Aging, chaplaincy, compassion, Hospice, Jewish medical Ethics, medical ethics, medicine, PAS, pastoral care, physician assisted suicide, religion, spiritual care, terminal illness
I often try to avoid the more controversial topics because no matter where one falls out on the issues, someone always says something offensive and hurtful. With that caveat, I could not sit back and not comment on the topic of physician assisted suicide, PAS for short. My impetus for writing about this topic is that in NJ, where I live, an article appeared in yesterday’s paper that indicated PAS is about to be debated in the state senate. While this is just debate, I feel all opinions on the matter are needed. To start, here is the article from the paper.
Controversial bill would allow terminally ill patients to decide when it’s time to die
Published: Thursday, September 27, 2012, 6:00 AM Updated: Thursday, September 27, 2012, 7:40 AM
By Matt Friedman/Statehouse Bureau
TRENTON — A state lawmaker says it’s time for New Jersey to openly discuss the most difficult of topics: whether terminally ill patients should be allowed to decide how and when they die.
Assemblyman John Burzichelli (D-Gloucester) on Monday quietly proposed a bill that would grant doctors the right to prescribe lethal doses of drugs to patients who have less than six months to live. It’s called the New Jersey Death with Dignity Act.
The South Jersey lawmaker wants suffering patients to have the option of ending their days on their own terms. He expects a long debate on the bill.
“This is the beginning of discussing a topic that we’ve got to get a sense of how people feel,” he said. “People are not favorable to a Dr. Kevorkian suicide bill that says someone who’s 45 and depressed and decides to kill themselves with help. That’s not what this bill is.”
Under the bill, no law would be enacted without voter approval, but Burzichelli said he is not sure if the final version will call for a public referendum. If it becomes law, patients would self-administer the drugs.
“In my mind it’s a matter of conscience, faith and a very private decision the individual should be in a position to make if they choose to,” said Burzichelli.
Patrick Brannigan, executive director for the New Jersey Catholic Conference, said while the Church does not require “futile medical treatments or high-tech interventions for the dying” and backs palliative care to ease pain — it does not support hastening the end of life.
“The New Jersey Death with Dignity Act as written is not about dignity or choice. The legislation would enable people to pressure others to an early death or even cause early death. The Act may also encourage patients with years to live to give up hope,” Brannigan said. “The Bishops of New Jersey strongly oppose any direct, intentional or purposeful taking of a human life.”
Mickey MacIntyre — chief program officer for Compassion & Choices, a group that provides counseling on end of life issues and pushes for legislation like Burzichelli’s across the country, said the bill would help patients and their families.
“It gives them the opportunity to share a loving and peaceful death, the opportunity to say goodbye to each other and experience memories that would be an honorable tribute to the patient’s life as opposed to memories of horrible pain and suffering,” he said.
Under the bill (A3328), patients who want to end their lives would have to first verbally request a prescription, followed at least 15 days later by another verbal request and one in writing, signed by two witnesses.
After that, the doctor would have to offer the patient a chance to rescind the request and recommend the patient’s next of kin be notified. A second doctor would then have to certify the original doctor’s diagnosis and affirm that the patient is acting voluntarily and capable of making the decision.
Patients deemed to have impaired judgement would not be eligible, and the doctors would be required to refer them to counseling. And health care facilities would be able to prohibit their doctors from writing the prescriptions.
The New Jersey legislation is modeled after laws in Oregon and Washington, the only states with statutes that allow doctors to prescribe life-ending drugs to terminally ill patients. One other state, Montana, allows it based on a court decision.
A similar measure is on the ballot this November in Massachusetts, and since the 1990s voters have rejected them in California, Maine and Michigan.
In Oregon, 935 patients received prescriptions and 596 died from ingesting them from 1997 to 2011, according to the Oregon Public Health Division. The patients’ most frequently mentioned concerns last year were “inability to participate in activities that made life enjoyable,” “loss of autonomy” and “loss of dignity.”
This appears to be the first time a lawmaker in New Jersey has proposed such a measure, said Peter Mazzei, a librarian for the Office of Legislative Services.
Assembly Speaker Sheila Oliver (D-Essex), who decides which bills get posted for a vote in the lower house, signaled she would review the legislation.
“The Speaker recognizes this as an serious and emotional issue, and the bill will certainly be reviewed,” said her spokesman, Tom Hester Jr.
There are a few issues at hand. The problem with PAS for me revolves around a few different strands of thought. First, Judaism would categorically forbid the deliberate hastening of death. And while that is irrelevant to the issue of legislation in its own right, it is important to state. Second, for the average person, PAS is often falsely equated with hospice care, which is the original dying with dignity model. I have spoken often about what scares people about hospice care. Most fear that hospice has the goal of hastening death. While I have shared how this is incorrect, the perception remains. I know it because I still often hear from families of dying patients about how the start of morphine means the end is coming, and then the equation becomes morphine=death. Unfortunately, this myth persists because of observational logic. If my loved died not too much after morphine was administered, then of course it must mean the person died from morphine. While this is false, it is easy to make it sound true. Ultimately, as we begin discussing the issue, it is incumbent that we remember that people are seeking ways of creating compassionate medicine, and while we might disagree about methodology, we need to allow these debates to be a means of reevaluating how we care for people in their final stages of life.