The Final Choice

The social conservatives who made a public circus of Terri Schiavo tried hard to link her case to the issue of assisted suicide, sometimes pointing fingers at a proposed California law. The argument never caught on with the public because it made no sense.

What the Schiavo case did illuminate was the need to be explicit about what medical intervention we would desire in circumstances in which we can’t say, or even know, what we want.

A better light on the assisted suicide issue comes from the state of Oregon, where voters approved such a law in 1994, with surprising results. Legal assisted suicides number only about 30 a year in the state. Attempts by the Bush administration to void the law failed, in part because Oregon built in good safeguards against the law’s misuse. It has barred assistance to people believed more suicidal than dying and prevented coercion by weary or greedy families.

Which is not to say such dangers don’t exist. California’s attempt six years ago to allow the terminally ill to decide when to die was one such example.

A well-intentioned but loosely worded bill by then-Assemblywoman Dion Aroner (D-Berkeley) would have simply let terminally ill adults obtain a lethal drug prescription that they could then use to end their own lives.

Today, an Assembly committee is scheduled to consider a more careful measure. Assembly members Patty Berg (D-Eureka) and Lloyd Levine (D-Van Nuys) have been laboring to fine tune their bill, AB 654. On Monday, they agreed to strike provisions that would have insulated nursing homes from liability in disputes over an assisted death. As now amended, the legislation rightly provides no protection from charges as serious as homicide if nursing homes intentionally aid or abet a patient’s death.

The new bill also closes some loopholes in Aroner’s measure. Where she accepted a terminally ill patient’s “informed decision” at face value, the new bill recognizes that those decisions aren’t always as independent as they might seem. Thus it explicitly forbids “the patient’s next of kin or any other third parties” from coercion.

AB 654 is still imperfect. It doesn’t go far enough to guarantee that terminally ill patients will get the counseling and medications they need to make a sober decision about exactly what it is they are trying to end: their pain or their life.

But the measure deserves far more serious consideration than its predecessor did six years ago.

Those who are dying deserve a say in the worth, or the untenability, of their last days. Oregon’s result seems to show that having a choice is often more important than using that choice.