Grappling with the implications of human dignity, suffering, living and dying is messy at best. There are thousands of professional articles and books addressing some aspect of the assisted dying and euthanasia debates. But there’s precious little available to lay citizens offering clear, concise information. There’s still less in a format that makes it possible to really understand the core concerns.
Terminology is often convoluted, misused or couched in rhetorical language. Medical, religious and philosophical opinions vary widely and are often authoritatively stated as undeniable truths. But the truth is that the truth is not so simple. Perhaps there is no universal right answer. Perhaps the best approach is to ask the right question. Should we, when terminally ill and approaching death, have the right to choose how that goes?
Formal and informal sources of information confuse terminology associated with assisted dying. It is not euthanasia. It is not continuous deep sedation. It is not medically or legally defined as suicide. Yet the media and many people still refer to this end-of-life option as assisted suicide.
Before enacted laws, assisted dying was referred to as physician-assisted suicide for lack of something better to call it. Framing terminology for the purpose of persuasion is particularly effective in arguing against assisted dying legislation. Terms such as suicide, self-murder and euthanasia are packed with meanings that have no place in the assisted dying debate — they are value-laden and connote illicit behavior, serving only to coerce and emotionally direct attention away from the issue at hand. Assisted dying is not euthanasia, and it is not medically or legally defined as suicide. It also is not the use of morphine at the end.
Not since abortion and the withdrawal of medical treatment has there been such controversy in the United States over personal choice in matters of the human body, its life and its inevitable death. Technically, this debate is no longer about whether assisted-dying should be permitted by law, since it has been legally established in the United States since 1997. But without federal guidance (the Supreme Court decided it wasn’t going down that road again), each state must choose on its own.
Professional groups are widely split on the issue. While some health care providers say they feel forced to compromise their ethical commitment to protect life, others go to work with the same ethical commitment to honor patient choices. Some contend it is unethical, while others argue that palliative sedation and assisted dying are not ethically different. Still others point to the underground use of euthanasia in the medical community to aid dying patients.
Assisted dying legislation makes it legally possible for a competent, terminally ill adult to choose to have a prescription to take when he or she feels the time is right. It protects the medical professional who writes the prescription. That’s it. It’s a clearly defined process with built-in safeguards to prevent abuse. Oregon’s law has been upheld around the world as a model, and there’s data to back up that it works.
Moral imperatives and rhetoric complicate the issue. Some appeal to the sanctity of life, yet some clergy agree that assisted dying is in highest keeping with sanctity, compassion and morality. Some argue that the gods, being immortal, are not affected by matters of mortality, so the timing and conditions of dying belong only to mortals. This is my personal favorite.
Slippery-slope arguments say passing these laws will lead to wholesale eradication of those deemed unfit by others. Some fear the laws will lead to widespread elder abuse and the forced deaths of our aging population. It’s important to take a deep breath here. The fact is, researchers find no such correlation between assisted-dying laws and these or any other abuses.
If ever there was a matter of import to life and death, this is it. This is not a time to be passive about what a patient option law in Maine would mean: to have the right while you are dying to have more say in what you need. To get clear on the issues, it is critical to understand what these laws do and do not permit and what that really means — without smoke, mirrors, rhetoric or hype.
Valerie Lovelace of Westport is founder and executive director of It’s My Death, a new 501(c)(3) nonprofit, which has a mission to provide holistic end-of-life services and community education to people who wish to actively explore the meaning of life through embracing the certainty of death. Her website is www.itsmydeath.com.