Written Testimony of Catherine Glenn Foster, Esq.
President & CEO, People United for Life
Against S. 1208 and H. 1926, The “Massachusetts End of Life Options Act”
Submitted to the Joint Committee on Public Well being
June 25, 2019
Pricey Senator Comerford, Representative Mahoney, and Members of the Committee:
I function President and CEO of People United for Life (AUL), America’s unique and most lively organization advocating for life-affirming help and protections for the most weak members of our communities. Established in 1971, AUL has devoted almost 50 years to advocating for everybody to be welcomed in life and protected in regulation. In my follow I concentrate on life- and health-related legislation, and I am testifying as an professional in constitutional regulation usually and in the constitutionality of end of life-related legal guidelines specifically. I’ve additionally written extensively on the end-of-life concern, most just lately in The Human Life Evaluation. I recognize the alternative to offer written testimony towards S. 1208 and H. 1926, collectively known as “the Act,” which might legalize suicide by medical means in Massachusetts.
I’ve completely reviewed S. 1208 and H. 1926, and it’s my opinion that the Act places already-vulnerable persons at even larger danger, fails to protect the integrity and ethics of the medical career, and goes towards the prevailing consensus that states have a duty to protect life.
Suicide by Physician Locations Already–Weak Persons at Larger Danger
Massachusetts has a duty to guard weak persons—together with individuals dwelling in poverty, elder adults, and those dwelling with disabilities—from abuse, neglect, and coercion. Considering the danger posed to those weak people, legalizing suicide might be thought-about neither a “compassionate” nor an applicable answer for many who might endure melancholy or loss of hope at the end of life.
Certainly, contrary to the prevailing cultural narrative, the cause why individuals think about in search of help of their suicide is neither pain nor worry of ache. In the final 15 years, pain and worry of pain have never been in the prime five causes cited by those looking for assisted suicide in Oregon;1 the newest knowledge from Washington State reveal the similar considerations.2 As bioethicist Ezekiel Emanuel has famous, “the main drivers [of those contemplating suicide by physician] are depression, hopelessness, and fear of loss of autonomy and control. . . . . In this light, assisted suicide looks less like a good death in the face of unremitting pain and more like plain old suicide.”3
Emanuel just isn’t alone. Many in the bioethics, authorized, and medical fields have raised vital questions relating to the existence of abuses and failures in jurisdictions that have accepted prescription suicide, together with a scarcity of reporting and accountability, coercion, and failure to assure the competency of the requesting patient.4 Probably the most weak among us, reminiscent of the poor, the elderly, the terminally ailing, the disabled, and the depressed, are equally worthy of life and much more in want of equal protection underneath the regulation, and state prohibitions on selling or enabling suicide mirror and reinforce the well-supported coverage “that the lives of the terminally ill, disabled and elderly people must be no less valued than the lives of the young and healthy.”5 Chatting with this disparate remedy, Dr. Kevin Fitzpatrick wrote, “When non-disabled people say they despair of their future, suicide prevention is the default service we must provide. Disabled people, by contrast, feel the seductive, easy arm of the few, supposedly trusted medical professionals, around their shoulder; someone who says ‘Well, you’ve done enough. No-one could blame you.’”6
There was discussion of a “suicide contagion,” or the Werther Effect.7 Empirical evidence exhibits media coverage of suicide evokes others to commit suicide as properly.8 One research, which included assisted-suicide statistics, demonstrated that legalizing assisted suicide in certain states has led to an increase in general suicide rates—assisted and unassisted—in those states.9 The research’s key findings present that after accounting for demographic, socioeconomic, and other state-specific elements, physician-assisted suicide is related to a 6.three% improve in general suicide rates.10 These effects are even larger for people older than 65 years of age—14% improve.11 And so suicide prevention specialists have criticized assisted-suicide advertising campaigns, writing that a billboard proclaiming “My Life My Death My Choice,” which offered an internet site tackle, was “irresponsible and downright dangerous; it is the equivalent of handing a gun to someone who is suicidal.”12
The Supposed Safeguards Are Ineffective in Follow
Despite the so-called “safeguards,” opening the door for suicide by way of prescriptive means also opens the door to real abuse. For example, the Act’s requires that there be a minimum of two witnesses to the request for life-ending medicine—but only one have to be a disinterested social gathering, a minimum of in concept. The Act explicitly permits one of the events to be a relative, beneficiary, or other interested get together, easily circumventing the alleged safeguard designed to protect the individual from strain, coercion, or abuse. The “disinterested witness” could possibly be the partner, vital different, or greatest pal of the witness. This provision does little or no to guard the individual, particularly since they don’t seem to be even required to know the affected person however merely should have seen the patient’s “provided proof of identity.”13
In addition, the Act assumes the physicians are capable of make the right analysis that a affected person is has an incurable and irreversible illness which can “result in death within 6 months.” But this fails as a safeguard as terminality just isn’t straightforward to predict. Present studies have proven “experts put the [misdiagnosis] rate at around 40%,”14 and there have been instances reported the place, despite the lack of underlying symptoms, the doctor made an “error”15 which resulted in the particular person’s dying. Prognoses may be made in error as nicely, with one research displaying at the least 17% of patients have been misinformed.16 Nicholas Christakis, a Harvard professor of sociology and drugs, agreed “doctors often get terminality wrong in determining eligibility for hospice care,”17 and Arthur Caplan, the director of the Middle for Bioethics at the College of Pennsylvania, considers a six month requirement arbitrary.18 Even the Oregon Health Authority admitted, “
Suicide by Physician Erodes the Integrity and Ethics of the Medical Career
Prohibitions on physician-enabled suicide additionally shield the integrity and ethics of the medical career, together with its obligation to serve its sufferers as healers, as well as to the rules articulated in the Hippocratic Oath to “keep the sick from harm and injustice” and to “refrain from giving anybody a deadly drug if asked for it, nor make a suggestion to this effect.”20 Likewise, the American Medical Affiliation (AMA) does not help physician-assisted suicide, even for people dealing with the end of life. The AMA states that “permitting physicians to engage in assisted suicide would ultimately cause more harm than good. Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.”21 Actually, the AMA states the physician should “aggressively respond to the needs of the patients” and “respect patient autonomy [and] provide appropriate comfort care and adequate pain control.”22 Simply this month, the AMA reaffirmed its position towards suicide by doctor by a vote of 65-35.23
Furthermore, the Act threatens the integrity of the medical career and the conscience rights of healthcare professionals. Although it allows well being care providers to choose out of collaborating in providing treatment to sufferers for this objective, it requires that they refer patients to different suppliers and bear the costs of such transfer.24 This choose out provision is insufficient for suppliers whose conscience forbids them from collaborating in any respect in the premature ending of a life. Referral to a prepared doctor continues to be facilitating the consequence, and even more so when a healthcare provider should spend cash on data transferal.
This Act harms the medical career, physicians, and people who may be struggling to process the shock of a troublesome analysis. It opens the door for physicians to be pressured to violate medical ethics, corresponding to the Hippocratic Oath to “do no harm,” as well as their ethical convictions or spiritual beliefs towards taking one’s personal life or aiding one other to end her life. If handed, physicians who object to physician-assisted suicide for moral, spiritual, or ethical reasons can be pressured to decide on between violating their conscience or violating the regulation and probably dropping their medical license. This Act will increase the danger that patients might be coerced or pressured into prematurely ending their lives when pitched with assisted suicide as a viable remedy choice together with its alleged benefits. Moreover, a physician is prohibited from proceeding with any life-affirming care even for a terminally sick affected person until that patient has given informed consent, which beneath the Act, must embrace information about physician-assisted suicide.
The U.S. Supreme Courtroom has said “
The Majority of States Affirmatively Prohibit Medicalized Suicide
At present, the overwhelming majority of states—a minimum of 39 states—affirmatively prohibit assisted suicide and impose legal penalties on anyone who helps one other individual finish his or her life. And since Oregon first legalized the follow in 1996, “about 200 assisted-suicide bills have failed in more than half the states,” and more states have moved to ban the follow than have decided it was value the danger.27 In Washington v. Glucksberg, the United States Supreme Courtroom summed up the consensus of the states: “In almost every State—indeed, in almost every western democracy—it is a crime to assist a suicide. The States’ assisted-suicide bans are not innovations. Rather, they are longstanding expressions of the States’ commitment to the protection and preservation of all human life.”28
This longstanding consensus among the overwhelming majority of states is unsurprising when one considers, as the Courtroom did, that “opposition to and condemnation of suicide—and, therefore, of assisting suicide—are consistent and enduring themes of our philosophical, legal and cultural heritages.”29 Certainly, over twenty years ago, the Courtroom in Glucksberg held there isn’t any elementary proper to assisted suicide in the U.S. Constitution, discovering as an alternative that there exists for the states “an ‘unqualified interest in the preservation of human life[,]’ . . . in preventing suicide, and in studying, identifying, and treating its causes.”30
Thus, Massachusetts should reject S. 1208 and H. 1926 and proceed to uphold its obligation to shield the lives of all its citizens—especially weak people reminiscent of the unwell, elderly, and disabled—and keep the integrity and ethics of the medical career. Thanks.
Catherine Glenn Foster, M.A., J.D.
President & CEO
People United for Life