Assisted suicide: Mercy or malpractice?

The 360 is a feature designed to show you diverse perspectives on the day’s top stories.

Speed read

What's happening: Last week, Maine became the eighth state in the country to legalize assisted suicide. The new law allows doctors to prescribe a fatal dose of medication to terminally ill patients who are expected to die within six months.

The law stipulates that the patient must be of sound mind and must take the medication themselves. It includes a number of steps, such as a second medical opinion and waiting periods, to protect against misdiagnosis or coercion. Similar stipulations exist in other states that allow for assisted suicide.

Oregon became the first state to legalize assisted suicide — also frequently called "aid in dying" — in 1997. The issue spurred significant controversy in the 1990s, in large part from the actions of Dr. Jack Kevorkian, a medical pathologist who helped about 130 terminally ill people end their lives. He spent eight years in prison for second-degree murder stemming from one case.

Why there's debate: Advocates for assisted suicide see it as form of mercy that saves a terminally ill person from what can often be a prolonged, painful and expensive natural death. They also argue that patients should have the ultimate say over how their lives end without having to consider nonmedical forms of suicide.

Opponents believe there is too much risk of people being manipulated in choosing assisted suicide, either by family members or insurance companies. The American Medical Association says the practice is "fundamentally incompatible with the physician’s role as healer." Some doctors who support the principle have concerns about its practice, such as the availability of life-ending drugs and the lack of scholarly research on the topic.

There are also fears that existing laws could be expanded until they resemble euthanasia laws in the Netherlands, where assisted suicide is permitted for patients as young as 12 and for those with psychiatric disorders. A number of religions forbid assisted suicide in all cases.

What's next: Although assisted suicide is legal in just a handful of states and Washington, D.C., support for the idea is spreading. Maine is the fifth state to legalize the practice since 2015. Several other states have considered similar legislation recently. In March, an "aid in dying" bill came up short in the Maryland state Senate by a single vote.

Perspectives

Patients should have the right to decide how their lives end.

"Suicide may be a sort of failure, but deciding how one wants to end one’s life must be the ultimate human right. If people need help to handle it with dignity, doctors should offer them help, not condemnation." — Simon Jenkins, The Guardian

A doctor speaks of his father's experience.

"Sadly, it took my father's suffering to teach me what medical school did not: At a certain point, the suffering of ongoing treatment does not constitute a life worth living. I hope other patients and families might consider these issues while they still can. … I hope, too, that if I ever have to confront this decision, I will be allowed to make a choice." — Dr. Robert Klitzman, CNN

Valid worries about abuse and coercion haven't come true.

"Fears about abuse of the elderly or those with disabilities have not materialized, and, with [several U.S. states] having more than 40 years of combined experience with assisted death, there have been no instances of documented abuse or coercion." — Editorial, Washington Post

A terminal patient hopes to avoid a horrible natural death.

"I anticipated having months left to live, but now my doctors say it may just be weeks. I want to rob cancer of its prize. I want to go out on my own terms. That’s why I want the option of medical aid-in-dying to peacefully end my suffering from the very possible end-of-life scenarios for me: gasping for air or choking on my own blood." — Kevin Roster, USA Today

America's broken health care system shouldn't be trusted to fairly implement assisted suicide.

"We are told that doctor-assisted suicide should be a choice for patients who have tried everything. This ignores the fact that having access to ‘everything’ is a luxury that not everyone has." — Lisa Blumberg, Connecticut Mirror

Lack of oversight allows space for misuse and abuse.

“Nowhere in the laws is there any sort of guidance for how to do it. There is no oversight to make sure that it’s happening in a safe way." — Palliative care physician Laura Petrillo to the Atlantic

Assisted suicide undermines core principles of the medical profession.

"If we allow this form of euthanasia into our health care system, it will inevitably corrode and destroy the values that define the health professions and lead to public trust in them. … No one will be immune to its long term corrosive and destructive effects on the health care system."
— Dr. Joseph Marine, Baltimore Sun

Assisted suicide means accepting that terminal patients have no value left.

"The person lying in a hospital bed might be distraught and convinced that he will be better off leaving living to others. But it can’t be denied that even a tiny slice of time can be used to accomplish much. A smile can be shared, a kind word spoken; an apology can be offered, or a regret confronted; repentance can be achieved or peace made with an alienated friend or relative." — Rabbi Avi Shafran, Fox News

Laws don't protect vulnerable people from being coerced into suicide.

"Proponents of assisted suicide like to point to the myriad of 'safeguards' in their laws, but the reality is once the prescription is picked up from the pharmacy, there is absolutely no oversight in the law to protect the ill person from someone else who wants to hurry their death along, be it an insurance carrier, an heir or a caregiver." — Mike Reynolds, Bangor Daily News

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