D. Joy Riley, M.D., M.A.
I doubt that Paul Simon had Physician-Assisted Suicide (P-AS) in mind when he penned the words to “Slip Slidin’ Away,” but they seem strangely apropos. The terms in the debate are the first to slip, slide away: the Hemlock Society became Compassion and Choices. The latter, which is involved in the Tennessee debate, is hopeful that physician-assisted suicide will become “aid-in-dying”; that is, before it slips into voluntary euthanasia, and then slides away into involuntary euthanasia.
What would happen if physician-assisted suicide (P-AS) were legal?
- The role of physicians would be drastically altered. Guaranteeing a right to one means giving another a responsibility. Physicians would no longer be healers, but killers. How does a patient place trust in a physician after such a dramatic shift?
- Who determines which therapy or prescription is offered? It is no secret that a prescription for barbiturates is cheaper than chemotherapy drugs. Just ask Randy Stroup or Barbara Wagner.
- Extending the right to P-AS to one person is like planting kudzu in the South. It will not stop there, but will surely spread. Voluntary euthanasia in Belgium is a case in point. Voluntary euthanasia is defined as “the act, undertaken by a third party, which intentionally ends the life of a person at his or her request,” per The Lancet. In 2002, Belgium granted that right to adults; in 2014, it extended it to children. (See also this Daily Mail article.)
- The “right to die” becomes “the duty to die.” Britain’s Mary Warnock, in arguing for a duty to die, wrote, “To fall on one’s sword may, in some circumstances, be what one most desires; but these days one may need help to do it.” This raises significant questions. What happens if the patient is/becomes too frail to self-administer the oral medication to kill him/herself? Who can help? Does a family member then administer it? If the oral medication doesn’t work, what happens? Is the physician required to draw up a syringe full of lethal medication?
- Some have equated P-AS with “natural death.” That is true in the same way that the result of a lethal injection in a state execution is “natural.”
Most assuredly, there is a better way. Pain control and comfort measures are both necessary and desirable, and can be provided through palliative care. We can share our selves, our time, and our goods with those we love as we confront life’s end together. Local organizations of No One Dies Alone provide volunteers to be present with those who have no family or friends close by. Fear — of pain, loneliness, loss of control — fuels the cry for physician-assisted suicide. The proper response to fear is not to kill ourselves early. Rather, we need to work together to address the fear, caring for one another in ways that relieve the fear and anxiety. We need to extend the care, not the killing.
A version of this article appeared in The Tennessean’s letters to the editor; read the piece here.