IN A COMPLETE ABOUT-FACE, in early December, the Massachusetts Medical Society gave state legislators the nod to enact dangerous public policy that puts my life and the lives of thousands of others in Massachusetts at risk. The medical society rescinded its longstanding opposition to assisted suicide, commonly held with the American Medical Association, that assisted suicide “would ultimately cause more harm than good” and is “fundamentally incompatible with the physician’s role as healer.”
Overturning this policy puts pressure on the Joint Committee on Public Health, which is now considering identical assisted suicide bills, H.1194 and S.1225. The committee, which has killed seven previous bills, should continue to reject assisted suicide as simply too dangerous for the people of Massachusetts.
The bill, despite its promise of “end-of-life options,” ultimately takes choice away from people. Because assisted suicide would immediately become the cheapest “treatment” offered, it would encourage insurers to reject traditionally covered treatments. That’s already happening in states where assisted suicide is legal.
Dr. Brian Callister, a Nevada physician, reported earlier this year that two patients were denied routine treatments with 70 percent cure rates by their respective California and Oregon insurance companies, which offered coverage for assisted suicide instead. And again, once assisted suicide became legal in California, Stephanie Packer, a young mother with scleroderma, was denied her prescribed treatment but learned that her assisted suicide copay would be $1.20.
To qualify for assisted suicide under the proposed statute, you need to have a prognosis of six months or less to live. Every year, however, doctors misjudge the time a person has left, and thousands “graduate” from their six-month “terminal illness” hospice benefit. People outlive terminal expectations all the time, like the late Senator Ted Kennedy, who lived a full year longer than his terminal diagnosis of 2 to 4 months. In 2012, Kennedy’s widow, Victoria, wrote that the additional months he lived were meaningful and productive, and left behind priceless memories.
The bill requires no official witness at the death, creating opportunities for foul play. Especially vulnerable will be the 10 percent of Massachusetts adults over the age of 60 estimated to be abused every year, almost always by family members. A caregiver or heir to an estate can witness a person’s request, pick up the prescription, and then administer the lethal dose without worry of investigation — the bill immunizes everyone involved.
Among the bills’ hollow “safeguards” is a provision requiring people who request assisted suicide to have a one-time counseling appointment to determine that the person “is capable and not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.” But impairing judgment is what depression does, and few psychologists are confident they can diagnose depression in a single visit. People in the midst of a severe depression can usually present as “unimpaired,” especially in a single meeting with a counselor they’ve never met before, who is not even required to be a psychologist or psychiatrist. Depression is treatable and reversible. Suicide isn’t.
Finally, assisted suicide sets up a two-tier system, in which “quality of life” judgments by others steer some people to suicide prevention services and others toward death. Disabled people, including people disabled by their serious illness, are especially vulnerable. A recent study in the New England Journal of Medicine described the main motive for assisted suicide requests as “existential distress.” The official reports from Oregon and Washington show that the top five reasons to request assisted suicide do not even include pain, but rather distress over dependence on others, loss of abilities, bodily shame, incontinence, and feeling like a burden.
We disabled people reject the idea that the dependent aspects of our daily lives make our lives undignified.
Opposition to assisted suicide is centered in communities of color and the working class. Black and Latino voters, opposed to assisted suicide by more than 2-to-1, effectively defeated assisted-suicide ballot Question 2 in 2012. People historically disrespected and neglected by our health care system are rightly suspicious of the power to prescribe death.
Assisted suicide brings the prospect of lives lost to insurers’ coverage denials, misdiagnosis, coercion and abuse, suicidal despair, unsupportive families, and prejudice. It undermines suicide prevention efforts and fosters suicide contagion. Massachusetts legislators should vote “no” on legalizing assisted suicide.
John B. Kelly is director of Second Thoughts Massachusetts, a citizens group opposed to the legalization of end-of-life assisted suicide.