Physician Assisted Suicide in Massachusetts


Next Tuesday, those of us registered in Massachusetts will have the opportunity to vote on “Question 2″ – prescribing medication to end life, otherwise known as physician-assisted suicide.

As described by the state secretary, “This proposed law would allow a physician licensed in Massachusetts to prescribe medication, at a terminally ill patient’s request, to end that patient’s life. To qualify, a patient would have to be an adult resident who (1) is medically determined to be mentally capable of making and communicating health care decisions; (2) has been diagnosed by attending and consulting physicians as having an incurable, irreversible disease that will, within reasonable medical judgment, cause death within six months; and (3) voluntarily expresses a wish to die and has made an informed decision.”

There are, of course, a number of other safeguards built in, such as the need to make the request twice, separated by 15 days, in the presence of witnesses.  However, there could probably be stronger safeguards to protect individuals who are experiencing depression and anxiety, and might have preferable alternatives to physician-assisted death.

The proposed law is similar to measures already in place in Oregon and Washington state, where statistics show relatively low uptake and certainly not the sort of slippery slope that critics seem to be worried about.  In today’s NY Times, however, Zeke Emanuel describes 4 myths about physician-assisted suicide that might give some pause to people like me who plan to vote “Yes” on Question 2.  In the end, though, it strikes me that preserving room for maximal choice in these difficult end-of-life situations is for the best.

Without delving into the merits, which has been done very well elsewhere, let me just make a quick note about something else that struck me re: Question 2, which was the pamphlet of materials I received at home about the ballot measure.  It came from the state secretary, had an excellent, understandable summary of the law and what it would do, and included brief statements for and against written by selected advocates.  I thought this was an incredible mechanism to promote informed voting and deliberative democracy – and because I always have human subjects research ethics on the brain, it made me think of the possible ways this approach could be adapted to improve informed consent.  Perhaps traditional consent forms could be accompanied by a brief neutral statement about a study from the IRB, followed by short statements pro and con about the decision to participate. Just a thought.

And finally, one more note: we’re having a bioethics-heavy election day in Massachusetts this year.  Question 3 is about whether we should eliminate state criminal and civil penalties for the medical use of marijuana by qualifying patients.

Holly Fernandez Lynch is executive director of The Petrie-Flom Center for Health Law Policy, Biotechnology, and Politics at Harvard Law School. This post originally appeared on the Center’s new collaborative blog project, Bill of Health.

7 replies »

  1. Physician-assisted suicide should be a legal option for adults with terminal illnesses. Physician-assisted suicide empowers terminally ill adult patients, and allows them to better prepare for their inevitable death. Legalization of physician-assisted suicide would not create a pandemic of people requesting their physician help them die simply because they are sick or depressed, as some might argue. It would not give too much power to doctors or insurance companies. In fact, legalization would not necessarily even lead to an increase in the number of cases of physician-assisted suicide per year. Research shows that, even where it is legal, a relative few actually choose this route to die. What legalization of physician-assisted suicide does is add one more choice that adults with terminal illnesses can make at a difficult time. Physician-assisted suicide is certainly not a choice that is right for everyone. People have their own beliefs and are entitled to their own opinions as to who, or what, should determine the time of a person’s death. Physician-assisted suicide is, however, the right choice for some and it should be a choice that is legally available to them.

  2. In this country we are given the right to choose so much for our lives and the lives of our family. However, when it comes to the end of those lives we are very limited in what we can provide to stop the pain and suffering associated with a debilitating injury or terminal illness. Voluntary Euthanasia or Assisted Suicide provides us with an avenue to stop these types of suffering and allows us to have the right to die on our own terms. Not by the will of the injury or illness. Doctors in this country provide knowledge, medication and surgery to prolong our lives. When there is nothing more they can do to stop the pain and suffering they should be given the right to help end it, if it is the will of the patient. While there are three states that have legalized Physician Assisted Suicide the country is still divided on granting this right for the masses. When it comes time to leave this world no one should have to suffer with pain and indignity, everyone should have the right to die a merciful, peaceful death.

  3. I remember a senior physician telling me during my residency that she thought people who believed in physician assisted suicide were immoral. Her husband, she explained, was a psychiatrist and anyone wanting to die needed to receive appropriate pain medication and anti-depressants.

    This senior physician was a very caring and good technical physician. But I always thought her dogma and absolutism in thinking reflected a significant part of what was wrong with US healthcare. I am glad to see an intelligent discourse taking place with both facts and for/against commentary so people can really think about issues that may affect us all.

  4. I wonder how Republicans, and their evangelical brothers, would view this law in their, “patient centered care” campaign to destroy Obamacare.

  5. Wow, this is interesting to say the least. I had no idea this was being voted on. I don’t know how I feel about the subject, but an informative article either way. Luckily, I don’t live in MA and don’t have to take a stance (yet). Thanks for the interesting read. -Mandy

  6. It’s really interesting how close the outcome was in Oregon back in 1994: http://bit.ly/RCEEUy 51.3% in favor, 48.7% against. Then 60% were against repeal in 1997.

    I have no idea how the rest of the US general population feels about it … Maybe we’ll see soon?