This process will be voluntary, not just for patients, but for health care providers. Doctors who do participate will be required to report every case in which they dispense lethal medication to the Department of Health. Still, opponents of physician-assisted suicide claim that, despite regulatory safeguards, it leads to the murder of people considered expendable or burdensome by their relatives, insurance companies, or society in general.
Their fears, or fear mongering, are refuted by facts about the effects of similar Death with Dignity laws in Oregon and Washington. The numbers of people who use these laws are small; the numbers who use the lethal medications they receive are even smaller.
In Oregon, where the law has been in effect for 14 years, a total of "935 prescriptions have been written and 596 individuals have ingested medication." Last year, of the 114 patients who received lethal medication, 71 patients ingested them. In Washington, 103 patients received medication in 2011, and 70 people ingested them.
Of course, some people may have obtained or been administered medications in violation of the law, but that is no argument for repeal. Abolishing the right to physician-assisted suicide would not decrease the number of questionable suicides anymore than abolishing abortion rights would decrease the number of back-room abortions.
But opponents of assisted suicide are not persuaded by the Oregon and Washington experiences, either because they assume that the slide toward euthanasia remains inevitable, or because they categorically condemn assisted suicide, even when it's the voluntary act of terminally ill, competent adults.
It represents "the absolutization of autonomy," Cardinal O'Malley laments. "(A)ll expressions of personal freedom must be judged by their social implications." Your decision to end your life, on your terms, violates "our communal commitments and values."
This view of suicide as selfish, even when undertaken to avoid extreme pain and suffering, is central to the debate over it. Even if physician-assisted suicide laws are not abused -- even if they don't lead to euthanasia or the devaluing of sick, poor, and disabled people -- they are anathema to people who believe we are socially and spiritually obliged to cling to life, just as others are obliged to care for us as we do.
Does selfishness lie in the desire to end your unwanted life or in the refusal of other people to allow you to do so? It's a moral or ideological question, not an empirical one, and it's at the heart of a unbridgeable divide between people who strongly oppose and support physician-assisted suicide.
My understanding of selfishness, compassion, and justice differs fundamentally from that of the Cardinal. I cared for my mother and father at the end of their long lives and tried to help them fulfill their needs and desires, not my own. Both were mentally competent and their approaches to death were entirely consistent with their characters, and their approaches to life. My father wanted to fight, against all odds, and his doctor gave him every chance -- increasing his morphine only at the end, when his suffering was pronounced. If I had urged her not to ease his pain, so that I might spend more time with him -- that would have been supremely selfish.
My mother had been ill longer and while she enjoyed life despite some disability imposed by heart disease, at the end, when she crashed, she was more accepting of death. A very practical woman, she declined invasive procedures that could have prolonged her life. "What's the point," she said to her doctor a few days before she died. "I'd only have to go through this again."
She wanted to be medicated into unconsciousness in her final days; she wanted doctors to "hasten" her death. They declined to do so. I'd promised her I'd help her die, and purposefully made a scene in the hospital corridor, demanding that doctors increase her morphine. They obliged, but my mother drifted in and out of consciousness, acutely aware of her circumstances, tracking her own death, apparently impatiently. "Why does it take so long?" she asked.