November 5, 2012

Vote NO on Question 2 in Massachusetts

On the Massachusetts ballot this year is Question 2 which would allow physician-assisted suicide.  The sponsor behind the bill is the former Hemlock Society which has renamed itself Death with Dignity.  Corrupting not only language,  the initiative, if it became law, would corrupt the medical profession and pharmacists making them accomplices in suicide.    There is no reason why pain by dying patients can not be treated with medications.

It's an extremely poorly written law with no safeguards against abuse, not even a requirement that the death certificate shows suicide as the cause of death.  Families do not have to be notified nor are patients requesting such assistance required to have a psychiatric evaluation to ensure they are of sound mind.  We should be devoting our efforts to improving palliative care and promoting hospice so that those at the end of life can have a good death, a death with real dignity.  Dying alone after ingesting 100 seconal is not a death with dignity. 

Along with those listed below, I urge a vote NO on Question 2.

The Massachusetts  Medical Society

The proposed safeguards against abuse are insufficient.  Enforcement provisions, investigation authority, oversight, or data verification are not included in the act. A witness to the patient’s signed request could also be an heir.
Assisted suicide is not necessary to improve the quality of life at the end of life. Current law gives every patient the right to refuse lifesaving treatment, and to have adequate pain relief, including hospice and palliative sedation. 
Predicting the end of life within six months is difficult; sometimes the prediction is not accurate. From time to time, patients expected to be within months of their death have gone on to live many more months — or years. In one study, 17 percent of patients outlived their prognosis.
Doctors should not participate in assisted suicide. The chief policy making body of the Massachusetts Medical Society has voted to oppose physician assisted suicide.
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“Allowing physicians to participate in assisted suicide would cause more harm than good. Physician assisted suicide is fundamentally incompatible with the physician’s role as healer. “Instead of participating in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life. …  Patients must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication.”

Boston Globe

Authorizing assisted suicide is “not, in itself, an answer to the far deeper question of how to help patients make end of life decisions.”

Boston Herald

Dr. Barbara Rockett, President of American Medical Association’s Foundation

Centuries ago the physician Hippocrates wrote the Hippocratic Oath, which many of us took when we became physicians and guides us in the ethical practice of medicine. It states that when treating patients, physicians will “First do no harm.” It goes on to state that “I will give no deadly medicine to anyone if asked nor suggest any such counsel.” Physician-assisted suicide is in direct conflict with this statement which, when followed, has protected the patient, physician, society and the family, and at the same time has committed doctors to compassion and human dignity.

Lahey Clinic Medical Ethics Lecture Series: The Arguments Against Question 2 and Physician-Assisted Suicide

Massachusetts Academy of Family Physicians.

Joseph Gravel, president of the MassAFP, said in a statement. “This certainly includes end-of-life care. It is clear that we need to continue to work to provide those suffering from serious illnesses, depression, and other conditions that can lead to hopelessness highly effective palliative and hospice treatments that are now available.


Committee Against Physician-Assisted Suicide

American Medical Association

Allowing physicians to participate in assisted suicide would cause more harm than good. Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.

Suicide is Always a Tragedy

Cardinal Sean O'Malley to Catholics:  It would bring spiritual death, a cheapening of human life, and a corrupting of the medical profession. It means making the pharmacists, doctors, nurses, family members, friends and society itself, accomplices in a suicide. Our task is to help prevent suicide and provide the very best palliative and hospice care for our terminally ill loved ones.

Cardinal O'Malley to non-Catholics:  Suicide is never a dignified way to die.  Suicide always impacts others beyond the individual.  Doctors strongly oppose.  Disability advocates strongly oppose.  Terminal diagnoses are often wrong.  Question 2 is strongly flawed (ingestion of 100 pills of Seconal without a doctor present;  no witnesses need be present; no oversight of drug after dispensed; no enforcement provisions, investigative authority, oversight or data verification).  No requirement for psychiatric evaluation.  Complex issues like this should be decided in a legislative context not by ballot initiative.

Vicky Kennedy, widow of Ted Kennedy in CapeCodOnline

The language of the proposed law is not about bringing family together to make end of life decisions; it's intended to exclude family members from the actual decision-making process to guard against patients' being pressured to end their lives prematurely. It's not about doctors administering drugs such as morphine to ease patients' suffering; it's about the oral ingestion of up to 100 capsules without requirement or expectation that a doctor be present. It's not about giving choice and self-determination to patients with degenerative diseases like ALS or Alzheimer's; those patients are unlikely to qualify under the statute. It's not, in my judgment, about death with dignity at all.
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My late husband Sen. Edward Kennedy called quality, affordable health care for all the cause of his life. Question 2 turns his vision of health care for all on its head by asking us to endorse patient suicide — not patient care — as our public policy for dealing with pain and the financial burdens of care at the end of life. We're better than that. We should expand palliative care, pain management, nursing care and hospice, not trade the dignity and life of a human being for the bottom line.
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When my husband was first diagnosed with cancer, he was told that he had only two to four months to live, that he'd never go back to the U.S. Senate, that he should get his affairs in order, kiss his wife, love his family and get ready to die.

But that prognosis was wrong. Teddy lived 15 more productive months. During that time, he cast a key vote in the Senate that protected payments to doctors under Medicare; made a speech at the Democratic Convention; saw the candidate he supported elected president of the United States and even attended his inauguration; received an honorary degree; chaired confirmation hearings in the Senate; worked on the reform of health care; threw out the first pitch on opening day for the Red Sox; introduced the president when he signed the bipartisan Edward M. Kennedy Serve America Act; sailed his boat; and finished his memoir "True Compass," while also getting his affairs in order, kissing his wife, loving his family and preparing for the end of life.

Physician-Assisted Suicide Is Not Progressive  Ira Byock in the Atlantic

Right to die" is just a slogan. No civil right to commit suicide exists in any social compact.
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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.
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In today's "Newspeak" the Hemlock Society morphed into Compassion and Choices, which promotes "death with dignity" and objects to the word "suicide," preferring "aid-in-dying" and "self-deliverance." These terms sound more wholesome, but the undisguised act is a morally primitive, socially regressive, response to basic human needs.
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America is failing people who are facing the end of life and those who love and care for them. Giving licensed physicians the authority to write lethal prescriptions is not a progressive thing to do.

When Your Doctor Is Your Executioner

It was a short step from there to deciding that illness and suffering needed a quick and “merciful” end. Rather than use the pain medications we have and care for those who are elderly or infirm, we quickly moved to the argument that killing them was the “moral” and “humane” thing to do. First we called it “mercy killing.” When that gentle phrase became tainted, the advertising folks supplied a new one. Today we call it “death with dignity.”  Somewhere along the line, we lost the understanding of just how dangerous a doctor who no longer feels a responsibility to be a healer can be.

Suicide by Choice?  Not so fast

NEXT week, voters in Massachusetts will decide whether to adopt an assisted-suicide law. As a good pro-choice liberal, I ought to support the effort. But as a lifelong disabled person, I cannot.
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My problem, ultimately, is this: I’ve lived so close to death for so long that I know how thin and porous the border between coercion and free choice is, how easy it is for someone to inadvertently influence you to feel devalued and hopeless — to pressure you ever so slightly but decidedly into being “reasonable,” to unburdening others, to “letting go.”
Posted by Jill Fallon at November 5, 2012 1:37 PM | Permalink