In spite of a wave of backlash from coalitions opposing physician-assisted suicide, Washington, D.C., may join five states in passing the Death with Dignity Act, a bill that would allow doctors to prescribe lethal doses of drugs to terminally ill patients with less than six months to live.
Currently under consideration by the D.C. Council, the Death with Dignity Act of 2015 was proposed by Councilmember Mary Cheh (D-Ward 3) last January. The bill will be put to a vote by the council’s Health and Human Service Committee on Oct. 5. In its current form, the bill gives terminally ill adults the option of pursuing end-of-life measures through a consulting physician’s prescription of medications, which would induce death in a sleeping patient.
A coalition opposing the D.C. legislation, including organizations such as the Patients’ Rights Protection Fund and Not Dead Yet, contend assisted suicide should not be a viable option for these patients, especially because many suspect vulnerable patients may be pressured to make the irreversible decision.
The medicine is ingested orally and does not require a doctor to be present, meaning patients can select the time, place and circumstances of their death.
The bill further requires that a patient make two verbal requests for the treatment, separated by at least 15 days, to a physician and submit a written request at least 48 hours before the medication is dispensed. There must be at least two witnesses to the written request who can attest that the patient is acting voluntarily and not being pressured to sign the form.
Physicians are also required to inform the patient of feasible alternatives including comfort care, hospice care and pain control. If passed, the District will join Oregon, California, Washington and Vermont in permitting physician-assisted suicide. The cause is championed by advocates including Daniel Diaz, whose 29-year-old wife Brittany Maynard chose to end her life in 2014 after a terminal brain cancer diagnosis. Maynard moved to Oregon, where physician-assisted suicide has been legal since 1994, to obtain a prescription for a legal dose of drugs because in her home state of California, physician-assisted suicide was still illegal.
G. Kevin Donovan, director of the Pellegrino Center for Clinical Bioethics at the Georgetown University Medical Center, asserted that the majority of the medical community opposes assisted suicide.
“We’ve seen that the indications and the circumstances for assisted suicide and euthanasia have multiplied and expanded to include things like anorexia nervosa, blindness, transgender confusion and even loneliness and depression,” Donovan said.
However, Georgetown University Law Center professor Lawrence Gostin, who specializes in human rights, said he believes with the appropriate restrictions the Death With Dignity Act can prove to be a positive ordinance.
“If the law is structured right, research shows that abuses are rare if ever,” Gostin said. “To me, human beings have the autonomy and the dignity to make all choices in their lives. The most intimate and the most important one is when is the right time to die.”
Donovan dismissed the notion claiming the Death with Dignity Act gives patients complete control over their lives.
“You can understand the discrepancy and the irony in insisting on the right of autonomy to do the one thing that removes all autonomy,” Donovan said.
Donovan added that modern medicine largely manages and treats physical pain, which means most patients who pursue assisted suicide measures suffer from existential pain.
“What we’re talking about actually is not the pain, but the pain that people are experiencing and driving them to this is really an existential pain,” Donovan said. “The thing that helps them the most is not saying we can end your life sooner, but we can offer you the support and the love and the respect and walk with you step by step along that journey.”
Vita Saxa President Amelia Irvine (COL ’19), whose organization defends human life from conception until natural death, cautioned that the Death With Dignity Act may cause terminally ill patients to cave under pressures from friends and family.
“I have some main concerns about the pressures that people would feel to go through with taking the medication even if they don’t want to, because of pressure from family or friends or just the overall feeling of being a burden,” Irvine said. “The second sort of philosophical issue I have with it is normalization of suicide. Every life has an enormous value.”
Stressing the bill’s rigorous provisions to safeguard patients from coercion and protect vulnerable populations, Cheh argued the measure will provide a compassionate choice for terminally ill adults who wish to die with dignity.
“In the states where similar Death with Dignity laws exist, experience has shown that relatively few patients will request life-ending medication and not everyone who receives the medication will use it,” Cheh said in a press release. “However, being provided with this option is a source of great comfort. In the face of a terminal illness, patients are able to continue treatment with the peace of mind that they ultimately have the choice to die in a dignified and humane manner — if they choose to do so.”