Assisted Suicide in D.C.

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September is Suicide Prevention Month. Yet as municipalities around the country are host to charity runs and awareness campaigns, the 13 members of the DC Council are considering a measure to legalize physician-assisted suicide in the District of Columbia.

Under Bill B21-0038, entitled Death with Dignity Act of 2015, a DC resident with a terminal illness and six months or less to live (a prognosis which is nearly impossible for a doctor to make with any reasonable certainty) could obtain a lethal prescription.

The bill suffers from a startling lack of commonsense safeguards. First, there is no mandated mental health screening, which means that patients suffering from depression and other psychological disorders that impair a person’s judgment are particularly vulnerable. Only if the doctor believes the patient has a psychological disorder will the patient be referred to counseling. But relying on a doctor who may have little or no psychological training to detect mental health problems in a patient with whom he may have had very little contact is wholly inadequate.

Second, the bill encourages “doctor shopping” by broadly defining the attending physician (who is authorized under the bill to write the lethal prescription) as a doctor “selected by, or assigned to, the patient” and who has “primary responsibility for the treatment and care of the patient.” While a physical examination of the patient, or at the very least, a face-to-face meeting between the patient and the attending physician would be expected, it is not expressly required in the bill, nor is there a requirement that there be a patient-doctor relationship prior to the suicide request. This opens the door to the very real possibility that a patient will seek out a sympathetic doctor with whom he has had no prior treatment relationship. While it is true that a second doctor must also sign off on the suicide request and that this second doctor will conduct an examination of the patient, the bill fails to provide any meaningful safeguards to prevent this second opinion from becoming a rubber stamp.

Third, the bill removes the patient’s family from the equation by allowing a patient to elect not to inform his family of his decision. Just when a person needs community support the most—when he is in crisis—the bill sanctions the isolation of the suffering patient from what is for many, a source of support.

These glaring oversights should not come as a surprise. In the name of radical autonomy, the bill promotes the lie that the only “life worth living” is one free of suffering; one which is autonomous, productive, and lived according to our designs. Opponents of assisted suicide are not blind or callous towards the very real suffering, both psychological and physical, of persons facing terminal illnesses. But rather than “solve” the problem of suffering by advocating for the death of the sufferer, opponents advocate for effective pain management, which can provide comfort in nearly every situation a terminally ill patient faces, and psychological counseling, to help a patient process his situation and fight depression.

Reading through the bill, the most jarring paragraph comes near the end, when the bill baldy claims, “[a]ctions taken in accordance with this act do not constitute suicide, assisted suicide, mercy killing, or homicide, under the law.” Really? Despite the text of the bill, legislative definitions cannot change reality. Such acts do constitute suicide, assisted suicide or homicide and attempting to redefine what is and always has been contrary to the natural law and gravely immoral as something “merciful” is a grim fairy tale.

Much like Humpty Dumpty, who tells Alice in Lewis Carroll’s classic story that when he uses a word “it means just what I choose it to mean — neither more nor less,” the blatant and intentional denial that these actions are suicide or assisted suicide breeds a denial of reality that will have grave consequences. Moreover, assisted suicide, by means of a physician-prescribed lethal drug, whether taken in hand by the “patient” or administered by the doctor, is actually euthanasia by definition of the act undertaken. Euthanasia is the “act or omission which of itself and by intention causes death, with the purpose of eliminating all suffering.” (Evangelium Vitae par. 64). The intention of the physician and the one who suffers is to procure death. The physician’s assistance, instrumental to actions taken, are anything but passive.

Once a society buys into the lie that our dignity and value are expendable at will, determined by a utilitarian ethic, measured in terms of our economic productivity and ability to do what we want—when we want, and how we want—we forfeit the truth that our dignity and value are rooted in our very nature as human beings and not in any external achievement, ability, or material thing. If that lie takes root and if assisted suicide is legalized, we can expect euthanasia, both voluntary and involuntary, to soon follow, just as we have seen in Belgium, where the first child was euthanized just over a week ago.

As we close out Suicide Prevention Month, let’s remember that the lives of all persons are worth protecting, including the lives of those suffering from debilitating and terminal illnesses who, rather than lethal drugs, need effective pain management, psychological counseling and community support. Life, in any stage, is too great a gift to be thrown away.

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Elyse M. Smith, Esq.