement for a doctor to be present at the time of death, to prevent potential problems, like an heir scheming the death of a family member to gain inheritance. “Doctor shopping” is also seen as an issue. There was a “No Assisted Suicide Campaign” that said that “human life is sacred at every stage and should be protected.” Medical care that makes it possible to keep the terminally ill alive is costly, raising fear that some may chose suicide to ease the burden on their relatives. There is also the fear that this law could lead to insurance companies determining it is more cost-effective to provide this sort of aid in dying than lifelong medical care.

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In four European countries, Switzerland, Luxembourg, Belgium, and the Netherlands,  there are even less requirements for assisted suicide. The Netherlands was the first European country to approve assisted suicide, maintaining that the patient’s suffering must be unbearable, but this is not limited to physical suffering such as pain. This could include fear of suffocation, for example, or increasing personal deterioration as well as loss of dignity. Dutch law covers adults and children over 12 who are suffering unbearably with no prospect of relief. Switzerland permits even adults who are neither ill nor Swiss residents to be helped to die. Belgian law is similar, stating that the patient’s suffering must be unbearable and result from an incurable disorder, and also has no requirement for the patient to be terminally ill.

Belgium is the only country in which euthanasia is legal for all ages. Euthanasia refers to a procedure in which a doctor takes a person’s life, whereas assisted dying involves the patient taking the final action themselves. In August of 2o14, the first case of a minor, a 17 year old, committing doctor-assisted suicide was reported. There was much controversy regarding this and the fact that in the 10 years since this approval in Belgium, the number of cases rose from 1000 to 8, 752. One supporter of this liberal legislation stated: “I think it’s very important that we, as a society, have given the opportunity to those people to decide for themselves in what manner they cope with that situation.”

There are many controversial ideas and questions that are raised as a result of these laws. Where do you draw the line? What happens when this option becomes the more pragmatic and practical one in this country, replacing the common practice of sending the elderly to a nursing home? Could it ever go to the extreme? 1984? Playing God?

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“One of my patients called me and asked me if I was comfortable supporting her decision for assisted dying,” said an oncologist in Denver, Colorado who has mixed feelings about assisted dying. She personally has only been part of the process for one patient, but under circumstances in which she felt comfortable doing so. The doctor knew the patient for three years–she was actually her next door neighbor–and she knew about the details of her terminal disease. This doctor explained that, “If it wasn’t my patient, I would not feel comfortable writing a prescription or supporting this choice.  I could be a consultant for other patients based on where they are in their disease, but I would have restrictions towards being an advocate for the process. It’s a very tough choice to make as a doctor. We also have two conversations with the patient – the second one after several weeks, in order to make sure they really want to go through with it.” When asked if this doctor personally supports this sort of end of life option, her response was, “I believe it does have a role. There’re people that don’t want to go to a nursing home, they’re exhausted and they are suffering. I have seen enough cancer to know how debilitating it can be and how it can remove people’s dignity in the process when they cannot control the pain. But from a religious perspective assisted dying does not have a role, and that is why some doctors do not feel comfortable at all being part of this decision. Yet it is also important to note that many people request this option, although very few go through with it.”

Assisted dying or assisted suicide will continue to be a controversial subject. What does this mean in terms of ethics? Right now we put dogs to sleep. This is assisted death. What will happen as we become more comfortable with the idea?

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