A recent CTMirror op-ed argues that medical aid in dying contradicts the physician’s calling to provide “cure and hope.” Hope is a fragile thing, and in the face of terminal, violent illness, it can become a weapon used to justify the unjustifiable.
This year, I had the honor and the horror of holding my father as he died from a long bout with liver cancer. It was not the peaceful, medically curated passing so-often framed by opponents of aid in dying. It was prolonged. It was agonizing; it was, in every sense of the word, violent.
Worse, the nature and length of my father’s end was unnecessary.
The author suggests that death should never be the “treatment.” This framing is incorrect. When a body has been ravaged by a terminal condition, when the “cure” is a biological impossibility, the treatment isn’t death—the treatment is the cessation of torture.
The author, a physician, raises the specter of “coercion,” claiming that patients might choose death to avoid being a financial or emotional burden. He worries about the “subtle forms of influence.” Yet, he is silent on the most overt form of coercion present in our current system: the physical and legal coercion that forces a dying person to remain tethered to a bed in a state of horrific decline because a third party’s moral compass deems their exit “premature.”
To insist that a patient must endure a violent end under the guise of “prolonging life” isn’t a medical triumph: it is an abdication of humanity, of empathy and decency. It is also the state and the American Medical Association colluding to deny a human being the final agency over their own suffering.
Hopefully, the AMA will soon catch up with its own membership. A survey published in the Yale Journal of Biology and Medicine found 60% of physicians believed medical aid in dying should be legal. A study of Colorado physicians in the Journal of General Internal Medicine found more than 80% “willing to discuss medical aid in dying with patients and provide a referral”. The number willing to be an attending was lower (28%), but due to their feeling unprepared, medically, to properly assist rather than due to any ethical concerns.
The CTMirror op-ed invokes the case of Eileen Mihich as the basis for deep concern that safeguards can and will fail. However, using a single outlier to oppose an entire legal framework is analytically disingenuous.
First, no policy is perfect. Should we take murder laws off the books because there continue to be murders and because some are able to game these laws in their favor? If not, then how can we hold medical aid in dying to such an impossible standard?
Second, data from states where aid in dying is legal show that these laws are used by a tiny fraction of the population and mostly by those already enrolled in hospice. An article in JAMA Oncology found that in Oregon, the state with the longest-running program, only 38.6 per 10,000 deaths (less than 1%) are via medical aid in dying.
Further, a study published in the Journal of the American Geriatric Society examining 23 years of data show 88.2% of users are already in hospice and in 88.1% of cases, family was informed. That is, medical aid in dying in practice is far from the wild-west show it would seem were one to look only at the Mihich case.
Perhaps most cutting is the author’s dismissal of “quality of life” as a “misguided notion.” This would be akin to arguing the goal of human dignity is an insufficient foundation for human rights. To call the desire for freedom from suffering a “false compassion” is an insult to every family who has watched a loved one vanish behind a veil of pain and medication. There is no human value in a forced, agonizing expiration. There is no dignity in a death that leaves the living traumatized and the dying robbed of their last shred of autonomy.
The essay also maintains “It is not the role of government to determine who does or does not have more human value than others.” First, that’s a wholesale mischaracterization of the situation. Medical aid in dying laws grant autonomy, they don’t deny it. No one -–neither medical providers nor patients—- can be lawfully forced to participate in medical aid in dying.
Second, has the government decided our pets have more value than do humans because veterinarians may lawfully euthanize pets in cases where their lives would be just an extension of cruel suffering? Should we take animal euthanasia off the books because the government made a value-based decision in creating the legal framework allowing it?
A medical provider cannot claim to be “patient-first” while holding a patient hostage to their own failing biology. I held my father through a death that didn’t need to be so long and cruel. I support medical aid in dying because it would be my wish no one else would have to do that.
David Richards lives in Deep River.