A terminal illness diagnosis provokes a complex and intense series of discussions and decisions. The patient, his family, doctors, pastors, friends and support system must digest devastating information and determine how to meet it. There are many variables that influence the process, few of which are easy to navigate. Easing the transition from life to death is the thesis driving these difficult conversations, though, and for those facing terminal illnesses, physician-assisted suicide is an appropriate option.
However uncomfortable the topic – and it is greatly so, for centuries of cultural and religious taboos, if not for the personal heartbreak that losing one’s life or a loved one engenders – physician-assisted suicide can provide certain patients the relief they seek when facing a gruesome, painful and prolonged natural death. The Colorado Legislature is considering a measure that outlines the parameters for when such life-ending measures are appropriate. House Bill 1135, the Colorado Death with Dignity Act, provides a precise protocol for physician-assisted suicide, with many safeguards to ensure that patients who seek the option thoroughly are informed and exhaustive in their decision-making process, with access to support throughout.
The bill, sponsored by Reps. Lois Court, D-Denver, and Joann Ginal, D-Fort Collins, would allow physicians to prescribe life-ending medication to terminally ill patients of sound mind who have been given fewer than six months to live. These patients must request the medication – three times: once in writing, twice verbally, with waiting periods between each request. The written request must be witnessed by two people, one of which can be neither a relative, heir or caregiver. The patient must be able to administer the medication himself – no physician, prescribing or otherwise – may do so. Further, the prescribing physician must first educate their patients about alternatives, including counseling, hospice or other treatments. No physician is compelled by this bill to prescribe life-ending medication, and no patient similarly is compelled to ingest it.
Given its careful construction, House Bill 1135 answers many of its opponents’ concerns about physician-assisted suicide. The Centennial Institute at Colorado Christian University issued a policy brief condemning the measure as “eugenics for the infirm,” claiming it would compromise doctors’ religious beliefs and serve as a slippery slope to rampant use of the practice as well as euthanasia. There is little evidence to warrant such fears. In Oregon, whose assisted-suicide law provides the model for Colorado’s measure, 71 individuals used the law in 2013 – among roughly 32,000 people who died in the state that year. Since the measure was implemented in 1997, the most Oregonians to use it in a given year was 85 – in 2012. The annual average is 47. Upward of one-third of those prescribed the medication choose not to use it.
It seems, then, that the vast majority of patients seeking life-ending medication do so after exhausting all other possibilities and are choosing to end the suffering whose conclusion is impending. The prescribing physician is therefore performing the obligation to “ease pain and suffering and to promote the dignity and autonomy of dying patients in their care” – a call the Colorado Medical Society uses to frame its opposition to legalized assisted-suicide. The logic does not align. Further, House Bill 1135 addresses the American Medical Society’s concern that “Patients should not be abandoned once it is determined that cure is impossible. Multidisciplinary interventions should be sought, including specialty consultation, hospice care, pastoral support, family counseling and other modalities.” The concern is absolutely valid, and the Colorado Death with Dignity Act ensures that patients receive those interventions, as well as the autonomy to make painstaking decisions about all the alternatives – including suicide.
