The case of Brittany Maynard, the 29-year-old Oregon woman who recently chose to end her own life after being diagnosed with a terminal brain tumor, has brought much attention to assisted suicide, and many have been moved by her tragic situation. However, we rarely hear about the true ethical concerns, nor that legalization is opposed by virtually every disability rights organization.
Having lost my father and other loved ones to terminal illness, this is of particular concern to me. We are right to have compassion for those who suffer, but the proper response is care, not physician-prescribed death.
Let’s consider some problems assisted suicide poses:
Legalized assisted suicide has become a socially acceptable form of discrimination. Would we ever provide poison to a teenager who has lost a sense of hope or purpose, or call such a suicide dignified or courageous? Of course not.
We offer suicide prevention to some individuals (counseling, affirmation of their worth and purpose, improved care), while offering suicide assistance to others. In doing this we reinforce their worst fears, answering the unspoken questions “Am I still valuable? Am I still worth fighting for?” with a heartbreaking “no.”
Why the two different responses? Simply put, we see the ill, disabled and elderly as second-class citizens. How many of us have said we would never want to be a burden to our families, or to lose our dignity by becoming dependent on others? We may think such comments are selfless, but the message is clear: We see the ill and disabled as undignified and burdensome in their suffering and dependency.
Patients’ decisions are often made out of financial considerations and fear of becoming burdensome. Legalization places a tremendous pressure on such individuals, who feel a sense of obligation to take advantage of the law in order to free their families from the expense and time their care demands.
Furthermore, health care is more expensive than death, and assisted suicide becomes a treatment where it is legal. In Oregon, for instance, Barbara Wagner was told chemotherapy would not be covered by her insurance, but assisted suicide would. This becomes commonplace, particularly among the underinsured. While assisted suicide is depicted as a right, it often becomes an imposed sentence.
It is impossible to put adequate safeguards in place to prevent abuses. The decision is typically approved by a general physician and witnessed by family, all of whom can have conflicts of interest. Such physicians are not qualified to evaluate mental issues, and legalization removes incentives to improve pain management options. The medical response to suffering becomes death rather than quality palliative care.
Prognoses are often wrong. Brittany Maynard was given six months to live and a grim prospect of suffering. Some deemed her situation hopeless. We will never know if she would have been like Heather Knies, of Phoenix, who was diagnosed with the same cancer as Brittany, given six months to live, and is alive and well 10 years later. Or like David Williams, given the same diagnosis and prognosis 13 years ago. His fight with cancer is ongoing, but he values his experience and the time he has been given: “Without me going through what I’ve gone through, I don’t think I would be able to reach people the way I reach people.”
But even if Brittany’s prognosis were correct, can anyone doubt that those six months with her family would have been meaningful? None of us know how long we have, none of us are free from suffering and none of us can escape death. That does not deprive our lives of value and meaning. When suicide is encouraged, we are robbing patients and their families of their most precious gift: time with those they love.
Despair is a natural reaction to suffering and the certainty of death. The proper response is improved psychiatric and palliative care — not suicide. We must consider that when we use such words as “dignified” or “courageous” we are glorifying and normalizing suicide for young people, condoning discrimination and undermining the courage and dignity of the countless men and women who are taking advantage of every day they can have with their families.
Suicide is never good health care. It is always a tragedy and an incalculable loss for us all.
Mary Nadeau Reed is projects director for New Orleans Right to Life.