How would you prefer to die? While having sex, some answer. But most just want to die at home among loved ones. However, most people die in some kind of facility. We also fear pain. But usually pain can be medically managed. The real issue is quality of life at the end. People want to feel they have some control over what’s happening to them.
Our medical and legal systems work against that. Suicide is not allowed, certainly not with medical help. Some get around this by refusing nourishment. Actually a pretty nasty way to go.
Brittany Maynard was a California gal who got brain cancer at 28. Aggressive treatment failed. Maynard’s end-game looked horrible, and doctors couldn’t help her. So she moved to Oregon, which had adopted a “Death With Dignity” law in 1994. This allowed her to get a prescription for 100 Seconal capsules. Maynard enjoyed the time she had left, and when the disease’s depredations duly overcame that enjoyment, she popped the pills. In five minutes she was sleeping peacefully; in an hour or so, an ex-parrot.
But before that, Maynard helped campaign for California legislation similar to Oregon’s. Governor Brown signed it in 2015; the fourth state with such a law. Efforts are underway to get one passed in New York.
My libertarianism says you should be free to do what you want, as long as no one else is harmed. Nothing is more fundamental than your right to control your own passing.
The proposed law has many safeguards. It would only apply after a terminal diagnosis (death expected within six months) confirmed by two doctors; and a written request with two witnesses. The patient must be mentally capable, and while there can be help, the fatal dose must be self-administered. The patient must also receive counseling on other options. And must wear green shoes.
Some opposition comes from religious quarters – the idea of taking things out of God’s hands. Of course all medical interventions do that. There is also the allied “sanctity of life” argument. But if life is sacred, it is sacred first and foremost to the individual living it. Whatever meaning it has is primarily its meaning to him or her; and they should have the freedom to choose the right time to end it. Denying that autonomy seems indeed antithetical to the concept of life as sacred.
Also, some believers maintain that suffering is redemptive. Fine if the suffering is your own choice. But to demand it for another is not redemptive, it’s just cruel.
Medical organizations have also traditionally opposed these laws. Some doctors see them as fundamentally contrary to the Hippocratic oath (“First, do no harm”), and don’t want to be put in morally ambiguous situations. However, some organizations are moderating that stance; in California, the local one opted for neutrality. In Oregon, under the new regime, end-of-life care has improved, and doctors wound up feeling better about things.
Opposition has also come from advocates for the disabled, who fear such laws could put vulnerable people at risk. That’s a paternalistic attitude – most disabled people themselves actually want to have the choices the law would allow. In polls, they are as much in favor as the general population – which supports such legislation, by large majorities. And while many opponents cite potential abuses, Oregon’s experience fails to reveal a single such case.
Then there’s the “slippery slope” argument – if euthanasia is permitted, it could evolve into being required, or people pressured into it. Again, Oregon’s experience rebuts this; after twenty years it hasn’t happened, and the numbers utilizing Oregon’s law haven’t risen over time. But meanwhile all of public policy is a slippery slope. At every point on the slope, we must make choices and decisions. As rational creatures, we can do this.
Little by little, step by step, human beings gradually have been getting better at how to do things, improving our quality of life. “Death with Dignity,” giving us more and better options for controlling our own circumstances, is one example. This is progress. It’s why I’m an optimist.
* Note, this post is based on a talk by Corinne Carey of “Compassion and Choices New York,” a nonprofit working to improve care and expand choices at the end of life.