California last considered right-to-die legislation in 2007. But now, the case of Brittany Maynard, a Californian who moved to Oregon so that she could painlessly end her life, may help persuade the Legislature to try again.
Over the last month, Maynard has become a national poster case for such laws. She's an attractive spokeswoman, only 29 years old, rational and articulate on the subject of why she plans to end her life — perhaps as soon as Saturday — before her aggressive brain cancer can rob her of cognitive function and impose a painful, seizure-ridden death. Her youth sharpens the tragedy, and her advance selection of a specific death date lends a grave and somewhat startling aspect to her tale, though in recent days she has said that the timing depends on whether she is still getting enough joy out of life.
The Gallup Poll has found for 20 years that about 70% of Americans support allowing physicians to help terminally ill patients end their lives “by some painless means.” Surveys of Californians by the Field Poll have mirrored those results. Yet only four states have right-to-death laws, the oldest in Oregon. Legislation in California and elsewhere has been defeated partly because of outcry from religious groups that suicide is an immoral act. Others complain that such laws create a slippery slope in which suicide becomes the norm, and patients are denied life-extending treatment by greedy insurance companies that would rather they kill themselves, or are pressured to do so by evil-intentioned relations who don't want to spend the patients' savings on end-of-life care.
The reality, after 16 years under Oregon's law, is nothing like that. Fewer than 800 terminally ill patients have taken advantage of the law, using medication prescribed to them by a doctor to end their lives. The law has not been abused; there have been only a handful of minor administrative violations by physicians.
Insurance companies already reject claims for certain treatments for the dying; the protocols for coverage are the same whether or not a state has a death-with-dignity law. As for morality, no amount of discussion will change strongly held personal beliefs. But it's not as though people can't get or don't already have the means to kill themselves — they just don't have the ability to do it peacefully.
The cautious 2007 California bill contained many safeguards — perhaps too many. It would have allowed assisted suicide only for people with a prognosis of death within six months. Warnings, psychiatric evaluations, counseling and a two-week waiting period would have been imposed. Two requests for lethal medication would have been necessary, one in writing witnessed by two people who weren't relatives, heirs or the patient's current healthcare providers. The patients would have needed the mental and physical faculties to take the drugs themselves; doctors or others could not have assisted. The physician's role would have been simply to provide a prescription for the lethal medications (in Oregon, doctors are occasionally present at the deathbed as well). And no doctor would have been under obligation to provide such a prescription.
Hospice care has gone a long way toward providing terminally ill patients with comfort during their last months, but it's not right for everyone. Many people do not want their final days to be marked by the loss of physical and mental abilities, the inability to draw full breaths or weeks spent in a haze of painkillers — or worse, in pain that palliative care does not fully alleviate. Right-to-death laws do not impose death on the very sick. Rather, they allow people who face imminent death to do so peacefully and without agony. Society should not rob them of that right.
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