Physician-Assisted Suicide Is Not Progressive

"Right to die" is just a slogan. No civil right to commit suicide exists in any social compact. 

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Massachusetts State House [Jessica Rinaldi/Reuters]

The issue of legalizing physician-assisted suicide doesn't fall cleanly along liberal-conservative lines. However, it's fair to say that most social conservatives ardently oppose assisted suicide, while a clear majority on the political left support legalization. That's the case in Massachusetts where Question 2 is on November's ballot, and according to recent polling is very likely to pass.

I am an outlier, in that I am a registered Democrat and progressive, as well as a physician who has cared for people with life-threatening conditions for more than three decades. I support universal health care, voting rights, disability rights, women's rights, Planned Parenthood, gay marriage, alternative energy, and gun control. I yearn to see an end to the war on drugs and the war in Afghanistan. And, I am convinced that legalization of physician-assisted suicide is something my fellow progressives should fear and loathe.

When cast as a rights issue, it's hard for progressives to resist. But "the right to die" is just a slogan. No civil right to commit suicide exists in any social compact. Human beings have a biologically imposed obligation to die; and, as Jean Paul Sartre reminded us, suicide is always an option. However, even if a civic right to suicide did exist, suicide and assisted suicide are very different things. Suicide might be a purely private act; but physician-assisted suicide involves two people, one of whom is trained, certified, licensed, and compensated by society.

Supporters of initiatives to legalize physician-assisted suicide worry about people who die badly. On that we agree. If the moral worth of a society can be measured by how well it cares for the most vulnerable of its members, the America in which I live and practice medicine scores poorly. Much of the suffering I see among people with advanced illness is preventable. Many of the indignities I witness are imposed.

Sick people commonly endure undertreated physical suffering and a dizzying array of system-based personal assaults. There is a maze of appointments, irrational insurance hoops, and requirements, and indecipherable bills. I hear patients express embarrassment at becoming a burden to those they love, dread at the prospect of draining their family's savings and shame of being forced into medical bankruptcy. Public policies could go a long way to dissolving this quagmire, but legalizing physician-assisted suicide isn't one of them. Giving doctors lethal authority would address none of the deficiencies in medical practice, health care financing or social services that bring ill people to contemplate ending their lives.

Oregon is often held up as an example of a place where legalized physician-assisted suicide has worked well. Its Death with Dignity Act is a template for legislation in other states, including Massachusetts. It is widely assumed that if a terminally ill individual qualifies for a lethal prescription, he or she automatically qualifies for hospice care. Not true. In actuality, criteria for physician-assisted suicide in Oregon are more liberal (sic) than eligibility for hospice care.

Presented by

Ira Byock

Ira Byock is director of palliative care at Dartmouth-Hitchcock Medical Center in Lebanon, N.H., and author of The Best Care Possible: A Physician’s Quest to Transform Care Through the End of Life.

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