Boston Public Radio hosted a vibrant dialogue this week around the Massachusetts Death with Dignity ballot measure Bay Staters will vote on this November. Several key discussion points were addressed by radio host Callie Crossley as she engaged Dr. Marcia Angell, supporter of the proposed Massachusetts Death with Dignity Act, physician, former editor-in-chief of the New England Journal of Medicine, and Dr. Lynda Young, an opponent of the proposed law.
From this short 30-minute broadcast I’ve extracted a handful of gems I think you’ll enjoy. And I encourage you to take a little break from your day to listen and tell us your favorite quotes in the comments below, on Facebook, and through Twitter.
From the start, Dr. Angell helped listeners understand what the initiative is and described her confusion about how anyone would oppose it:
In my mind the real question is “why would anyone oppose it?” This Act merely permits dying patients, ones who find their suffering unendurable and who can’t find the relief that they want, permits such patients to ask their physician for a medication that would allow them to end their lives somewhat earlier. These people are dying; remember that. Allow these patients to die a little more peacefully.
I don’t see how this can be a threat to anyone. It’s their choice—they don’t have to ask for the medication—and it’s the doctor’s choice as to whether he or she wants to comply. Why would anyone—the state, organized medicine—why would anyone want to tell someone else how much suffering they have to endure as they face death?
Dr. Angell also explained how physician-assisted dying is completely separate and different from suicide (a word opponents inaccurately use to scare people). With suicide “someone—usually a younger person—with a normal life expectancy chooses death over life. Here, unfortunately, these patients don’t have that choice. They are dying. They are just choosing the manner of their death.”
So often opponents try to put palliative care in conflict with physician-assisted dying. Dr. Angel helped explain how this is a false dichotomy; rather, it’s about more options instead of limiting a person to only one option:
To say you can’t permit physician-assisted dying because we have good palliative care is as though you’ve said you can’t have heart transplantation because we have good heart drugs. This is for when the patient decides that good palliative care has not worked. This is the patient’s decision.
On the argument of the Hippocratic Oath:
This is not about physicians. This is about patients. We have to remember this. Yes, physicians should heal, but this isn’t when healing is possible. Healing is not possible for these patients. So then, what physicians should be doing is concentrating on relieving their suffering as they wish.
After listing the medical associations which do respect patient autonomy and support patient-centered care, Dr. Angell explained what is often the core of some of the other medical organizations’ opposition:
They are too engaged in their own self-image. They say “This is what we do. We have hope. We heal.” And medicine should be more specific—less abstract, less one size fits all. It should be an individual doctor dealing with the individual circumstances of that patient, what that patient needs and desires. And it’s about patients.
When asked about who’s used the law in Oregon and Washington, Dr. Angell put forth a scenario to help illustrate the sense of control people regain under a Death with Dignity Act:
We celebrate when people are healthy. We say, “Oh, this person is in control of his life, he’s independent.” And why should we, when they are dying, suddenly say, “No we don’t value that. We don’t want you have control, we don’t want you to be independent, we don’t want you to make up your own mind?” It’s sort of an odd thing.
Something I found very telling throughout the interview: Dr. Angell and Crossley at different times reiterated all of the safeguards written into the initiative which have kept people safe under the Oregon and Washington Death with Dignity Acts, Dr. Young even admitted fears put forward by opponents haven’t happened in the 15 years of Oregon’s law, and Crossley suggested to Dr. Young to consider amendments to the text of the proposed law to add additional requirements the opponents say are missing. After all this, when asked if opponents could support the initiative, Dr. Young still said no, they would still oppose.
This isn’t new. During Oregon’s long struggle to defend their groundbreaking law, opponents just kept coming up with new roadblocks. When in fact, no matter what, they could never support the law because of their own religious beliefs.
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