Physician Assisted Suicide…. – by Dr. Richard B. Fife

Wikipedia defines physician-assisted suicide as “suicide committed with the aid of another person, sometimes a doctor’ and it has been described as “medical aid in dying in the United States for terminally ill, mentally capable adults who self-administer medication to shorten their own dying process.” As the Affordable Care Act (Obamacare) was being discussed as possible legislation many opponents of the bill talked about the creation of “death panels.” What this really turned out to be was end-of-life counseling sessions; and, in 2016, doctors could charge the federal program for this service. Almost 225,000 advance care planning conversations have been billed to Medicare. The controversy will most likely reemerge in Congress over the funding for these discussions with physicians about end-of-life treatment preferences because Representative Steve King of Iowa has introduced a bill entitled “Protecting Life Until Natural Death Act.” The White House has also moved to get terminally ill patients to consider options other than assisted-suicide by backing the “Right to Try Law.” This law would make experimental medications available before being approved by the Food and Drug Administration.

To take a step back, let’s consider again that discussion about assisted-suicide being held by a National Hospice Ethics Committee back in 1993-94. At that time physician-assisted suicide was not legal in any state in the country. A referendum on a law had failed in several states and was now being considered in 1994 in the state of Oregon. It was called the “Death with Dignity Act.” It passed in Oregon by a vote of 51% to 49% and became law in 1994. In a future column, I will discuss the reasons for the ethics committee to vote against this legislation and why things have changed so much since the original law was passed in Oregon. Since that date, physician-assisted suicide has become legal in six states – Vermont, California, Washington, Colorado, Montana and Oregon. In all of these states except Montana, Wikipedia points out that the laws state explicitly that “actions taken in accordance with (the Act) shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide under the law.” The purpose of this was to distinguish the legal act of medical aid in dying from the act of suicide.

One thing that is apparent is that the notion of assisted-suicide for the terminally ill has gained greater acceptance in the 20 years since the passing of the “Death with Dignity Act” in Oregon. Many hospice advocates had once argued that hospice would be the real alternative to assisted-suicide, as pain would be controlled and emotional and spiritual support would be given to the dying patient and his or her family. However, during this same 20-year period, hospice has grown in numbers and acceptance at the same time that assisted-suicide has become popular. Furthermore, at one time, hospices would never consider the possibility of assisted-suicide; and, now, that too may be changing.

What happened and how do you feel about it? Feel free to add your comments on this interesting subject as we explore it further. Email us