(Note: None of the following should be interpreted as an endorsement or rejection of any candidate. NDY does not endorse candidates for public office.)
Hillary Clinton was in Oregon over the weekend. Predictably, she was asked about assisted suicide:
Q: What’s your attitude toward Oregon’s assisted suicide law?
A: I believe it’s within the province of the states to make that decision. I commend Oregon on this count, as well, because whether I agree with it or not or think it’s a good idea or not, the fact that Oregon is breaking new ground and providing valuable information as to what does and doesn’t work when it comes to end-of-life questions, I think, is very beneficial.
Q: Would you have voted for it if you were a resident of the state?
A: I don’t know the answer to that. I have a great deal of sympathy for people who are in difficult end-of-life situations. I’ve gone to friends who have been in great pain and suffering at the end of their lives. I’ve never been personally confronted with it but I know it’s a terribly difficult decision that should never be forced upon anyone. So with appropriate safeguards and informed decision-making, I think it’s an appropriate right to have.
First, we should all probably get used to this. Clinton and Obama are in a heated race for the Democratic nomination and won’t want to do or say anything to piss off Oregon voters. John McCain is a little more unpredictable, but he’s well aware that the national race will be a tight one and he’s pretty solid on that “states’ rights” stuff.
As to Clinton’s answer – or answers – since she’s contradicting herself, it’s obvious she hasn’t had anyone brief her on the Oregon reports since she still seems to be suffering under the illusion that pain and suffering drive people to ask doctors for lethal prescriptions.
The most frequently cited end-of-life concerns were: loss of autonomy (100 percent); decreasing ability to participate in activities that made life enjoyable (86 percent); and loss of dignity (86 percent).
More patients were concerned in 2007 about inadequate pain control (33 percent) than in previous years (26 percent).
Christie also reports that there were no psychiatric referrals for evaluation of depression, which has raised expressions of concerns from several quarters:
In 2007, for the first time, no patients who requested assisted suicide were referred for a psychiatric evaluation. The law requires doctors to order such an exam if they believe a patient’s judgment is impaired by a psychiatric or psychological disorder. The number of patients referred for psychiatric evaluations has steadily declined each year the law has been in effect.
Dr. Linda Ganzini, a professor of psychiatry and medicine at Oregon Health & Science University who has published numerous studies on assisted suicide, expressed concern about the decline of psychiatric exams, however.
“I think it’s risky how low the rate of mental health evaluations is,” she said, “because people with depressive disorders are more likely to be able to get a (lethal) prescription if you’re not being very careful.”
This raises some questions about some of those highly praised “safeguards.” So does the scandal involving the Oregon State Board of Nursing, which an investigation found did a better job of protecting nurses than it did the safety of patients, including a patient who received an illegal lethal dose of medication, but the nurses involved claim that the patient requested it.
Most troubling and surprising is Clinton’s reference to assisted suicide as “an appropriate right to have.” The reason it’s surprising is that back in 1997, her husband’s administration – in a position definitely not poll-tested, was to oppose the argument that assisted suicide was a “right” when it came up in front of the Supreme Court, as described in this 1997 article by NY Times reporter Linda Greenhouse:
The Clinton Administration entered the cases on behalf of the states. Solicitor General Walter Dellinger argued in both cases today.
In contrast to the states’ lawyers, who urged the Court to find that there was no constitutional right at stake, Mr. Dellinger urged the Justices to recognize that terminally ill people have a ”liberty interest” in not having the state prevent their relief, through doctor-assisted suicide, from ”severe pain and suffering.” However, he said, the states’ interest in ”affirming the value of life” and protecting vulnerable patients should be given even greater weight, and the prohibitions should be upheld.
”The systemic dangers are dramatic” in a society that allows doctor-assisted suicide, Mr. Dellinger said. ”The least costly treatment for any illness is lethal medication,” he added.
Let’s hope this departure from Bill Clinton’s presidency isn’t an example of what Chelsea Clinton meant when she said her mom would be a better president than her father was. Dellinger’s words about the “least costly treatment” still hold true. It’s something that someone who puts such high importance on universal health care coverage should keep in mind. –Stephen Drake
PS – It already feels like a long election season. I suspect that sooner or later, John McCain might end up a subject of discussion here as well.