Physician-Assisted Suicide Legislation is Ill-Advised

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Watching a loved one suffering the final trauma of a terminal illness is to experience an emotional, physical and mental roller coaster. The feelings of helplessness are surpassed only by the realization that what we are going through is only a portion of what must be going through the mind, body, heart and soul of our loved one.

Patients and their loved ones need compassionate care from a host of sources. Spiritual and emotional care can be as critical as the treatments for the patient's physical ailments, especially in the final stages of their illness. Unfortunately, mental health care is not regularly prescribed to terminally ill patients in our health care system, and people may underestimate the mental toll of their illness.

This is one reason the pursuit of physician-assisted suicide in state law is so ill-advised. Proponents of HB 74 End of Life Prescription Amendments, which was proposed to the Utah Legislature this session, view the ability to end one’s life with physician-prescribed drug cocktails as a compassionate response to the final traumas of terminal illness. While the motives may be understandable, the proposed solution is ill-advised at best.

First, proponents of physician-assisted suicide usually hold that people should be able to take lethal drug cocktails to escape unbearable pain. However, statistics from states that allow physician-assisted suicide reveal that most people seek and take the drugs not because of unbearable pain, but because of fear. Fear of losing bodily autonomy, fear of being a burden on family, fear of being unable to do the things they enjoy are real fears and need to be addressed. But those fears could be better addressed through mental health care than through suicide. And yet, in Oregon in 2020, 245 people took their lethal prescription, while only three were referred by their treating physician for psychiatric or psychological evaluation before being given the prescription.

The phenomenally few referrals for psychological evaluations reveal one of the many flaws in the so-called “safeguards” in assisted-suicide laws. One of the most touted safeguards is a provision that allows a treating physician, at his or her sole discretion, to refer a patient for an evaluation before issuing the prescription. In practice, this means tasking a cancer specialist, for example, with making a mental health diagnosis.

Studies show that doctors without a specialty in mental health have a difficult time diagnosing depression, and sometimes great difficulty even talking to their patients about their feelings after learning they have a fatal illness. Even trained, competent psychiatrists doubt they could make an adequate diagnosis without a long-term relationship with the patient. On the other hand, at least 60 percent of terminally ill patients suffer from depression and at least 98 percent will choose not to use the lethal medications if they receive proper mental health care.

Proponents of physician-assisted suicide also seem to be convinced that the drug cocktail is quick, painless and 100 percent effective. The facts reveal the inaccuracies of this perspective. As noted by the Euthanasia Prevention Coalition, the assisted suicide drug cocktails have known side-effects. The Seattle Times reported on new, cheaper drug cocktails in March 2017, the first of which “turned out to be too harsh, burning patients’ mouths and throats, causing some to scream in pain. The second drug mix, ... has led to deaths that stretched out hours in some patients — and up to 31 hours in one case.” While most deaths will be quick, the pain for the unlucky few can last not just for hours, but up to three days in at least one reported instance.

The issues with assisted suicide are legion, while  there are better, more compassionate and less fatal solutions to the fears terminally ill patients face. Our culture of death leads far too many to believe that being reliant on others is an indignity that must always be avoided. Having journeyed with two family members who faced the fears of terminal illness, I can say with certainty that ending their lives early would have denied them and our family important moments of unbelievable grace. I can also say unequivocally that mental health care at the time of diagnosis would have made the final days much easier to face.

Jean Hill is the director of the Diocese of Salt Lake City’s Office of Life, Justice and Peace. Contact her at jean.hill@dioslc.org.