The Affordable Care Act is under attack. Many people are uninsured and Medicaid funding is threatened. There are corporate imperatives to reduce healthcare costs even if quality is compromised. Primary care doctors are in short supply with many people forced to go the emergency room for routine ailments. Minorities, the old and people with disabilities are often subject to medical prejudices or ‘quality of life” misconceptions.
We are told that doctor assisted suicide should be a choice for patients who have tried everything. This ignores the fact that having access to “everything” is a luxury that not everyone has. We must address healthcare inequities in Connecticut and beyond before we even consider legalizing doctor assisted suicide.
Let’s not be confused by double speak. The bill (HB 5898) that the Connecticut legislature is poised to consider has nothing to do with “aid in dying.” Aid in dying is palliative care to improve the quality of a person’s remaining life. The World Health Organization views such care as a human right. The bill would not expand desperately needed access to palliative care or expand patient autonomy – patients already have the right to refuse any type of treatment. Instead, the bill concerns the authority of doctors. It sets forth the circumstances under which a doctor could actively prescribe lethal drugs to directly cause the death of a supposedly willing patient without fear of liability.
If the selective writing of lethal prescriptions was a valid medical practice, as proponents assert that is, there would be no reason for laws to immunize medical professionals from suffering any consequences from doing so. What is being proposed in HB 5898 would amount to a radical change in medical culture. Causing death could be viewed as an option in the “care” of some patients.
Legalized assisted suicide could be used for-profit entities for their own purposes. There have been cases in Oregon of insurers denying payments for new treatments but offering to pay for lethal drugs. This is an issue that is totally ignored by HB 5898.
Proponents talk of “safeguards.” Nothing can prevent an erroneous prognosis or keep a vulnerable person from subtly being steered. Moreover, the bill’s focus is on the parameters of permissible medical behavior and not on patient protection. Thus, the minimal criteria written into the bill apply only to the prescribing of the lethal drugs, and not to their use. Any mental health evaluation to determine if a person has impaired decision capacity is made when he requests the drugs.
There is no requirement that a person be evaluated just prior to taking the drugs although mental state can fluctuate widely based on physical factors like oxygen level. It is conceivable that a person could take the drugs during a temporary depression or on impulse. Drugs are to be self-administered but there is no mechanism for insuring that will always be the case. It would be very easy for mistakes or abuse to occur and never be discovered.
It is deceptive to think that the main opposition to HB 5898 is faith based. The strongest opposition — the opposition with the most street cred -– are disability groups who represent people who have also been seen as hopeless in medical settings. We oppose legalizing assisted suicide on public policy grounds. With society and healthcare system as it presently is, it would be inherently dangerous to pass HB 5898.
Lisa Blumberg, an attorney and freelance writer, is a member of the bipartisan disability advocacy Second Thoughts Connecticut.
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