Should Massachusetts legalize assisted suicide - (NO).

The Boston Globe published, on August 19, a Yes and a No response to the question: Should Massachusetts adopt the proposed physician-assisted suicide bill? Dr David Clive argued Yes while Dr. Laura A. Petrillo argued No.

Dr Laura Petrillo

Dr Laura Petrillo
Palliative care physician at Massachusetts General Hospital; Newton resident

Although the United States is in the throes of the greatest health and economic crisis of our era, a bill to legalize physician-assisted death has advanced through the Massachusetts Legislature, drawing on our lawmakers’ valuable time and attention.

As a palliative care physician, I wish we were focused on just about anything to improve care for seriously ill patients and their families besides this polarizing issue.

Even before COVID-19, it was clear our health care system fails people as they die. The 2014 Institute of Medicine report, “Dying in America,” revealed that patients experience fragmented care and that families are the backbone of caregiving, with limited support. Even when patients are insured, health care is expensive, driving people to ration their medications and forcing families into bankruptcy.

There is also enormous societal bias connected with aging that leads to over- and under-treatment of older adults. Ageism in turn exacerbates discrimination on the basis of socioeconomic status, since inequality leads to earlier and greater effects of aging among patients from disadvantaged groups.

Our flawed health care system, steep medical costs, and ageism all contribute to interest in physician-assisted death, which proponents term “death with dignity.” The implicit message is that being sick is pitiful and burdensome. Indeed, in Oregon, where physician-assisted death has been legal since 1997, 59 percent of those who ended their lives in 2019 cited as one reason concern about being a burden to family and friends. In addition, 7.4 percent of patients mentioned financial implications of treatment as a motivating concern.

We have an urgent responsibility to improve the experience of dying so no one feels the only option to maintain their dignity is to hasten their death. In an optimal system some may still make that choice, but we are a long way away from an optimal system, and COVID-19 has only worsened financial strain and stigmatization of older adults as a burden on society. I hope the proposed bill is not adopted and that instead we focus more broadly on fixing our current health care system and providing relief and protection to individuals and families in this time of crisis.