Thursday, May 21, 2015

Selling assisted suicide in California. Wordplay is not enough.

This article was published by the National Review online on May 20, 2015.

Jacqueline Harvey
By Dr Jacqueline Harvey

Suicide is hard to sell. After 23 years of failed attempts to legalize assisted suicide in California, lawmakers and lobbyists may have finally found a strategy that works: They just won’t call it suicide. And on the death certificate, they’ll simply lie.

Entitled the “End of Life Option Act,” California Senate Bill 128 mandates that “the cause of death listed on an individual’s death certificate who uses aid-in-dying medication shall be the underlying terminal illness,” not the lethal dose of poison that actually caused the individual’s death. Advocates of assisted suicide coined the term “aid in dying” and concocted the rationalization that killing oneself does not qualify as suicide if you have a life expectancy of six months or less. Yet it appears that it is not palatable enough to list the preferred misnomer, “aid in dying,” as the cause of death and that the only way lawmakers and lobbyists feel they can sell self-destruction is to falsify public records. 

Suicide, Stigma, and Branding 

In 1992, California became the second state to place the assisted-suicide issue directly before the voters, a year after a similar ballot initiative was defeated in Washington State (but two years before an initiative narrowly passed in Oregon). In these early case studies on the power of wordplay, assisted-suicide proponents found that the word “suicide” was deadly to their cause. People recoil from it. Polls show that support for assisted suicide decreases by as much as 20 points when the word “suicide” is used, even though the substance of the question being asked remains unchanged. When we consider that California Proposition 161 failed by a margin of 54 to 46, it is clear how important semantics are.   

Six previous legislative attempts, from 1994 to 2007, failed. It seems that taking care to control language does not by itself distract people from the truth that a person taking poison to hasten her death is practically the very definition of suicide. Proponents of assisted suicide feel the need to call it anything but suicide and to rationalize it, because suicide is a deeply disturbing act, which we combat through suicide-prevention programs, even going so far as to physically detain persons until they are deemed to be no longer a threat to themselves. We talk suicidal people down from ledges. Assisted suicide asks these vulnerable people if they need a push.

That the End of Life Option Act tries to hide what really happens when a patient chooses to end his own life echoes the shame inherent in suicide. It also highlights the downright sanctimonious double standard in discussions of the physically and the mentally ill. When media applaud physically ill persons like the late Brittany Maynard for choosing self-destruction, or “aid in dying,” this points the finger at persons who take their own lives even though they do not have terminal physical illnesses. To euthanasia advocates, those poor mentally ill people committed suicide, but yet there is no attempt to spare them the posthumous shame of whitewashing their death certificates. The cause of death for these persons will not be listed as “depression” or “schizophrenia” or whatever underlying anguish led them to suicide. 

To be consistent, of course, rationalizations for self-destruction cannot stop with the physically ill. Many argue that, while a terminally ill person may prefer death to continuing to live even a few more months with his physical affliction, they fail to see how those who suffer with mental illnesses may prefer death to living for years with their affliction. In the Netherlands, after many years, legal assisted suicide for the dying has evolved into death on demand, with six out of ten doctors admitting to killing a patient who was simply “tired of living.” California is approaching that slippery slope. 

When Terminal Illnesses Are Not Terminal 

Assisted-suicide advocates insist that a terminal diagnosis with an arbitrarily projected life expectancy of six month is the difference between assisted suicide being sanctioned as “aid in dying” or condemned as suicide. They fail to consider that some patients with terminal illnesses do not die from their diagnosed disease. 

Consider this woman who, nine years ago, was given just two months to live after receiving the same diagnosis as Brittany Maynard. She continues to thrive. Had she chosen “aid in dying” on receiving her diagnosis, would that have been suicide? It certainly would have been a tragic, unnecessary loss of a human life. 

Then there is Jeannette Hall, who was diagnosed with squamous cell carcinoma in 2000. She rejected assisted suicide at the last moment and continues to speak out against assisted suicide. Had she decided differently back then, Jeannette would not have committed suicide, under the terms of Senate Bill 128: She would have died of squamous cell carcinoma, according to her death certificate, not the lethal dose of poison she ingested. This law not only has the potential to take years from people’s lives, it has the potential to pressure them into taking their own lives when they could have beaten their illness. 

California lawmakers think that even “aid in dying” is an undignified cause of death and that it should be kept out of public records. Clearly they recognize the truth of what assisted suicide is and are trying to hide it. Suicide is suicide, no matter how California lawmakers attempt to sanitize and sell it. 

Jacqueline C. Harvey, a public-policy scholar with Euthanasia Prevention Coalition International, has a Ph.D. in public administration and policy and focuses on end-of-life legislation at the state level. Follow her on Twitter @drjcharvey. 

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