It’s not end-of-of life care. It’s assisted suicide, and it needs to be stopped
Hartford Courant, March 16, 2021
It defies imagination that Connecticut is contemplating legalizing assisted suicide when COVID-19 deaths have exceeded 500,000 nationwide. The virus has laid bare the inequities and prejudices of our health system. Low-income people and people of color are dying at disproportionately high rates. Connecticut has the highest COVID-19 nursing home death rate in the Northeast. There have been an appalling 91 nursing home deaths per 100,000 Connecticut residents. [1] Early in the crisis, members of the Harvard Medical School Center for Bioethics wrote chillingly that “typical medical options may soon not be available to everyone.”
Yet, as concerned health care providers said, “Guidelines that evaluate patients by age or ‘comorbid conditions [that] impact survival’ or ‘underlying medical diseases that may hinder recovery’ implicitly rely on value judgments about these patients’ quality of life and deny these patients justice in our health care system.”
The Connecticut assisted suicide bill would let a doctor write lethal prescriptions for people deemed to have a life expectancy of less than six months if they so request, and would grant broad legal immunity to everyone involved in their deaths. Terminology about an “end-of-life option” or “aid in dying,” confusing assisted suicide with palliative care, or soaring rhetoric about choice and self-determination belies the fact that the only course of action facilitated is death.
There is a sharp distinction between a patient deciding when not to have life-prolonging treatment — which a patient has every right to do — and a doctor actively and knowingly prescribing lethal drugs to directly cause the patient’s death. As Dr. Joseph Marine, professor at Johns Hopkins University School of Medicine, has stated, assisted suicide “is not medical care. It has no basis in medical science or medical tradition. … The drug concoctions used to end patients’ lives … come from the euthanasia movement and not from the medical profession or medical research.”
It is a misconception that people turn to assisted suicide due to uncontrollable pain. Oregon data indicate that among the leading reasons people request lethal prescriptions are psychosocial factors such as perceived lessening of autonomy or feeling they are a burden. An “end of life option” law forecloses options in a very basic sense. It arbitrarily uses health status to exempt people from the suicide prevention services others receive (while discounting the possibility of errors in diagnosis and prognosis as well as the potential for support services to address the person’s concerns).
Assisted suicide sends the wrong message to people with disabilities. It is telling that in Washington state, one of few states that, like Oregon, has legalized assisted suicide, just 4 percent of the people who have used the act were given mental health evaluations.
Although the law proposed for Connecticut would mandate that a person receive “counseling” to determine mental status before obtaining lethal drugs, that is just to determine if there is “impaired judgment.” The law also allows for licensed clinical social workers, in addition to psychologists or psychiatrists, to do the mental health consultation. There is also no requirement that a person be evaluated just prior to taking these drugs. Mood and outlook can fluctuate radically based on physical factors like oxygen level as well as situational factors such as dread of being isolated in a nursing home because of the lack of in-home support.
Disinterested parties need not be present to ensure the drugs are self-administered and taken freely. The difficulties created by the pandemic have caused domestic abuse to skyrocket. There are bound to be at least some cases in which a person is steered or coerced into taking the pills by someone whose life might be emotionally, practically or financially easier if he died sooner rather than later.
In this grim time, a Boston University study has found that COVID-19-related stressors have caused one out of three adults to be depressed. The lead author wrote eloquently, “We would hope that these findings promote creating a society where a robust safety net exists.”
Legalizing assisted suicide would do the opposite. It would increase the shredding of the social fabric. Now is not the time for the state to enact this type of law. If we are honest about the inherent dangers, there will never be such a time.
Lisa Blumberg is a Hartford-area lawyer, writer and disability rights activist.
[1] The online article incorrectly stated that there were 91 nursing home deaths per “100,000 nursing home residents” instead of per “100,000 state residents.” See https://www.journalinquirer.com/connecticut_and_region/connecticut-has-highest-northeast-virus-death-rate-in-nursing-homes-report-says/article_7258891e-e22d-11ea-9e7d-a3f9ec5de365.html