Choosing Death, Ctd

Brittany Maynard, the 29-year-old terminal cancer patient who publicized her intention to make use of Oregon’s assisted-suicide law, took her life on Saturday. Sarah Kliff pushes for a broader conversation:

We don’t like to think about death — and so we don’t. State legislatures rarely grapple with assisted suicide laws in any serious way. Regulating death is terrible politics. And so death goes unregulated. But the dearth of debate and discussion doesn’t eliminate assisted suicide. Instead, it pushes it into the shadows, where doctors will only admit anonymously to helping patients end their own lives.

Surveys of oncologists show that some cancer doctors, when asked anonymously, will admit to helping patients die.

A heavily-cited 1996 survey of more than 2,000 doctors, published in the Lancet, found one in seven oncologists had “carried out euthanasia or physician-assisted suicide.” The real number might be much higher. Most doctors don’t like talking about physician-assisted suicide because they work in states where it is technically illegal.

Lindsey Bever cites some resistance to assisted suicide:

“Now we have a young woman getting people in her generation interested in the issue,” [Arthur] Caplan wrote in [an] article published on Medscape. “Critics are worried about her partly because she’s speaking to that new audience, and they know that the younger generation of America has shifted attitudes about gay marriage and the use of marijuana, and maybe they are going to have that same impact in pushing physician-assisted suicide forward. …

Ira Byock, chief medical officer of the Institute for Human Caring of Providence Health and Services, spoke loudly against the practice. “When doctor-induced death becomes an accepted response to the suffering of dying people, logical extensions grease the slippery slope,” he wrote in a New York Times op-ed. He cited statistics in Holland, where the practice is permitted, that claim more than 40 people sought and received doctor-assisted death for depression and other mental disorders. “Even the psychiatrist who began this practice in the 90’s recently declared the situation had gone ‘off the rails.’”

Olga Khazan remarks that there “are a number of questions prompted by Maynard’s death, but one of the most troubling is, what happens when the patient seeking lethal medications isn’t as bright, purposeful, and tranquil as Maynard was?”:

Oregon physicians reject five out of six requests for the lethal medication.

One reason: Physician-assisted suicide requests are less likely to be honored if the patient sees themselves as a burden or if they’re depressed. But because feeling unwanted and suicidal ideation can be two symptoms of depression, physicians may have difficulty knowing whether the patient would have a change of heart if their mental state improved. Does the patient want to die because they’re depressed, or because they’re terminally ill—or some combination?

Reflecting on the ethics, Jazz Shaw makes a distinction:

One commonly mentioned item – and a very valid one – is that we should be careful not to conflate assisted suicide (as was the case here) with the question of Do Not Resuscitate orders and excessive “heroic measures” to bring back those who have slipped beyond our grasp. This is something I may have unwittingly done, and clearly should not have. They are indeed two separate things, and the key feature which distinguishes them is that one involves extraordinary measure to delay a death which is imminent through natural causes while the other is a conscious choice to forcefully terminate a life which would continue for some time without intervention. Put more bluntly, one is suicide by definition while the other is an act of surrendering to the conclusion of events which arrive unbidden. …

I also read some very emotionally powerful arguments from readers about removing such decisions from God’s hands and taking them into our own. I cannot imagine a more heart rending burden than facing that question, and it is something which people of faith may have to deal with in their final days, each in their own way. There is clearly merit in the point that the suffering of Jesus on the cross sets an example for the faithful, but I would also note that not all mortals are born with His level of strength.