Physician-assisted suicide involves a physician prescribing
lethal medication to a patient, but not administering it, instead having the
patient ingest it themselves. The practice is legal in several states and
Washington, D.C.
In an effort to make sure similar legislation is not passed in
Virginia, the Virginia Catholic Conference is urging the public to submit
comments opposing it to their legislators by Oct. 15.
Though legally termed “Medical Aid-in-Dying (MAID),” the Catholic
Church recognizes this practice as physician-assisted suicide. As such, it is
condemned by the church.
Jeff Caruso, executive director of the VCC, said, “Whether a
doctor directly ends a person’s life or assists a person to commit suicide, in
both instances a life is being taken. We must never treat the gift of life as
something that can be abandoned.”
He noted St. Pope John Paul II called assisted suicide “an
injustice which can never be excused, even if it is requested.”
Delegate Kaye Kory requested the Joint Commission on Health Care
staff examine laws in states where physician-assisted suicide already is legal.
The commission is composed of state senators and delegates, some of whom are
also physicians, and focuses on health-related issues and their effect on
residents and health care services.
The JCHC staff reviewed the laws with the goals of answering what
the impact was of informing patients about other end-of-life options, such as
palliative care and hospice; how providers and health care systems implemented
the law; whether patients had been coerced or abused in any way and if there
are laws to protect them; how physician-assisted suicide has impacted health
care costs; and, if it becomes legal, how many people in Virginia would be
likely to utilize the service. The study took nearly two years to complete and
was presented to the JCHC Sept. 18.
The JCHC established a work study group made up of members from
dozens of organizations across the state, including the VCC. This allowed
members on opposing sides to have the chance to denounce or defend the
practice. During work group meetings in 2017 and 2018, the VCC stated its
opposition to physician-assisted suicide.
According to Caruso, they repeatedly objected to the term
“Medical Aid-in-Dying,” which he said was “inaccurate and misleading
terminology.” The VCC also helped compile 10 reasons to oppose
physician-assisted suicide.
Those reasons include:
—the claim that assisted suicide is the result of a “broken,
profit-driven health care system,” stating that financial pressure is usually a
factor in the decision to end one’s life, and that people can be steered by
insurance companies toward assisted suicide, since available life-giving
treatment is often expensive;
—that the practice is a threat to the vulnerable, poor and disabled;
—that the argument that physician-assisted suicide ends one’s
pain is ineffective because that is rarely the reason one turns to suicide;
—the definition of terminal illness necessitates a prognosis of
less than six months to live, which is “wildly misdiagnosed” and can lead to
fear and depression in the patient, which in turn can lead to thoughts of
suicide.
“Both private and public insurers will have financial incentives
to pay for a lethal prescription rather than more expensive and prolonged healing
treatment, leaving the poor vulnerable to coercion,” Caruso said. “Those
suffering from illness are often concerned about being a financial or emotional
burden to others, which can create pressure to end one’s life.”
Still, proponents of the practice argue that physician-assisted
suicide gives patients the opportunity to “die with dignity” on their terms and
at their time. According to the study by the JCHC’s staff, supporters claim
this is different from suicide because suicide “often involves people who are
severely depressed and no longer want to live,” which is different than people
who are “suffering life-ending illnesses and understand that there is no hope
for a better outcome.”
JCHC asserts patients are protected legally and always in control.
While they vary slightly from state to state, there are several steps that are
required before a lethal drug is prescribed, including being counselled on
other forms of treatment, such as hospice and pain management; getting a
terminal diagnosis confirmed by more than one doctor; the patient has to have
no underlying mental illness and be mentally capable of making the decision to
end their life; and coercion and abuse are subject to criminal charges.
JCHC contends there has been no substantiated claim of coercion
or abuse since the practice was first utilized in Oregon 20 years ago. They
also note that the vast majority of those who chose physician-assisted suicide
already were enrolled in hospice and/or receiving palliative care. They have
earned wide support across the political, ideological and religious spectrums,
according to the JCHC study.
However, opponents point to the fact that legalization has been
rejected by dozens of states, as well as the American Medical Association, and
that the U.S. Supreme Court rejected the claim that assisted suicide was a
constitutional right in 1997.
The Hippocratic Oath states doctors should not participate in
physician-assisted suicide. It reads: “I will neither give a deadly drug to
anybody who asks for it, nor will I make a suggestion to this effect.”
Opponents also note that while no substantiated claims of abuse or coercion
have been proven, that doesn’t mean they haven’t occurred.
Instead of doctors assisting patients in suicide, the church
advises them to assist patients throughout their lives by providing palliative
care so they can “live each day with dignity.” Pain management is a key factor
in this, and the church supports medical intervention to aid patients in pain,
as well as helping them with their most basic needs by providing physical and
emotional support.
The Catechism of the Catholic Church also states that,
“Discontinuing medical procedures that are burdensome, dangerous,
extraordinary, or disproportionate to the expected outcome can be legitimate.
Here one does not will to cause death; one’s inability to impede it is merely
accepted” (2278). This is different than providing the patient with deadly
drugs to end their life.
One component to consider is substantive interventions.
Substantive interventions include “control of pain and other symptoms; referral
to a hospice program; general reassurances and specific reassurance that the
prescription would be made available; treatment of depression; a social work
consultation; an alternative means of hastening death; and a palliative care
consultation.”
For those who received a substantive intervention, a 2000 study
in Oregon showed that 31 of 67 patients changed their minds about ending their
lives compared to only 11 of 73 patients who were not provided a substantive
intervention. These results show that, when given more options for care,
patients are less likely to end their lives.
In 2011, the U.S. Conference of Catholic Bishops issued a
statement condemning physician-assisted suicide. It states, “People who request
death are vulnerable. They need care and protection. To offer them lethal drugs
is a victory not for freedom but for the worst form of neglect.”
The USCCB asserts that, “Life is out first gift from an
infinitely loving Creator. It is the most fundamental element of our God-given
human dignity. A choice to take one’s life is a supreme contradiction of
freedom, a choice to eliminate all choices. And a society that devalues some
people’s lives, by hastening and facilitating their deaths, will ultimately
lose respect for their other rights and freedoms.”
This articles is reprinted with permission of the Catholic Virginian.
Share your thoughts
To submit comments to the Joint Commission on Health Care,
go to vacatholic.org and click on “Take Action,” then “Action Center” or email
[email protected].
