By Lisa Blumberg

Lisa Blumberg

The traditional strategy of groups promoting assisted suicide for initially passing a law legalizing the practice is by touting a few minimal requirements as inviolable safeguards. Assisted suicide, they assert, will be a rarely used option for a small, well-vetted cohort of people who are dying, suffering and with no remaining alternatives who have thought long and hard about their decision. As Jason Negri, policy advisor for the  Patients Rights Action Fund has said, this is “a calculated move to garner support from people who are uncertain about assisted suicide.”

Then after a law is enacted – usually after multiple unsuccessful efforts – proponents suddenly become concerned with “access” by which they mean making it easier for life-ending prescriptions to be written. Requirements once described as safeguards such as a waiting period between requests or the need for two doctors to concur on eligibility are chipped away at. It has happened in virtually all of the handful of states where these laws have been passed.

Some supporters are candid about this strategy.  Josh Elliott, a Connecticut legislator and proponent of legalized assisted suicide has said that getting any assisted suicide law regardless of what it says   enacted, “would open the door to evaluation and expansion.” (Connecticut to date has not been able to get an assisted suicide law through the legislature).

However, other supporters flushed with a few victories are getting impatient with this incremental approach. They want to go whole hog right from the get-go. In this  spirit, ethicist Thaddeus Pope grades  the newly enacted Delaware Assisted Suicide law on access based on four expansionist criteria.   He gives it two Ds, a B+ and A for an overall grade of a B.

He is quick to point out that his grading is on a curve. He is only comparing Delaware to other assisted suicide laws in the US. He is not comparing it to the laws he really admires, and thinks are the eventual way of the future such as those in Belgium and Canada that permit euthanasia for any willing person with “grievous and irremediable medical condition” regardless of whether they are terminally ill. If he did that, Delaware’s grade would be quite a bit lower.

 Delaware’s only A  is in following expansionist West Coast assisted suicide states to permit advance practice nurses as well as doctors to determine a person’s eligibility for assisted suicide and write lethal prescriptions.

My take: This gives short shrift to the complexity in judging life expectancy and implies that assisted suicide is an ordinary medical procedure like wrapping a sprain. It also expands the pool of people who could derive a livelihood from the legalization of assisted suicide.

Delaware earns a D for requiring state residency, but Pope thinks this requirement may be short lived. 

My take: Dispensing with a residency requirement reinforces the misperception that assisted suicide is healthcare and eligible people should be able to seek it. It also directly advances the commercial interests of the assisted suicide industry in the state. Assisted suicide practitioners are always front and center in challenging residency requirements.

Pope also gives Delaware a D for requiring a 15-day waiting period between separate requests for a lethal prescription. Most West Coast assisted suicide states have reduced the waiting period to 48 hours or less.

My take:  A truncated or non-existent waiting period again reinforces the misperception that assisted suicide is healthcare.  It belies what a profoundly shattering and irreversible thing it is to cause death.

Delaware earns an B+  on what Pope call transparency. Delaware requires opting out facilities to provide notice to the public of that fact, but Pope says that “it remains to be seen if this will be well-regulated like Colorado or laxly regulated as in California.”

My take:  By well-regulated, Pope seems to mean consistently enforced and it is here that Pope really shows his bias.  He doesn’t seem overly concerned with the touted “safeguards” of the act.  He supports provisions which undercut them.  In a recent blog, he dismisses the possibility of assisted suicide drugs being ingested by a person other than the patients to whom they have been prescribed as an ordinary healthcare risk. (He acknowledges that instances of this has occurred).  Yet, he is concerned about enforcement of a provision that essentially amount to free advertising for the assisted suicide industry and subliminal suggestion, i.e. our facility does not provide this type of thing,but you may be able to get it elsewhere.

Since we are talking about grades, we might as well talk about lessons. So, what is the lesson here? Many proponents are dissatisfied with the “basic” assisted suicide bill, even as they navigate political constraints and so put in minimal restrictions. They want to normalize assisted suicide by portraying it as healthcare. It is not enough for them to legalize assisted suicide and eventually euthanasia. They went to facilitate the practice of it. They want a swath of the population to die that way. They just don’t say why.