Three former Washington State Governors have endorsed the Death with Dignity Initiative I-1000, Republican Dan Evans and Democrats Booth Gardner and Gary Locke. A fourth, Republican John Spellman, is opposing the measure. I’d been planning to write a final post about all of the myths and lies being spread by the I-1000 opposition, but Spellman’s recent editorial in the Seattle PI contains enough of them that it serves as the perfect springboard for this post anyway.
It is not often I publicly disagree with my former gubernatorial colleagues, Booth Gardner and Daniel Evans. While I respect them both, I must firmly disagree with their support of the assisted suicide initiative, I-1000.
Both frame the issue as one of strictly personal choice. But what’s at stake is actually much broader. Derek Humphrey, co-founder of the Hemlock Society, has asserted repeatedly that euthanasia and assisted suicide will inevitably prevail in our society because they make economic sense.
Think about that for a second. What on Earth is he saying? Obviously it’s cheaper to have people with serious illnesses die sooner rather than later. But when economics enters the picture, it’s no longer a matter of strictly personal choice. Do you really think that, once implemented, assisted suicide will remain merely a “personal choice,” isolated from not-so-subtle coercions of everyday life and magically protected from health care rationing?
Yes, I do, and we can look at Oregon for the proof. Oregon’s law has been on the books for 10 years now, and there’s absolutely no evidence that it’s moving any closer to being anything other than a personal choice. No one anywhere wants coercions, and no one anywhere is talking about coercions. As in Oregon, only the terminally ill individual makes the choice under I-1000, not doctors, not health care providers, not family members, not the government. The belief that I-1000 will lead to an end where people have less choices has no basis in reality.
When Gardner says I-1000 is a good “first step,” I think we have to take that claim very seriously.
The first step we’re taking here is one towards having greater say over our own medical decisions, something that has gradually been taken away from us for the past few decades. This is a first step towards more autonomy, more privacy, and more dignity.
This week, a judge in Kitsap County sent a medical marijuana patient to jail because the judge disagreed with the patient’s decision to use medical marijuana over far-more addictive opiates, even though his doctor approved of it. Is this is the kind of intrusive government nannyism that Governor Spellman and others want? How is this any different from what I-1000 opponents want in end-of-life scenarios?
This initiative is just one way we can start fighting back. Government officials should never be in a position to impose any kind of moral litmus test on our medical choices, especially when they overrule the advice and consent of doctors.
Our choices affect the common good. As a state we don’t allow people to exercise the “personal choice” of driving a motorcycle without a helmet, because the social costs are too high and we all bear those costs. Legalizing assisted suicide will change the whole fabric of medical care, and it will radically alter the doctor-patient relationship. That’s one reason why the American and Washington medical associations actively oppose assisted suicide.
For starters, one can once again easily look towards Oregon to see if their law “changed the whole fabric of medical care.” It did not. In fact, there’s evidence that palliative care (caring for someone with chronic pain) has actually improved since Oregon’s law was passed. And second, a majority of Washington doctors surveyed support this law, even if some of their umbrella organizations do not.
Only one state, Oregon, allows assisted suicide, and it provides the template for I-1000. In Oregon, things have not turned out as proponents claim. For one thing, the economic effects of that law have reared their ugly head. The Oregon Health Plan recently sent out letters informing some patients that although it would not cover their cancer treatments because they were too expensive, it would be happy to pay for their assisted suicide.
This situation has nothing to do with Oregon’s law. Health care plans across the country deny people life-saving treatments and force people to explore alternatives. Just because Oregon has a death with dignity law has not made it any more likely that health care providers in that state will deny treatment. The same thing will be true in Washington. There’s no evidence whatsoever that health care providers will find it easier or more convenient to avoid giving people real care.
In addition, Oregon’s alleged safeguards don’t appear to be working. A study this month found that one of four people requesting assisted suicide suffered from untreated depression. Not one resident requesting assisted suicide last year was referred for depression, even though one of the law’s alleged safeguards requires people requesting assisted suicide to be referred to a mental health professional if they exhibit signs of depression.
Depression is a long-term clinical condition. Most people who are at the end of their lives are going to be sad about it. But to say that doctors across Oregon are misdiagnosing people who come in and request the prescription is insulting to doctors. If this law is commonly ensnaring the depressed, where are the living relatives who feel that their now-deceased relative was taken advantage of? They don’t exist. The bottom line is that this is a narrow statute that generally only appeals to strong-willed individuals. No chronically depressed person would ever make it through the safeguards and there’s zero evidence anywhere that any have.
Our choices also affect those closest to us. Yet I-1000 allows a loved one to be given a lethal overdose without a family member ever being notified.
This is because of doctor-patient confidentiality laws. Again, I-1000 opponents reveal what they’re all about, making more of your personal medical decisions subject to state regulation.
Oregon’s program is shrouded in secrecy. That’s one reason why the Oregonian in Portland has come out against I-1000, saying, “Essentially, a coterie of insiders run the program, with a handful of doctors and others deciding what the public may know.” I-1000 goes even further than Oregon’s law; it requires doctors to falsify the death certificates, and there will be no way to discover abuse.
This is the most blatant lie in the editorial, and one of the most blatant lies I’ve seen in this entire campaign. I-1000 is no different than Oregon’s law when it comes to death certificates. When a person requests, receives, and uses the death with dignity prescription, their cause of death is listed as their underlying illness. This is exactly how it should be. The underlying terminal illness is the cause of their death. Just because they chose to die on their own terms does not change what brought about the particular outcome. Putting suicide on their death certificate would technically be inaccurate. This is how I-1000 will work, and that’s the right way to do it.
The past president of the King County Bar Association concludes that I-1000 “would subject poor, disabled and other vulnerable patients to dangerous outside pressures to end their lives prematurely, could not effectively be monitored or policed and is deeply contrary to the role of health care providers as healers.”
He’s absolutely wrong, and we already know this for a fact because of the experience in Oregon. No one who is poor, disabled, or otherwise vulnerable has been unfairly coerced into a premature death. Absolutely none. Not a single one in ten years. Why? Because the law requires that the person involved explicitly expresses their desire for death with dignity to two separate doctors at two separate times. Anyone with an interest in coercing another person to commit suicide will have no interest or ability to corrupt this process. And if there are corrupt doctors out there, well, they don’t need I-1000 to do this in the first place. They can already prescribe lethal doses of opiates and other drugs as long as it’s under the auspices of palliative care. I-1000 simply does not put people at risk of being coerced into suicide. Anyone who tells you otherwise is lying.
Throughout this campaign, I’ve often compared this debate to the debate over abortion. Both issues involve a matter of choice for a controversial medical decision. They both involve an individual’s value judgments over life and death. They both involve a very vocal minority whose religious views or moral inclinations compel them to take away people’s choices in an attempt to protect them from themselves (or as they often try to claim, to protect society as a whole). And the arguments on both sides can get very emotional. But this is one issue where putting aside the emotion and using reason is an absolute must.
Governor Spellman asserted above that one reason to vote against I-1000 is because health care providers might cover that instead of the far more expensive cancer treatments. But is the possibility that a health care provider might cover abortion, but not the costs of bringing a child to term, a reason to take away a woman’s right to choice? Of course not, that would be silly. It’s the same thing here. We shouldn’t be limiting our choices because of what an unscrupulous health care provider might do to us if we demand more freedom. We should demand both our choices, and for our health care providers not to screw us over. I-1000 can not fix our health care mess. But it’s a lie when opponents claim that it will make it worse.
It’s true I’ve written a lot about this initiative (some of you think too much), but I really can’t overstate how important I feel it is to pass this. I was new to the Pacific Northwest when Oregon passed their law and was excited to be in a region that was at the forefront of valuing individual liberty. But it seems like since then, the mood of the entire nation had been going in the opposite direction. Part of this had to do with our response to terrorism and part of it was the nadir of the radical “pro-life” movement, which thankfully began to die down after the Terri Schiavo fiasco.
Government has a role to play in protecting people from the unexpected – from tragedies that one can’t possibly avoid on their own. But government should not be in the business of trying to protect us from ourselves. Giving government that right is the real slippery slope here. Please vote yes on I-1000.