Death Activists Oppose Limits on Virtual Access to Assisted Suicide

This article was published by National Review online on March 22, 2023.

By Wesley J Smith

Assisted-suicide advocates say they believe in “strict guidelines to guard against abuse.” They don’t. They write bills as broadly as they deem politically expedient and then expand access as people become accustomed to doctors prescribing overdoses to ill, suicidal patients.

And they take advantage of any exigency to expand access to lethal prescriptions. Thus, in recent years, ideologically committed doctors began assisting suicides by telemedicine. This approach was made easier during Covid when the DEA permitted controlled substances such as barbiturates — which are also used in assisted suicide — to be prescribed after virtual consultations.

• Article: Support the DEA and prevent assisted suicide by telehealth (Link).

Now, with the pandemic fading, the DEA is proposing a new rule — that doesn’t target assisted suicide — which would place a minimal restriction on such telemedicine prescribing. From the “Proposed Rule Summary“:

Not Permitted. Telehealth visit [to prescribe Schedule II controlled substances] without:
• Prior in-person medical evaluation by prescribing medical practitioner; or
• Referral from a medical practitioner who conducted prior in-person medical evaluation

In other words, before Schedule II controlled substances could be prescribed, at least one doctor would have to meet with the patient in person — either the prescriber or a referring physician. That’s not exactly onerous and would seem to be a reasonable approach considering the power and potential dangers of these drugs.

But don’t tell that to the assisted-suicide crowd. The suicide boosters at Death With Dignity are mounting a campaign to help assisted-suicide supporters submit negative comments about the proposed rule. From the organization’s “DEA Public Comment Campaign Toolkit“:

A recently-proposed DEA rule change would prevent doctors from prescribing controlled substances via telemedicine without first conducting an in-person evaluation. Terminally ill patients nearing the end of their lives are almost always too sick to visit a doctor in person. This rule change would restrict access to health care, and make it incredibly difficult for terminally ill patients to receive routine palliative care and medicines that can ease their pain. We must act quickly to generate as much public comments as we can, to convince the DEA to consider the harmful impact of this rule change on terminally ill Americans.

That’s simply not true. Terminally ill patients almost always have personal contact with their personal doctors and/or specialists — usually on an ongoing basis over time. And the rule would only require one such face-to-face consultation. Moreover, hospice physicians and certified nurse practitioners who prescribe morphine and other opiates in that circumstance make house calls.

So why oppose a reasonable rule that will prevent inappropriate prescribing of potent substances and protect patients involved in legitimate medical treatments far more often than assisted suicide? Here’s the answer: Unregulated telemedicine opens the door to unrestricted assisted suicide.

We already see what I call “doctor shopping” in many assisted suicides. If a suicidal patient’s own doctor refuses to prescribe lethally high medicine doses — whether for conscience reasons or because the physician does not believe the patient qualifies for hastened death — the patient can obtain a referral from an advocacy group to a doctor willing to prescribe, even outside their specialty or field of expertise. For example, a part-time California ER doctor went into business prescribing death to patients he had never treated.

Now, with residency requirements to obtain assisted suicide being repealed in Oregon and Vermont, without the new rule, a suicidal patient could plausibly obtain lethal drugs from out of state without ever having a personal consultation with a single doctor involved in the assisted-suicide process. That’s why activists want to prevent the proposed DEA rule from being promulgated.

Ensuring one personal meeting with a doctor who is going to prescribe death would seem to be a minimal protection against abuse if there ever was one. But assisted-suicide activists only pretend to believe in limitations. What they really seek is assisted suicide (and eventually, lethal-injection euthanasia) without meaningful restrictions. Those with eyes to see, let them see.