Qaseem: Patients should not be denied assisted suicide

Yaqoob Qaseem, Columnist

On March 22, Valentina Maureira, a 14-year-old Chilean girl suffering from cystic fibrosis, changed her mind about her desire for euthanasia. A mere month after pleading for permission to die, the girl completely reversed her decision. A young life was saved and revitalized as a result of laws forbidding euthanasia. The story screams outrage against the right-to-die movement.

Despite the potential peril of euthanasia revealed by Maureira’s story, euthanasia and assisted suicide movements have gradually gained traction around the world in recent decades. The French Parliament recently passed a bill approving the deep sedation of terminally ill patients, a practice with clear connections to euthanasia. Euthanasia is legal in both the Netherlands and Belgium, and assisted suicide is legal in Germany, Switzerland and five U.S. states. Brittany Maynard, a terminally ill brain cancer patient who moved from California to Oregon to legally end her life, spoke out in support of California’s End of Life Option Act posthumously last Wednesday.

The wide range of laws assisting patients in ending their lives may seem truly alarming in light of Maureira’s story. Euthanasia and assisted suicide both have the immensely evil power to end dark lives that may yet turn bright. Nonetheless, when carefully crafted, certain forms of right-to-die laws undoubtedly have their place in society.

Oregon’s Death with Dignity Act allows patients who have been given less than six months to live to end their lives. According to the National Institutes of Health, the average age of survival of patients with cystic fibrosis who live to adulthood is 37. With the specific case previously mentioned, doctors expected the girl had about three and a half more years of life. The difference of three years is substantial, although determining an exact cutoff for such laws is admittedly challenging.

More significantly, Oregon’s law requires the patient to be capable of making the decision to die. Specifically, the patient must be at least 18 years of age and psychologically sound. The patient must also make two discrete requests for the prescription of life-ending drugs separated by at least 15 days. In the process, the patient is educated on all alternatives to the assisted suicide, including a range of palliative care options. Two witnesses must be present for the decision, and the diagnosis and prognosis of the patient must be confirmed by both the prescribing physician and another physician independently.

In the case of Maureira, Oregon’s law would not have allowed assisted suicide to take place due to age restrictions. Nonetheless, the arsenal of protective measures incorporated into the law may still not be sufficient to avoid tragedies in other cases. The characteristics of patients with only fleeting moments of despair rather than a persistent yearning for eternal silence must be closely scrutinized to ensure assisted suicide is allocated appropriately. For instance, the legalization of child euthanasia in Belgium is certainly concerning based on the reversal of Maureira’s decision. Moreover, parental consent is clearly an insufficient safeguard, as Maureira’s father supported her petition for euthanasia.

Of course, some argue assisted suicide has no place in the world even for suffering individuals with an adamant desire for death. Such an argument, however, goes deeply against one of the core principles of medical ethics: autonomy. Patients have a right to make their own individual decisions regarding their lives and healthcare procedures. Exceptions encompass patients below the age of 18 and mentally ill patients, both of whom are thus also rightfully excluded from Oregon’s law.

In the case of autonomous, terminally ill patients, who are we to deny them the right to die? The law in Oregon allows physicians to choose not to participate to ensure caretakers are not forced to take actions contrasting with their personal beliefs. The patients, once deemed capable and subjected to the various lines of defense, are merely given pills they may choose to take or leave on their side tables. These patients are firmly convinced of the unbearable anguish of their lives and wish to depart the world in what they view as a dignified and peaceful manner. Each patient was born with the control of his own life, and society should not be allowed to pry away this autonomy due to the beliefs of specific individuals.

Yaqoob Qaseem is a Weinberg freshman. He can be reached at [email protected]. If you would like to respond publicly to this column, send a Letter to the Editor to [email protected].