Category: Health and Wellness
Tom Keane, writing in this Sunday’s Boston Globe, trots out all of the old fears and misconceptions about assisted suicide to scare people in Massachusetts to believe it is not an option that should be available to those who might opt for it. Keane believes that others — not you — know what’s best for you. Even when you’re dying of a terminal disease.
That’s too bad. Because we now have a couple of years of evidence from Washington state and nearly 15 years of evidence from Oregon — who have allowed for assisted suicide — that demonstrate fears about allowing assisted suicide are based largely in irrationality, not data.
Assisted suicide for those who are at the end of their lives, often in unbearable pain, is an option that should be available for all Americans. It is unconscionable that Keane believes he knows what’s best for you and I when it comes to our end-of-life decisions. It’s my life, and it should be my choice to die with dignity.
I don’t want Keane — or the government — telling me I have to suffer just because medicine or some random doctor says I have to. I want to die on my terms — in peace, not in pain.
Keane’s argument is a bit irrational itself, appealing to emotion rather than logic. Rather than rolling out data or actual cases where his fears have been realized in the U.S., he instead appeals to our fears:
A diagnosis of a terminal illness can easily leave patients despondent and considering taking their lives; the new law legitimizes that contemplation.
No, the new law recognizes the fact that terminal illness is, by definition, a death sentence. The actual length of one’s life might vary from that point, but it almost never changes the basic fact — you’re going to die a lot sooner than you imagined.
The new law also legitimizes what patients have simply been doing on their own for centuries. I’m not sure that’s a bad thing, when the law catches up with actual citizens’ practice.
But to scare you further (because, again, this is an argument based upon emotion, not logic), Keane trots out a scary letter:
Several years ago, in fact, one Oregon health plan, having refused to pay for medication that might prolong a patient’s life, sent her a letter proposing suicide as an alternative (and said it would be happy to pay for those drugs). With the new law in place, the economic incentive for Massachusetts insurers would be to encourage the cheaper way out as well.
Keane fails to mention an important component of the case1 — many health plans limit coverage of prescription drugs meant solely to extend someone’s life, but cannot cure the cancer itself.2 It’s a slightly more complex case than Keane summarizes above in a single sentence. The actual problem appeared to have little to do with assisted suicide, but a lot to do with the slow-moving wheels of bureaucracy keeping its policies up-to-date:
“We are looking at today’s … 2008 treatment, but we’re using 1993 standards,” Fryefield said. “When the Oregon Health Plan was created, it was 15 years ago, and there were not all the chemotherapy drugs that there are today.”
So the best example of the “evils” of an assisted-suicide law appears to be an insurance company letter that was misinterpreted by its recipient? Really??3
And sometimes his attempt at logic just breaks down altogether:
Many of the objections to the proposed law are practical. “Terminally ill,” for example, is defined as death within six months. Why not a year, or for that matter 50 years (in which case, I guess, a whole lot of us would be eligible)?
Umm, because phrases need to mean something, no? This is the definition other states have used, and despite some people’s misgivings, seems to be a definition that has some substance to it. Yes, it may be arbitrary, but what does it matter? Isn’t most law, in fact, somewhat arbitrary?4
Last, just because our knowledge can never be absolute, that’s a poor excuse to be against something:
Granted, there may be times where life is meaningless and oblivion really is the better option. But none of us, even in extremis, can really know.
We can’t really know about a lot of things, yet that doesn’t stop us from seeking answers. That’s the basis of most religions — and most medicine. Doctors don’t know when they cut into you that it will actually improve or save your life. An unexpected complication and that minor surgery could turn into a surgery that takes your life.
That’s the nature of medicine — and of life.
Assisted suicide is a simple, reasonable and dignified choice that individuals at the end of their lives should be allowed greater access to. The only reason to withhold such access is the belief that government knows better than you what’s best for you at the end of your life.
I believe that few of us would agree that government knows what’s best for us in our personal health decisions. With all things being equal at the end of your life, would you rather gain a few weeks of life living in a hospital bed, heavily medicated, with tubes running from you, with machines helping you “live,” or would you rather die in a place and at a time of your own choosing?
Even if you choose, “hospital bed,” shouldn’t that choice be yours, and yours alone?
I agree entirely with this post, save for one thing. I can't stand the phrase "assisted suicide". Its not a suicide, because you're going to die anyway. It is an assisted death. However, it is not a suicide.
Suicide is taking your own life. If you have a terminal illness, and you are strapped to a hospital bed, with more tubes than a pipe organ running in and out of you, you no longer have a life. You're alive, but you don't have a life. Life has been taken from you by cancer or whatever illness you have. You are taking control of your death. Thus, assisted death, not assisted suicide.
I agree with both the previous posts. Having said that, Dan, I've noticed you like to post a lot of these, but usually just leave it at copying and pasting the article. Do you agree completely? Somewhat? disagree? It would be nice to hear your own thoughts.
Thank you, Ocean Dream. I was wondering about that myself. I always enjoy reading the articles, but often wonder how the poster feels about what he's posting. That would put a whole other dimension into it for me.
jess,
i'm totally with this artickle- and though it pains me to say it, if i lived in america i'd seriously be thinking assisted death for myself.
i watched a documentry actually narated by terry pratchett about assisted death, it's called choosing to die if anyone is interested. brings up a lot of valid points
but yeah... what's left for me to say really
totally with this idea
Dan, if this is too personal, just ignore it. But you said if you lived in America you'd be thinking assisted death for yourself. I'm certainly not advocating that you go do it, but I am curious why you'd have to live in America to consider it.
I, too, wonder why living here would be the only reason for you to consider it.
I fully agree with this article as well.
oh no, alicia, you totally miss understood me.
their is nothing wrong with america- nothing at all
all i was saying was, that if i lived in america, i could see that as an option for myself (the artickle only mentions america) and as far as i'm aware, it's not even legal here in the UK.
i wasn't hating on america if that's what you all were thinking
nobody was thinking that. we were wondering why you wouldn't do it elsewhere. seems you were the one who misunderstood.
Yes I like Cody's term for it. I do say that people should be able to decide if they want to live out naturally, or die assisted.
Doesn't much matter to me if they are sick or not either. I'd hope a well person would try to repair the problems, but if they must, do it neatly, peacefully. Don't jump in front of my truck to get your release please!
No no, Dan. I didn't think you were hating on America. That's not how I took it at all. I was just curious why you felt you'd have to be in America to consider that option, why you could not consider it in the UK. But if it's totally illegal there, it makes sense.
I have actually come full circle on this issue over the years. When I was younger, and Oregon was considering this law, many argued the "slippery slope" idea, that the disabled would be considered unfit and we would be subjected to a sort of eugenics.
I chalk my following that line of thinking up to youth, and a case of maybe panic / self-preservation even if it isn't fully justified.
At my age now, I have a wife and a daughter who is almost out of high school, plus for the foreseeable future I am all there is financially. That being said, if I became deathly ill in this country as a middle-income American, I would self-terminate rather than leave them with untold amounts of debt. This isn't anybody's fault, no particular politician or party, but the reality that is never talked about is that those of us on private insurance generally pay out quite a bit for private care as it goes. I am not complaining, I am being realistic. So, if we are to embrace a financially-incentivized system, one in which ability to pay is first consideration, we who pay for the system ought to by rights be able to refuse to pay for service, aka self-terminate should the situation arise. The only moral constraint I can possibly see, as the one who is currently financially responsible for two other people, is not leaving them with astounding amounts of debt.
I had a window into this as a young man working at McDonald's where an elderly woman was working there doing mainly what we young people should be but the elderly not so much. She was working out her retirement to pay for her husband's lifesaving measures, he had already been long dead.
I personally will never leave a wife or a daughter in that situation. I'm not arguing myself morally superior but I will challenge those who would call themselves supporters of the sanctity of life, while they support the very system that is by definition pro-markets and of primary concern is ability to pay. I don't so much take issue with the system, it is a machine and yields the results it yields. I simply make the case that anyone who supports a privatized payer-centric system by definition supports the potential customer opting out of buying the service, aka self-terminate if it looks like the job is going to be beyond my means to pay. I would think differently, if I either was wealthy enough to be sure I would be able to pay for everything, or if, like some cancer victims, my expenses were being covered by a 3rd-party research outfit. And, I'm not advocating anyone on entitlements think this way: you live in a nation where the rest of us by popular vote and republican representation have decided to sponsor you, which was our decision. So since we decided to do that for you, this should not be your concern. But for those of us who are private payers, this is my personal perspective. Rush Limbaugh, whether you love, hate, or don't care about him, was technically correct about healthcare when he said in this country it is like choosing whether or not to buy an expensive vehicle. He wasn't saying people are cars: he was saying, it is a commodity in this country. If you live where it isn't a commodity, or if you are already sponsored, this isn't your concern. But as a thinking individual I understand how it works for real, for us private payers, and so if I have the responsibility to pay, I also have the right to forego services / payment for services. Since it's a commodity for us working people, like buying a Mercedes, then by definition it should come with all of the responsibilities, and the rights, that commodities come with. And one of those rights is the right of refusal to purchase. I've thought about this a lot over the last few years, while the wife is attempting to get a second career off the ground and I daily feel the financial squeeze, if not more often than that.
Is assisted suicide legal in Oregon? I thought it was.
i'll check for you bea. not sure why it shouldn't be.
Yes it is. It was controversial but it was made legal in 1994.
And too there is the do not resuscitate form, DNR. I had this filled out by a lawyer. Paid money to do that. Worth it for me: There is a box on the form you check if you don't even want to be resuscitated from a heart attack. Agree with big doctor bills. It can be awful. And when you get to a point where medicine does nothing or the suffering is so terrible, folks have rights to make decisions. I myself don't want to be a burden to anyone. Glad we are there in this country to make our own decisions.
I've known too many people, doctors, families, friends, who were left with making these decisions. And no human being really wants to make that kind of decision for another person. So your action in getting your decision in writing is commendable.
Contrary to popular moral panic, this discussion has not been about taking others' lives, it's been about people making their own decisions so that others will not be tasked with trying to decide what you wanted. This is as true for people who don't want to be resuscitated as it is for people who want every possible conceivable lifesaving measure taken at all costs, and everyone in between.
The reality is people have "let themselves go", stopped eating, or any number of other means to terminate for millennia. Only now, the potential for lifesaving measures is so vast the whole landscape has changed.
Even the animals will crawl away, find a reasonably comfortable place, and die, if it comes to that.