The District of Columbia's City Council will soon vote on legislation under the deceptively innocuous title: "The Death with Dignity Act." This assisted-suicide statute is hardly innocuous. Just as troubling, it is one of many pieces of legislation on the subject being introduced across the country.
I have no illusions about the nature of death and its pain. I've witnessed it firsthand. I also believe, unequivocally, that those at life's end and those who love them need and deserve care and support — not the implicit message that fragile lives should no longer be lived. The Hippocratic Oath includes an ancient promise not to "give a lethal drug to anyone if I am asked" and not to "advise such a plan." This bill identifies a vulnerable group of people — those with a "terminal" diagnosis — for whom this will mean nothing. Along with the Council, all District residents must read this proposal carefully and ask some hard questions.
First, the bill defines "terminal disease" as one that merely two physicians believe "within reasonable medical judgment … [will] result in death within 6 months." How confident should we be about imperfect predictions on such profound matters? These predictions can be wrong. What prevents this from expanding to include patients expected to live only 1 or 2 or 5 years? Or those who live with painful disability, debilitating injury, or chronic illness? Or those who find life burdensome in any deeply painful way? The rationale that allows death for any vulnerable person can easily — and not illogically – expand. The legislation includes euphemisms and technical guidelines to convince the public that this is not the start down that slippery slope. Cautionary tales from other nations warn us not to believe them. Just last month, a minor was euthanized in Belgium, and justifications for facilitating death have expanded far beyond the original statutory terms.
Second, two people must witness the patient's request for poison. Read carefully. One of them may be an "interested" party who stands to gain by the patient's death. Traditionally, wills have required multiple disinterested witnesses for obvious reasons. What does it mean to have erected greater safeguards to dispose of mere property than to end human life?
Further, the bill allegedly requires "counseling" if a physician believes that depression, coercion or other difficulty clouds a patient's judgment. How meaningful is this when the physician may hardly know the patient or where physician-shopping can run rampant? One should surely question whether depression could be distinguished from the natural sadness that follows traumatic diagnosis. Referrals for counseling are shockingly rare in states with similar laws. Why is the City Council not more concerned with expanding quality mental health care for suffering patients?
The bill claims to ensure that patients act "voluntarily" when requesting their poison. Is it credible that no one will feel obligated to spare loved ones expense or inconvenience by ending life? Some insurers cover lethal drugs but not other desired care. Do we honestly believe that this "option" will not become viewed as an obligation to conserve resources and ease burdens? The bill provides that ending life pursuant to this statute will not affect "any life, health, accident insurance, or annuity policy," or similar contract. This could subtly pressure those who know that faster death will result in faster payments to loved ones.
No witnesses are required when the drug is taken. Once the poison is procured, nothing prevents anyone from slipping it to the patient — or anyone else, for that matter — without their final free consent. No one would ever know.
Throughout the proposal, the euphemism "medication" is used. How does this differ from poison? If it truly is "medication" with such profound side effects, why is there no requirement that medical personnel be present when it is administered?
What of physicians? How easily can the same physician aggressively fight to preserve life while collaborating with the same patient to end that same life? Ironically, recent studies lament the distress felt by veterinarians facilitating the death of animals they have treated. If such distress results from animal deaths, there should be far greater angst by — and about — physicians who collaborate in human death.
This bill is dubbed the "Death with Dignity Act," and it promises to allow patients to "end … life in a humane and dignified manner." Does this imply that a courageous, messy fight for life — one's own or a loved one's — lacks humanity or dignity? From experience, I have seen the best of humanity and the fullness of dignity in providing those who are vulnerable with the care, compassion and support they deserve, rather than legislation that facilitates the end of their lives and suggests those lives are no longer worth living.
Contrary to common belief, those who chose assisted suicide do not cite excruciating physical pain as their primary motivation. Rather, they fear burdening others and losing "autonomy" and "dignity." It would be heartbreaking indeed if a false belief that lives have value only when they can be lived in independence and strength prevailed. Those who are the most ill need our best medical, emotional and spiritual care, effective pain management and ethical research into the diseases that have ravaged too many for too long. State after state across the political spectrum have rejected similar legislation. In following suit, the nation's capital can remind all that the lives of the most vulnerable must be preserved with dignity, with fierce gentleness and with a renewed commitment to quality, accessible care through the end of life.
Lucia Silecchia is a professor of law and vice provost for policy at the Catholic University of America. Thinking of submitting an op-ed to the Washington Examiner? Be sure to read our guidelines on submissions.