Nothing gets people more hyped up than when the state’s role either allowing or forbidding a deeply personal and morally ambiguous freedom comes into question.
This legislative session, the issue of “medical aid in dying” — when a doctor is allowed to prescribe life-ending medication to a terminally ill patient — promises to do just that. The issue has already proven itself to be polarizing and the debate about it is often heated, personal and annoyingly self-righteous.
Civil Beat has advocated before in favor of medical aid in dying, and we’re willing to do so again now because we see the issue as a plain and simple personal freedom — one that politicians may unfairly suppress because of their own religious beliefs or political fear.
Physician-assisted suicide, as the issue is also known, is something Hawaii has been grappling with for at least 20 years now. We have spent decades trying to understand the morality and legality of a terminally ill person’s right to end his or her suffering.
But six other states have now enacted this kind of legislation, and we’ve learned from their data, their best practices and the moving stories that have emerged. These states have shown there is a way to move forward on this issue that is both safe and morally responsible.
Aside from religious reasons — which should never be imposed by the government — opponents of physician-assisted suicide are running out of objections.
Compassion & Choices, the nonprofit spearheading this movement in Hawaii, clearly knows the momentum is in its favor. Advocates are starting off 2017 with a full-court press, including lobbying for legislation, polling public opinion (which is greatly in favor), and suing the state.
But they also know that social issues like this advance when the personal becomes political, which is why they have partnered with longtime Hawaii lobbyist John Radcliffe.
Radcliffe has stepped up to talk about his battle against colon cancer, which has included 42 rounds of chemotherapy. Now that the cancer has spread to his liver and been deemed inoperable, Radcliffe wants his doctor, Charles Miller, to be able to prescribe life-ending medication to him without fear of prosecution.
Radcliffe perfectly illustrates the type of patient who could benefit from medical aid in dying. He is, as the legislation would stipulate, a mentally competent, terminally ill patient. Not knowing exactly what lies ahead of him, he wants to have a medication on hand that he could administer himself if the suffering becomes too unbearable.
Which is not to say he will necessarily take his own life.
Oregon, for instance, has had a “death with dignity” law on the books since 1997. But since inception, only about 64 percent of those with life-ending prescriptions have chosen to use the medication. The fact that not everyone uses the medicine illustrates the crucial point that you don’t have to take it to derive the palliative effect.
In reality, medical aid in dying will likely be used by a very small percentage of Hawaii’s population.
In the past, opponents of medical aid in dying have argued that medical advances in pain management have decreased patients’ suffering, making medical aid in dying unnecessary.
But for those with terminal illnesses, the fear of the unknown is often the most painful part. Patients are fighting a mental battle as well as a physical one, and just having life-ending medication on hand gives them a much needed sense of control back. These patients can endure a lot more physical pain if they feel mentally in control of their own suffering.
Opponents of physician-assisted suicide also make the argument that patients can be coerced — by their doctors, their children, their evil stepmothers — into seeking and using the prescriptions.
But laws like Oregon’s protect against this hypothetical with several safeguards, including requiring two doctors to sign off on it and two witnesses to attest that the patient’s request is voluntary. Patients also must be able to take the medicine by themselves, without assistance.
The arguments against medical aid in dying frequently sound like the “slippery slope” arguments against abortion or same-sex marriage. Let men marry men, some people argue, and it won’t be long until there is polygamy or men marrying dolphins. Let women have access to safe and legal abortions, others argue, and it won’t be long until that is the primary method of birth control or full-term babies can be aborted.
The problem with this logic is that is conflates ideas and jumps to conclusions about the worst possible outcome without any real-world evidence. If an aggrieved caretaker, for instance, were to take advantage of medical aid in dying legislation to kill a family member, that would still constitute murder. Not to mention the fact that if someone is disturbed enough to want to murder an ill family member, they’ll probably find a way that doesn’t involve a multi-step, regulatory process.
In reality, medical aid in dying will likely be used by a very small percentage of Hawaii’s population — people like Radcliffe who just want a modicum of control and comfort as they face the worst. If only we could do more for them.