It’s known as end-of-life option, right-to-die, assisted suicide, and it has been a very controversial topic nationwide since Oregon became the first to enact such a law in 1997. California, after being signed into approval by Gov. Jerry Brown in October of 2015, had their own version come into effect on June 9th of this year. It received final approval two days ago, when Riverside County Superior Court Judge Daniel A. Ottolia denied a request to suspend the End of Life Option Act (ELOA).
Moral issues such as these are difficult to assess in a law aspect, but for those who suffer from a terminal disease, it’s important to them to be able to decide on their own terms when their life should end. A woman with Stage 4 colon cancer said she, “cried with relief” when the judge denied the motion to suspend the new law. No one wants to suffer through excruciating pain, nor do they want to force their family to watch them do so. However, California is just the fifth state – along with Oregon, Washington, Vermont and Montana (by court ruling) – to enact a right-to-die law; in fact, 38 states have laws which specifically state that a physician or doctor who assists in suicide is guilty of manslaughter. It’s clear that this issue will continue to be debated for a long time.
What do Opponents to california’s right-to-die law say?
There are many arguments on both sides of this issue, and those who are in opposition – the Life Legal Defense Foundation and the American Academy of Medical Ethics, to name a few – to the law make mostly relevant points. Addressing them one by one, we’ll juxtapose the arguments against what California’s new law actually says.
- “California’s End of Life Option Act does not require a psychological evaluation prior to receiving a prescription for aid-in-dying drugs.” This is mostly false. The person has to undergo evaluation by an “attending physician, consulting physician, psychiatrist, or psychologist” for it to be declared that they have the capacity to make medical decisions.
- “It violates the Hippocratic Oath.” This is mostly false as well. The original Oath did say, “I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan,” but this is from a document that was written more than 2,000 years ago. Times have changed, and the medical world has accepted this, adopting a modern version of the Hippocratic Oath, which includes notes on bedside manner, patient’s right to privacy and “prevention is preferable to cure.”
- “The Act puts vulnerable individuals at risk. We can’t ignore the economic factors at work in medicine. For example, patients in Oregon have been refused life-extending chemotherapy by their insurance companies, who instead opt to pay for aid-in-dying drugs.” This is mostly false. There are only two documented cases of this happening, both of which were in 2008. Applying context to those cases, one can understand why an insurance company would pay for aid-in-dying drugs but not treatment drugs. Barbara Wagner, who was given no more than six months to live due to lung cancer, was prescribed Tarceva, which by no means would provide a cure but would ease the pain. It cost $4,000 a month, and studies showed that it only increased a person’s life span by two months compared to a placebo. It had to have been awful to receive such a letter from the insurance company, but they don’t usually pay for drugs if there is less than a five percent chance that cancer treatment will prolong a person’s life by five years, which is defined as “futile care.” Even after the drug manufacturer gave it to Wagner for free, she only lived a very short time after starting it.
- “The Act communicates the message that under especially difficult circumstances, some lives are not worth living. This message will be heard by not only those with a terminal illness but also any person struggling with the temptation to end his or her life.” This is mostly false. We return to the required analyzation by a physician or psychiatrist to determine sound mind and body, and if they judge a person to be suicidal, then they will turn them down for the drugs and instead seek treatment for depression. Which makes this next argument against the bill very false:
- “The Act abandons vulnerable patients to lethal drugs. To abandon suicidal individuals in the midst of a crisis under the guise of respecting their autonomy is socially irresponsible.” It absolutely does not do this, as evidenced by this passage: “Nothing in this part may be construed to authorize a physician or any other person to end an individual’s life by lethal injection, mercy killing, or active euthanasia. Actions taken in accordance with this part shall not, for any purposes, constitute suicide, assisted suicide, homicide, or elder abuse under the law.”
- “The law puts patients at risk of being coerced by their loved ones to end their lives.” This is false. Elderly citizens have been scammed by their family members before, but there are strict rules laid out within the ELOA, namely that the person seeking aid-in-dying drugs must have the capability to administer the drugs themselves. Without a complete and thorough understanding of their situation, corroborated by a medical professional, and the physical ability to administer the drugs on their own, they are not allowed the aid-in-dying drugs.
How trustworthy and unbiased a “law” organization such as the Life Legal Defense Foundation is certainly up for debate, and their rhetoric in opposition to the ELOA does not appear to have a lot of merit. One thing is for certain: we cannot possibly understand fully what the thought process is of someone with a terminal disease. What works for someone else may not work for us, but if someone wants the option to not go through extreme pain and suffering, or force their family and friends to watch them go through it, then they should have it.
Legally speaking, there is nothing in our federal laws or Constitution prohibiting this freedom of choice. Given the proper protocol that prevents any coercion or gaming of the system, which California’s End of Life Option Act certainly appears to have covered, then those suffering greatly should be allowed to decide when their life ends, rather than allowing the disease to decide for them.