By any name, suicide bill would ease agony for terminally ill

You can’t strip all the emotion from the argument over assisted suicide. But cooling the coarse rhetoric could lead to a more rational and substantive debate.

The kind of coarse rhetoric I’m referring to was Cardinal Roger M. Mahony’s charge last week that Assembly Speaker Fabian Nunez (D-Los Angeles) is part of the “culture of death.” That’s church lingo and, with any luck, it won’t infiltrate the public policy dialogue.

The jargon of politics already is too coarse, with too many personal attacks. You’d think religious leaders would set a higher standard.

But I wrote about that last week.

Here, I’m going to cite some good arguments on both sides of AB 374, coauthored by Nunez with Assembly members Patty Berg (D-Eureka) and Lloyd Levine (D-Van Nuys). The bill would allow mentally competent people with less than six months to live to obtain a doctor’s prescription for lethal drugs they’d administer themselves. The measure recently cleared its first committee in the Assembly.

The first dispute, however, is over what to even call the proposal. Over the years, the concept has become known as “physician-assisted suicide.” Advocates decided they didn’t like that when polling showed “suicide” to be a loaded word, perhaps casting terminally ill people in the same negative light as terrorist bombers.

The American Academy of Hospice and Palliative Medicine prefers “physician-assisted death.” In Oregon, sponsors of a successful ballot initiative labeled it “death with dignity.” In Sacramento, backers of AB 374 have titled it “The California Compassionate Choices Act.” Sorry, that euphemism smacks too much of cynical focus group spinning.

Sponsors can call it what they want, but the most descriptive term is what we’re talking about: “assisted suicide.” My Webster’s describes “suicide” as “the act of taking one’s own life voluntarily and intentionally, especially by a person ... of sound mind.” Sounds like AB 374 to me.

I’ll acknowledge upfront supporting this concept -- simply as a civilized option for the dying who are desperate to escape not only the misery of pain but the indignity of being bedridden, poked by intravenous tubes and having strangers changing their diapers all day long, if they’re fortunate.

One of the worst arguments against the bill is a common theme echoed by state Sen. Tom McClintock (R-Thousand Oaks) last week in his blog.

“I don’t mean to sound cavalier,” McClintock wrote. “These are gut-wrenching issues any of us could someday face. But there are many simple, painless ways to end it all if one is of a mind to do so. And as the law school question goes, ‘If suicide is a crime, what’s the punishment?’

“So why then is it so important to provide an official legal mechanism to do something every person is perfectly capable of doing to themselves anyway?”

Well, Tom, here’s one answer: Some poor bloke is going to stumble across the body and perhaps be traumatized for life, especially if blood is involved -- even more so if the body-finder is an unsuspecting loved one.

Second answer: If the dying patient confides with a family member and recruits her help in the suicide, she could face up to three years in prison. There’s the punishment.

The California Medical Assn. opposes the bill for rational reasons. “Assisting in someone’s death is in direct conflict with a doctor’s ethical duties,” the group asserts.

“It’s not in our job description, and we don’t want to expand it in that direction,” says Dr. William Andereck, a San Francisco internist, CMA board member and medical ethicist. “We believe in maximizing patients’ quality of lives and doing everything we can to relieve suffering. We realize, in doing that, we may be shortening their lives. But it’s not our intention to end people’s lives.”

Under AB 374, however, a doctor could refuse to write a lethal prescription.

Andereck, speaking for himself and not the CMA, says he’d prefer a system where a patient could apply to government -- maybe down at city hall -- for a lethal prescription, as people now do for a disabled parking placard. A doctor already must certify that a patient is terminally ill to qualify him for hospice care, Andereck says. There could be a box on the certification that the patient could check to “fast-track” his death with a lethal dose.

The CMA also argues that the law could be abused by medical insurers or family members eager to relieve the financial burden of caring for a dying person.

Some disability groups fear that Uncle Willie in a wheelchair could be victimized by family members tired of caring for him.

But those kinds of horror stories also were predicted by opponents of the Oregon law, and they never came to pass. About the worst thing that happened -- actually, it may have been the best -- was when a man ingested a lethal prescription and woke up three days later. He died naturally after several weeks.

The California proposal is interwoven with tight safeguards: A patient would have to make two requests, one verbal, one in writing, the latter witnessed by two unrelated people with no financial interests. There’d be a 15-day waiting period.

I called Tom McDonald, 77, a former rocket industry engineer who’s dying of melanoma at his home overlooking Oroville Lake in Northern California.

“I just want this bill to go through so I don’t have to do anything radical,” McDonald says. “But I’m not going to let some insidious disease put me in agony and screaming. I want to take some pills and go slowly into a sleep mode and never come out. No agony. No problems. Die with dignity in comfort.

“That’s what this bill will be doing for me and others like me.”

The worst argument against the measure is Mahony’s: What McDonald wants is “against God’s law and God’s plan.”

Whose God? Not McDonald’s, although he was raised Catholic. Not most people’s, according to polls.

The Field Poll found last year that 70% of California adults -- including 64% of Catholics -- favored allowing incurably ill patients access to lethal drugs.

In a secular democracy, Tom McDonald and all of us should be free to follow our own faiths. If we’re goners anyway, we should be allowed to choose for ourselves when to cut our losses and cash in.

Reach the columnist at george.skelton@latimes.com.