Right To Die

By July 13, 2018 ethics

candle-2038736_1920The right to die issue – or death with dignity – as it has been named in the press and by advocacy groups, is a controversial topic. On one side of the argument some people are concerned that passing ‘death with dignity’ statutes and legalizing suicide might expose the most vulnerable groups of people in society. On the other side, some people suffering terminal illness are concerned with exercising their right to bodily autonomy, and deciding when and where that ends.

Briefly, in California, patients with less than six months to live determined to be of sound mind were legally able to be prescribed lethal doses of medication.  When the California End of Life Option Act went into effect on June 9, 2016, a group of anti-choice physicians filed a lawsuit seeking to halt the Act’s implementation. Judge Ottolia in August 2016 denied their request for an injunction to stop the new law from taking effect.

Recently, that changed when a Riverside County Superior Judge Daniel Ottolia deemed the bill to be illegally passed.  Disability advocates were overjoyed with his ruling and believe it was necessary to protect vulnerable and disabled people, many of whom might have persons that could financially gain from their demise.

This challenge of the law could possibly be overturned, as long as he refuses to revise his ruling.  However, the nonprofit organization Compassion and Choices have publicly called for him to set aside his ruling, and a survey done in 2015 by UC Berkeley declared that around three-quarters of California residents declared themselves in support of the death with dignity statute.

Currently, only seven states have a death with dignity statute on the books, as well as Montana, where assisted euthanasia is legal only with a court order. This is in stark contrast to Switzerland, where the attitude towards end of life care seems to completely different.  The attitude is so different that ‘suicide tourism’ is a phrase used to label people traveling from different countries to Switzerland for the purpose of committing suicide due to a debilitating illness or condition. Assisted suicide has been legal in Switzerland since 1942 for adults who are competent and capable of self-administering the drugs.

“She knew she had this option that the brain tumor could not defeat. If the suffering is to a point where, with all medical intervention they’re not able to keep her from suffering, like I said, she has the ability to pass away gently.”

– Dan Diaz, husband of Brittany Maynard, right to die activist

How much of a demand is there for this? In California, within the first six months of assisted euthanasia being legalized, 173 people were given prescriptions enabling them to end their lives.  Individuals allowed to choose this option were strictly vetted before being given the prescription medications. In addition to being terminal – less than six months to live, two doctors were required sign off on their prognosis, make two requests, one written and one verbal with at least fifteen days time between each request. As well, the standards for competency must be met, as one must make this decision of their own free will, and they would have to be capable of self-administering the lethal dose.  Assisted suicide is not an option for patients with a chronic illness or mental illness, only those with six months or less to live.

If California were to reinstate the law fully, some questions would surely be raised in the future. Such as, where is the line drawn between physical and non-physical diseases? Should a person with severe depression be allowed to end their life as it’s become unbearable? In The Netherlands, the courts would say yes. Recently, a 29 year old woman who was fully physically healthy chose assisted suicide due to severe, intractable depression that she believed impeded her from living a full life.

The debate over assisted suicide raises uncomfortable questions regarding competency, potential exploitation of vulnerable populations, the role of assisted suicide in minors, and other challenging topics.  This debate is a highly polarizing topic, and as science and medicine continually push the boundary between life and death, these questions will become more challenging, not less.