Assisted suicide: It's not that simple

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Hartford Current published an excellent article written by disability rights lawyer, Lisa Blumberg, titled: Medically assisted suicide: It's not that simple. In the article Blumberg explains why she opposes Connecticut assisted suicide Senate Bill 88.

Blumberg first explains how the assisted suicide drugs work.

First, there is no magic pill for a gentle death. No assisted suicide law gives doctor guidance on what a drug prescription to end life should contain. In Oregon, it has sometimes taken people up to 72 hours to die. With doctors free to devise a cocktail involving multiple drugs and desiring to keep cost down, side effects like burned mouths or seizures can occur. Terry Law, a frequently active assisted suicide doctor, said, “There’s lots of data on stuff that helps people live longer, but there’s very little data on how to kill people.” The focus of the FDA is, of course, to minimize drug toxicity, not maximize it.

Blumberg then writes about the reality of attitudes and bias.

Implicit bias involves making often unconscious assumptions about a person based on factors such as the person’s race/ethnicity, gender, socioeconomic status, age or disability. Doctors and nurses seem to exhibit the same level of implicit biases as the general population, with growing evidence that a clinician’s bias can impact the quality of a patient’s health care.

In a recent study of doctors’ perceptions of disabled people, 82.4% of the doctors surveyed felt that people with disability have a worse quality of life than others, and fewer than 57% said they strongly welcomed disabled patients. Lisa Iezzoni, the lead author and a health care policy researcher at Massachusetts General Hospital, said, “The magnitude of physicians’ stigmatizing views was very disturbing.”

Blumberg continues by writing about how estimates of life-expectancy will often be wrong.

Assisted suicide bills follow the Oregon model, leaving it up to doctors — any two doctors — to decide if a patient is terminally ill with a six-month life expectancy or less and thus eligible for a lethal prescription. However, such medical judgments are often wrong: 12%-15% of hospice patients outlive their six-month prognosis.

Implicit bias can influence the way a clinician sees likely patient outcomes. A doctor might assume a person’s functional limitations indicate frailty, undermining their chance to withstand standard treatment. Doctors don’t always get the distinction between disability — especially when it is progressive as it often is when combined with aging — and terminal illness.

Blumberg then tackles the issue of why people ask for assisted suicide.

Assisted suicide laws also direct that a doctor be satisfied that a person’s decision to die is not being unduly influenced by another. It is not clear how office visits can yield this information. If doctors start with the presumption that a person’s illness or accompanying disability inevitably diminishes his life, clues can be overlooked. The pandemic has caused depression rates to soar, and this is especially so among doctors. It is not fair to anyone to ask a health care worker who might be struggling or overwhelmed to evaluate the merits of an assisted suicide request.

Proponents of legalized assisted suicide tend to portray uncontrollable pain as the prime reason a person would want to die. Oregon data, though, indicates that people far more often request lethal prescriptions due to perceived lessening of autonomy, or feelings of being a burden. Indeed, a recent study has shown that a fear of going into a nursing home is much more likely to fuel a desire to hasten death than pain is. Such a fear is certainly rational, especially in this time of COVID-19. People with significant disabilities often live with it daily. However, this is a societal issue that must be solved by a commitment to broad access to quality in-home support.

Blumberg finishes the article by explaining how assisted suicide is not truly about choice.

The message behind assisted suicide laws is that it is reasonable for a certain subclass of people to want death hastened based on their health and disability. But a just community cannot make death the default option. Assisted suicide would not give patients more choice or control. Instead, it would be a reflection of the lack of choice or control that many people feel in our inequitable and beleaguered health system. This is unacceptable.

Lisa Blumberg is a Connecticut writer, lawyer and disability rights activist.