The late Jack Kevorkian, a saint to some and a demon to others, was the controversial proponent of physician-assisted suicide for the dying and ill. This November, Kevorkian comes to the Commonwealth, or the spirit of the man at least, in the form of Question 2. The ballot measure, neutrally titled “Prescribing Medication to End Life,” would allow doctors to help the terminally ill kill themselves. Kevorkian’s arguments took root in Oregon and Washington but so far have not found favor in the rest of the country. Massachusetts is thus somewhat of a test case: Is legalized suicide a trend?
Many of the objections to the proposed law are practical. “Terminally ill,” for example, is defined as death within six months. Why not a year, or for that matter 50 years (in which case, I guess, a whole lot of us would be eligible)? Then too, a prognosis of six months to live is an educated guess. Doctors are like weather forecasters: Their ability to foresee the future is far from perfect.
There are further worries. A diagnosis of a terminal illness can easily leave patients despondent and considering taking their lives; the new law legitimizes that contemplation. Several years ago, in fact, one Oregon health plan, having refused to pay for medication that might prolong a patient’s life, sent her a letter proposing suicide as an alternative (and said it would be happy to pay for those drugs). With the new law in place, the economic incentive for Massachusetts insurers would be to encourage the cheaper way out as well.
There are fears, too, that greedy heirs might coerce an early exit. The ballot measure tries to address that — unsuccessfully, I think— by requiring at least one non-heir be a witness to a patient’s suicidal declarations. But disinterested observers (or anyone really) need not be present to witness the death itself. So if someone sits bedside force-feeding deadly drugs to a patient, it’s likely no one will be the wiser. Indeed, one truly bizarre provision of the proposed law provides that those who do coerce others to kill themselves can be imprisoned for no more than three years — a small price to pay for what amounts to murder.
But suppose we could magically wish away all of these issues. Should we have state-sanctioned suicide? Libertarians argue that your body is your own, to do with as you wish. Some major religions disagree, but nothing in the proposed law requires the faithful to commit suicide. It simply permits it. Still, there are lines even the most ardent libertarian crosses with trepidation. Of the things we might do to our bodies, suicide is uniquely catastrophic and irreversible.
Then too, there is an underlying supposition of the “death with dignity” movement that some lives — particularly those where the end is near and pain is present — are not worth living. That deserves challenge. Consider the case of the late Senator Ted Kennedy. In May 2008, he was told he had a fatal case of brain cancer. In August 2009 — 15 months later — Kennedy finally passed away. During those months, he broke a filibuster on the Senate floor, gave a rousing speech to the Democratic National Convention, played a major role in Barack Obama’s election, advanced the cause of national health care, and was a key vote for the 2009 economic stimulus bill. If Question 2 was law and Kennedy had chosen instead to end his life, none of that would have happened.
Granted, if told we had a terminal disease, it’s doubtful most of us would spend the ensuing months addressing national audiences, pushing for wholesale public policy reform, or electing a president. We’d likely be doing things that are more mundane: admiring a grandchild’s drawing, comforting a friend, advising a one-time colleague, or just telling others they are loved. Mundane, yes, but still deeply important — the ordinary stuff of living.
People who work with the suicidal see it as a fundamentally selfish act — it’s all about me, and not the people around me. Question 2 enshrines such selfishness into law. Granted, there may be times where life is meaningless and oblivion really is the better option. But none of us, even in extremis, can really know.Tom Keane writes weekly for the Globe.
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