This week, a Wall Street Journal Op-Ed has reignited the heated, and polarized, debate on physician-assisted suicide in the United States. In his editorial, “A Doctor-Assisted Disaster for Medicine,” Oregon-based physician William L. Toffler, M.D. expressed his belief that assisted suicide: “… has been detrimental to patients, degraded the quality of medical care, and compromised the integrity of the medical profession.”
Dr. Toffler is a professor of family medicine at Oregon Health & Science and has been a licensed physician for 35 years. He says he has seen a profound shift in attitude toward medical care since 1997, when Oregon voters legalized physician-assisted suicide for terminally ill patients (by a narrow vote).
According to Dr. Toffler, some patients now fear they are being steered toward assisted suicide. He writes:
“In one case a patient with bladder cancer contacted me. She was concerned that an oncologist treating her might be one of the ‘death doctors,’ and she questioned his motives. This was particularly worrying to her after she obtained a second opinion from another oncologist who was more positive about her prognosis and treatment options. Whichever of the consultants was correct, such fears were never an issue before.”
Dr. Toffler is also troubled by the fact that physician-assisted suicide is covered by the state and taxpayer dollars, whereas many pharmaceuticals and medical services are not.
“Supporters claim physician-assisted suicide gives patients choice,” wrote Dr. Toffler, “but what sort of a choice is it when life is expensive but death is free?”
It’s a complex issue, and there’s another side to it. On November 1, 2014, terminal cancer patient and Oregon resident Brittany Maynard famously ended her life via physician-assisted suicide. Her choice, and her vocal support of assisted suicide, gave a face to the “death with dignity” movement.
“I still feel good enough and I still have enough joy and I still laugh and smile with my family and friends enough that it doesn’t seem like the right time right now,” Maynard said in a video released months before her chosen day of death. “But it will come, because I feel myself getting sicker. It’s happening each week.”
You can watch the video here:
Americans nationwide were moved by Maynard’s plight. Should she continue living as her violent seizures and pain grew worse until, in mere months, she faded away; or should she swallow a few pills that would allow her to die quickly and peacefully at home, surrounded by loved ones? Ultimately, she chose to control her death.
Since Oregon passed its death with dignity law, more than 850 terminally ill people have taken their lives with the barbiturates prescribed in physician-assisted suicide. As of late 2014, aid-in-dying practices are protected in five states, either by voted legislation or case ruling. (See which states allow assisted suicide.)
Advocates say death-with-dignity laws allow terminally ill patients to reduce unbearable suffering and die on their own terms. Opponents are concerned that these patients might be pressured by loved ones to take their own lives to save money or reduce the burden of caring for a family member with a devastating illness.
“For people to argue against this choice for sick people really seems evil to me,” Maynard told People before her death. “They try to mix it up with suicide and that’s really unfair, because there’s not a single part of me that wants to die. But I am dying.”
In coming years, will more states adopt death-with-dignity laws? Time will tell. The greater question is: should they? Or should Americans focus on giving terminally ill patients better access to hospice and palliative care? What do you think?