NRL News
Page 9
Fall 2012
Volume 39
Issue 4

As Massachusetts Doctor-Prescribed Suicide Vote Looms,
Suicide Is Now Leading Cause of Injury-Related Death in the U.S.

By Jennifer Popik, J.D.

With a presidential election dominating the headlines, little attention nationally has focused on the Massachusetts initiative to legalize doctor-prescribed suicide. Ballot Issue 2 is sponsored by “Dignity 2012,” composed of the national organizations Compassion & Choices and the Death With Dignity Center.

Opposed is a wide assortment of groups including the Massachusetts Medical Society, various disability rights groups, legal groups, and the Massachusetts Against Doctor Prescribed Suicide alliance.

If Ballot Issue 2 passes, Massachusetts would become one of a tiny minority of jurisdictions that legally permit doctor-prescribed suicide. Despite numerous ballot initiatives, court challenges, and well over 100 legislative efforts, doctor-prescribed suicide has been affirmatively legalized only in Washington and Oregon. (In Montana, the high court says that doctors are permitted to raise consent as a defense when they are defendants in a homicide or civil case.)

This push comes under the shadow of an unsettling new national study just published in the American Journal of Public Health. According to the study, suicide in America is now is the leading cause of injury-related deaths, surpassing deaths from car crashes.

The study found that the rate of death by suicide has increased by 15% over the past 10 years. The stakes for Massachusetts could not be higher.

There is credible evidence that in the two states that have statutorily legalized doctor-prescribed death for those believed to be terminally ill, the overall state suicide rate for teens and others has risen.

Oregon’s suicide rate has been “increasing significantly” since 2000 according to a 2010 state-issued report (suicides are not included under its doctor-prescribed suicide law). Moreover, the suicide rate in Oregon is a full 35% higher than the steadily rising national average. Critics worry that not attempting to prevent suicide in the very ill, and in fact encouraging it, may well have begun to help lift the stigma from suicide in general.

In addition to the deep concern over rising suicide rates, the ballot initiative in Massachusetts has implications beyond the Commonwealth. It is no accident that the pro-euthanasia lobby targeted Massachusetts. Euthanasia advocates are hopeful that legalization in Massachusetts would have a far-reaching influence, opening the door to passage elsewhere.

The state is home to the Harvard Medical School, which is currently ranked first among American research medical schools by U.S. News and World Report.

The New England Journal of Medicine, published by the Massachusetts Medical Society, is one of the oldest and most respected medical journals in the world. If doctor-prescribed death were to become standard medical practice in its home state, it might not be long before the notion that suicide is an appropriate response to illness would percolate through medical thought across the nation.

The groups opposing Ballot Issue 2 have exposed several false or misleading claims by proponents. For instance, while advocates claim the initiative restricts doctor-prescribed suicide to only the competent, it contains no requirement that the patient be given a psychiatric evaluation. Thus a physician with no previous relationship with a patient could write a lethal prescription without even an expert evaluation to see if the victim’s judgment is impaired by depression or other mental conditions—which is almost always the case. (For documentation, see www.nrlc.org/euthanasia/asisuid1.html.)

Indeed, in Oregon, on whose law the Massachusetts initiative is based, most lethal prescriptions are written by a handful of actively pro-euthanasia doctors who rarely refer their victims for the non-mandatory psychiatric evaluation. Further, both Oregon law and Ballot Issue 2 have no requirement for a witness at the time of death, so it is unknown if the person was still competent at the time she or he ingests the lethal prescription.

Disability rights activists have been particularly vocal opponents of the measure. In fact, several state and national disability rights advocates have requested a meeting with U.S. Senate candidate Democrat Elizabeth Warren (running against incumbent Republican Senator Scott Brown) to discuss their reasons for opposing Issue 2. Warren has gone on record saying that she was leaning in favor of the measure.

The disability rights activist groups include Second Thoughts, the Boston Center for Independent Living Inc., the Disability Rights Education & Defense Fund, the Cambridge Commission for Persons with Disabilities, and Not Dead Yet.

John Kelly, director of Second Thoughts, says that Ballot Issue 2 has dangerous implications for society, and particularly for people with disabilities. In an interview with the Boston area paper, The Pilot, he said, “It is dangerous for people who are already disadvantaged in terms of getting adequate medical care and full social respect. It is very dangerous for a society with such great levels of inequality.”

Kelly described the idea that someone restores their “dignity” through death as a philosophy directly opposed to living with a disability. He went on to say that there is legal and social confusion about the difference between terminal and disabled people that puts those with disabilities in the line of fire when assisted suicide is legalized.

He told The Pilot, “In the public mind being disabled and being terminal seem to run together, so we are so often already considered terminal that it will also put pressure on us.”

Although the presidential election will no doubt continue to dominate headlines, those concerned with protecting the lives of the most vulnerable must be equally concerned with the fate of the dangerous Massachusetts initiative.