Written by Msgr. Louis Marucci
On March 12, 2018 the N.J. Assembly Judiciary Committee passed the proposed (and, if I might add, misnamed) “Aid in Dying for the Terminally Ill” Act (A1504) which awaited a vote by the full Assembly. The bill’s Senate Counterpart, S1072, was still pending review by the Senate committee, which recently voted to approve the medically assisted suicide bill. This bill had been passed by the Assembly twice before but stalled in the Senate. The Senate Health, Human Services and Senior Citizen Committee voted 6-3 to approve the measure. The bill must now be passed by the full Senate and Assembly before heading to the desk of Gov. Phil Murphy for final approval or a potential veto.
The flaws in this Act are vast and seriously violate human dignity, disregard the fundamental needs of the elderly and disabled, and open the door to create the slippery slope that will lead to the direct killing of innocent human life. The experience of other countries shows that this is not theoretical.
The Netherlands is an example of the slippery slope on which legalizing physician-assisted suicide puts us. In the 1980s the Dutch government stopped prosecuting physicians who committed voluntary euthanasia on their patients. By the 1990s over 50 percent of acts of euthanasia were no longer voluntary, according to the 1991 Remmelink Report that studied the Medical Practice Concerning Euthanasia. In 2001 euthanasia was made legal. And in 2004 it was decided that children under the age of 12 also could be euthanized, if doctors believed their suffering was intolerable or if they had an incurable illness. Approximately 21 percent of the infant euthanasia deaths occurred without request or consent of parents. Euthanasia in the Netherlands went from illegal but not prosecuted, to legal, to including children.
This bill erroneously gives a patient diagnosed with a terminal illness and given a prognosis of less than six months to live the ability to request a lethal prescription to end his/her life. Yet this bill, and others like it, do not distinguish between persons who will die within six months with treatment and those who will die within six months without treatment. Consequentially, patients with treatable diseases (like diabetes or chronic respiratory or cardiac disease) and patients with disabilities requiring ventilator support are all eligible for lethal drugs because they would die within six months without the treatment they would normally receive.
This bill violates the dignity of the human person and underscores the serious risks of abuse and coercion posed by assisted suicide on those who are poor, elderly, disabled, members of marginalized groups, or without access to good medical care. The legalization of assisted suicide undermines attempts to treat the true underlying causes of a person’s illness and will result in deaths that are not truly voluntary or consensual.
Many people who are not terminally ill will also die, including persons who could live a long and productive life with appropriate medical treatment. Assisted suicide reflects a bias against persons with disabilities, serious illness and the elderly, facilitating an environment in which their destruction is deemed preferable to compassionately addressing their health problems. It undermines efforts to ensure that pain relief is available to all who need it, causing even greater pain and suffering to terminally ill patients and their families.
The act of prescribing a fatal dose of pills, moreover, undermines the very heart of medicine. Doctors vow to do no harm, and yet assisting in a suicide is the ultimate abandonment of their patients. Seriously ill patients — who often experience depression — need our authentic support, including doctors fully committed to their welfare and pain management as they enter their final days. Patients also need assurance that they are not a burden — that it is a privilege to care for them as all people hope to be cared for one day. A compassionate society devotes more attention, not less, to members facing the most vulnerable times in their lives.
If we have not learned from the practices in other countries, perhaps we should look at violations that have occurred within our own country. The facts are clear — in California, Vermont, and in Oregon — states that have passed assisted suicide bills — insurance companies have denied individuals expensive healthcare coverage but offered them low cost drugs to end their life. In an era of cost control and managed care, patients with lingering illnesses may be branded as a financial liability for the insurance companies, and decisions to encourage death could be driven by reducing costs.
Physician-assisted suicide creates legal opportunity for hidden elder abuse. In the United States elder abuse is considered a major health problem, with federal estimates that one in 10 elder persons are abused. Placing lethal drugs into the hands of abusers generates an additional major risk to elder persons. Society-approved death puts elders at risk for abuse through being coerced, pressured or even forced into suicide.
In a dollar-driven environment, it is too tempting for death to become a reasonable substitute to treatment and care when medical coverage is uncertain and medical costs continue to rise. In Oregon, at least two patients receiving medical care under the state-funded Oregon Health Plan report being denied chemotherapy but offered assisted suicide as an alternative. Other patients in Oregon and California have received word that their health insurance will pay for assisted suicide but will not pay for treatment that may sustain their lives.
Some polls indicate that the public is receptive to the general concept of assisted suicide. But the same polls show that when the public learns about the dangers of assisted suicide, especially for those who are poor, elderly, disabled, or without access to good medical care, their views shift against the practice.
Physician-assisted suicide laws are enacted on the basis of intolerable pain. No one should be forced to endure pain that is uncontrollable and unendurable. Most of us can sympathize with that; however, embracing excellent palliative care is the answer, not ending the life a person. The intention of palliative care is neither to hasten nor delay death and acknowledges that dying is a normal process.
I propose that we never endorse legislation that permits physician-assisted suicide, but only endorse legislation that multiplies our resources and provides qualified, compassionate care to patients and families at the end of their lives, as modeled in hospice programs, with adaptation for the chronically ill, elderly and disabled.
The Oath of Hippocrates has guided physicians for 2,400 years. The Oath states: “I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice … I will neither give a deadly drug to anybody who asked for it, not will I make a suggestion to this effect.” Even with all the advances in medicine over the last 200 years, the public perception is still that the Hippocratic Oath is an important indicator that the patient in his or her vulnerability can put trust in the physician. Euthanasia by health-care professionals undermines that trust.
I urge our Representatives to vote No to this bill and any legislation that permits physician assisted suicides, and for the general public to speak against it. Further, once again, I encourage our Representatives to promote and endorse legislation that multiplies our resources and provides qualified, compassionate care to patients and families at the end of their lives, as modeled in quality hospice programs, with adaptation for the chronically ill, elderly and disabled.
Msgr. Louis A. Marucci, D.Min. is pastor, Saint Andrew the Apostle Church, Gibbsboro.
To take action against Physician Assisted Suicide, send an email to https://njcatholic.org/faith-in-action. You can also call the Office of Legislative Services at 1-800-792-8630 between 9 a.m. and 5 p.m. to obtain the names and phone numbers of your two Assembly Members and State Senator. Tell them that you oppose A1504 and S1072.