I am the director of Second Thoughts Massachusetts, a group of cross-disability civil rights advocates who helped defeat the 2012 Massachusetts assisted suicide ballot question. Our progressive, civil rights arguments persuaded voters that assisted suicide is dangerous and discriminatory.
During the campaign, we acknowledged legalization’s superficial appeal through our group name, Second Thoughts: we found that the more Massachusetts voters heard about the real dangers of assisted suicide, the more they doubted its wisdom. With voter support plunging from 68% six weeks before the election to solid opposition, Massachusetts did indeed have serious “second thoughts” about assisted suicide.
During the campaign, it became clear that proponents were basing their arguments on a number of unfounded assertions. As Second Judicial District Judge Nan G. Nash repeats these errors in her “findings of fact,” I review two of them here.
Specious argument number one flows from the incorrect claim that doctors can accurately predict when someone will die. Years ago, assisted suicide proponents refashioned Medicare’s six-month hospice benefit into a medical diagnosis/prognosis on which to base life-and-death decision making. For the purposes of legalization initiatives, proponents decided that “terminal illness” would mean one probably has less than six months to live, based on the guesses of doctors. But just as 1/6 of people in hospice outlive their six-month hospice benefit period, so too, many people who receive a so-called “terminal diagnosis” live far longer than six months. A mistake regarding hospice eligibility can be inconvenient, a mistake regarding terminality for assisted suicide is reckless and fatal.
Judge Nash writes in Finding of Fact 3 that when people are given their terminal diagnosis, they must say good bye to friends and loved ones, put their affairs in order, come to terms with their imminent death and await the inevitable.
Massachusetts Senator Edward Kennedy received a strikingly similar – and incorrect – diagnosis. His widow Vicki’s powerful op-ed just days before the 2012 election helped seal defeat for the ballot question.
When my husband was first diagnosed with cancer, he was told that he had only two to four months to live, that he’d never go back to the U.S. Senate, that he should get his affairs in order, kiss his wife, love his family and get ready to die.
But that prognosis was wrong. Teddy lived 15 more productive months.
During that undiagnosed time, she wrote, Kennedy completed important senatorial work, finished a memoir, and got to spend treasured moments with his loved ones. In the disability community, we know many people who have been labeled “terminal.” One of our members was diagnosed with ALS as a 19-year-old in 1955, and is certain now – almost 60 years later, that had assisted suicide been available, he would have used it. There can be no “fundamental right” for the individual that threatens to cut short the lives of so many other people.
In her second specious argument, Judge Nash adopts the pro-assisted suicide tactic of conflating psychological suffering with physical pain. Judge Nash writes that people who have been labeled terminal get “subjected to invasive medical tests and procedures, loss of autonomy and control, extreme pain and other equally insidious indignities.”
And yet, there is not one documented case of someone turning to assisted suicide because of inability to control physical pain. The Oregon Reports don’t distinguish pain and concerns about future pain. Pain is a medical problem that palliative care can solve. As palliative care expert Ira Byock has testified,
If I thought lethal prescriptions were necessary to alleviate suffering, I would support them. In 34 years of practice, I have never abandoned a patient to die in uncontrolled pain and have never needed to hasten a patient’s death. Alleviating suffering is different from eliminating the sufferer. Allowing a person to die gently is importantly different from actively ending the person’s life.
In recognition of this fact, when the New England Journal of Medicine (NEJM) held an online poll last year, its hypothetical case was a man with metastatic pancreatic cancer, whose physical pain was well-controlled. Two thirds of NEJM’s respondents opposed legalization.
The kind of “extreme pain” that Judge Nash and proponents describe is psychological and social. As Massachusetts Dr. Marcia Angell wrote to the Boston Herald before the 2012 election, “dying sometimes involves great personal indignities, as well as mental distress from the realization that the situation can only grow worse.”
Questionnaires filled out by prescribing doctors in Oregon confirm that a main driver for assisted suicide is psychological distress. Doctors report that half of the people in Oregon turn to suicide because of “loss of control of bodily functions,” in other words, such things as incontinence. Last year, 49% of suicides were reported as turning to suicide because of “burden on family/caregivers.” We disabled people recognize the stigma and negative social messages that promote these feelings, but we also know from experience how meaningful supports can eliminate the problem.
We argue that people whose feelings of indignity and mental distress induce them to consider suicide deserve the same public support as other suicidal people, whether old or young. New Mexico must not undermine its effort to reduce youth suicide by approving other people’s suicide based on shame and humiliation.
No state has any interest in privileging one moral view of dignity over another, only an overriding interest to uphold and promote the inherent dignity of us all. Some people think that dignity is something that can melt away, leaving death the preferred alternative. These people, proponents admit, tend to be well-off and well-educated, people with a strong preference for control. Although presented as a good thing, this harsh and narrow understanding of dignity puts at risk the lives of older and disabled people with serious illness.
Assisted suicide proponents are overwhelmingly white. 97.3% of program suicides in Oregon have been white, in a state 78% white, 22% nonwhite. The Pew Research Center found earlier this year that, while nationally whites support assisted suicide 53%-44%, black and Latino voters register 65% opposition. I am sure you are finding the same trends in New Mexico.
We have a public health problem, but it isn’t certain people’s lack of dignity. It’s the turn by a powerful social class to assisted suicide as a societal solution. Allowing the Morris ruling to stand would only entrench this practice as the preferred social norm. Please act on behalf of all the people of New Mexico, please appeal the Morris ruling.
Thank you very much.
John B. Kelly
Second Thoughts Massachusetts
Ira Byock, MD. Testimony before the Vermont Senate Committee on Health and Welfare
Hearing on End of Life Choices, January 31, 2013. http://www.notdeadyet.org/2013/01/vermont-testimony-of-ira-byock-md-to-vermont-senate-committee-on-health-and-welfare-hearing-on-end-of-life-choices.html