Minnesota End-of-Life Options Act would decriminalize assisted suicide and is a dangerous road-map for future medical practice

Gordon Friesen
EPC President

As has been demonstrated in Canada, the most virulent strain of assisted death is that which presents itself as standard medical care. Unfortunately, the so called End-of-Life Options Act, now under consideration in Minnesota draws deeply from that source. (Link to the End-of-Life Options Act).

First, the name itself "end-of-life option" is apparently chosen to create obligations and permissions based on the medical "Standard of Care" as laid out in the Minnesota Patients Bill of Rights. For according to the text of this Standard, informed patient consent requires that doctors make their patients aware of alternative "options".

It is therefore strongly suggested (were this bill passed), that all doctors would have an ethical obligation to mention the possibility of assisted suicide every time they prescribe any other treatment (for terminal patients).

Indeed, if the Minnesota legislator had chosen to proceed with a firm declaration of assisted death as "medical care" there is no question but that all doctors and facilities (as in Canada) would be obliged to provide it. It is, however, plainly stipulated in the bill that no one (and no facility) is obliged to provide fulfillment (or any information) regarding the "Option". Moreover, this exemption is not provided (again as in Canada) on the grounds of any particular "right of conscience". The presumption therefore exists that participation and information regarding assisted death may be simply ruled out by professionals and service providers on the grounds of their own medical judgment. And hence: that no true medical obligation is claimed.

A second stab at the establishment of an assumed medical status, lies in the term "medical aid in dying", itself, defined to mean the actualization of said "option" through evaluation of request, determination of eligibility, and prescription of a lethal potion. Apparently we are thus invited to assume that allowing doctors to employ their special knowledge and privileges (for any other purpose whatsoever) automatically justifies the addition of that crucial adjective "medical".

However, we would do well to remember that the most important of a doctor's tasks lies precisely in deciding what is (or is not) medically appropriate for the patient. And since the definition of "medical aid in dying" speaks only of determining "eligibility" (with regards to legal criteria provided by the legislator) there is no hint of any such medical judgment.

Therefore, while the prescribing doctor may indeed be acting as an expert medical technician, he is nonetheless effectively employed as a blunt instrument, in response to the suicidal wish of the qualified patient. He (or she) is decidedly not making any significant medical judgment or proposition of care. The appellation "medical" is therefore a misnomer.

Much more appropriate, I submit, would be the term "Para-medical aid in dying", chosen to indicate a status perhaps closely related to the medical art (through the use of a common technical expertise in the manipulation of dangerous substances) but at the same time fundamentally distinct. (see: para- Med terms 'P': suffixes/prefixes in medical terminology)

The other usual justification of assisted death --non-medical this time-- comes from a direct appeal to some sort of "right-to-die".

If for instance, it were directly proclaimed that the State of Minnesota supports and guarantees a right for all persons (or at least for all terminally ill persons) to have access to assisted death (as the Canadian Province of Quebec has so engaged its guarantee) then there would be a clear duty for doctors (or some other mandated group) to provide that access. However, once again, since any forced individual or collective mandate is explicitly ruled out in the Bill: that justification for imposing obligations (or according permissions) can not be sustained either.

In conclusion, the Minnesota "bill for an act relating to health; establishing an end-of-life option for terminally ill adults" is built like a spider's web of suggestion and inference. Far beyond its immediate scope, a great conceptual space is apparently occupied, and sweeping logical consequences for future policy are claimed. However, the persuasive power of this conceptual net depends upon the observer failing to notice that it is not actually anchored in either of its corners.

For the Minnesota bill does not actually define the "end-of-life option" as medical care, nor does it establish a true "right-to-die", even for those who are eligible.

Hopefully, those opposed to assisted death will find enough support to defeat this Bill. But if that be so, there must also logically be enough support to previously strip out the dangerously tendentious medical verbiage with which it is laden. For one can not assume that such a Bill will never pass. And in that perspective, it is now, and only now, that we have the leisure of clearly defining future limits to logic and intention.

Gordon Friesen, November 10, 2022