We’re not only voting for the next President and a Senator from Massachusetts in November, but on a battery of ballot questions. Ballot Question 2 is one of the more controversial. The so-called “Death with Dignity” or “Right to Die” legislation would allow an adult resident who is (1) capable of making and communicating health care decisions, (2) diagnosed with an incurable and irreversible disease that will cause death within six months, and (3) voluntarily, and in an informed manner, so decides to obtain a prescription for medication to end his or her life. You can read the proposed legislation here.
Oregon and Washington state already have similar legislation in place. In Oregon, most candidates are well educated cancer sufferers over the age of 65, who died at home and were enrolled in hospice care. This “typical candidate” is familiar to many of us working with elders. Maybe it is because so many of us know or have known someone like this that the “Right to Die” issue has strong voices on either side.
Opponents:The Committee Against Physician Assisted Suicide is the leading group advocating against Question 2. They argue that Question 2 is poorly written, confusing, and flawed. While the legislation requires the doctor to mention alternatives to assisted suicide, it does not ensure they have adequate access to and information about these options.
The Committee and its supporters are also concerned that the law does not require the prescribing doctor to have expertise in the array of end-of life options. Another concern is that the legislation does not require the patient to receive physiological screening or care in connection with this request. There is also a concern that even by doctors’ admissions, estimates on how long patients have to live are just that, estimates. Patients can outlive their prognosis by months or even years.
Opponents argue that we should be offering the dying better end-of-life and palliative care rather than the option to die.
Supporters: However, supporters of Question 2 look to Oregon and see legislation operating as it was intended. Death with Dignity and their supporters see this legislation as empowerment for people with a terminal illness. They cite the Oregon and Washington laws, where over 80% of patients using the law had end-stage cancer, while most of the remaining 20% had end-stage Lou Gehrig’s or end stage end stage Emphysema. They also point out that while psychological screening is not required under the law, if doctors believe depression is involved in a patient’s decision to request assisted suicide, they must refer to a mental health professional.
Supporters also argue that patients are protected by the several requirements of the law. For example, the patient must make two verbal requests 15 days apart, followed by a written request witnessed by two people, one of whom is not a relative, beneficiary, or operator of the facility the patient resides in or receives treatment from. The doctor must also refer to a consulting doctor to confirm the diagnosis and prognosis. Lastly, supporters think of the law as being simply about choice. They believe people have a right to choose when their quality of life is so poor, or their inability to participate in life so extreme, that they want to end life on their terms.
This is not an easy question to say the least. Massachusetts residents are tasked with reviewing the legislation and considering the arguments on either side to decide the best way to move forward. Please contact us if you have other end-of-life planning questions.