court decision mostly revolved around technical issues involving
state and federal jurisdiction. But some have speculated it may
also lead to a renewed flurry of interest in other states in mimicking
the Oregon law. Under that law, if two physicians agree that a
patient is of sound mind and likely to die of a terminal illness
within six months, they may fulfill a request for a lethal dose
of narcotics after a 15-day waiting period.
Oregon statistics show that there have been 208 such assisted
suicides since the law was enacted in 1997. In California and
Vermont, assisted suicide laws have been introduced in the legislature
in recent years. And in the abstract, assisted suicide is popular
with the American public, according to polls.
But in the
end such proposals seem to be a tough sell. Oregon’s law
was approved by a narrow 51 percent of the voters. An assisted
suicide measure went down to defeat by a 51-49 margin in Maine
in 2000. The Hawaii legislature initially approved and then killed
a legalization bill despite all-out support from then-Gov. Ben
Cayetano. And in Michigan, for a time the ground zero of the assisted
suicide movement, a 1998 referendum initially polled 72 percent
approval but was defeated by an astonishing 3-1 margin.
situation in Michigan was doubtless colored by the, er, terminal
weirdness of Jack Kevorkian, a pathologist who had never actually
practiced medicine. He talked often and openly of his crusade
to use assisted suicide as a means of harvesting organs and conducting
research on the dying process. There were pictures of him making
house calls to local motels in his rusty Volkswagen with his death-dispensing
apparatus. And the vast majority of his 170 or so “patients”
were women; many were disabled or suffering from depression.
Kevorkian was sentenced to a lengthy prison sentence for his self-videotaped
offing of a man with Lou Gehrig’s disease, shown on “60
Minutes.” He was denied parole late last year by Democratic
Gov. Jennifer Granholm despite reports that he himself is now
also possible that the more the public generally thinks about
the issue, the less attractive physician-assisted suicide comes
to seem. High-toned chatter about “death with dignity”
and “individual autonomy” notwithstanding, assisted
suicide can be far messier than it seems from afar.
For one thing
there is that slippery phrase, “terminally ill.” Medical
studies show that predictions of imminent death are highly unreliable
even when made by experienced physicians. Then there is the example
of the Netherlands, the world capital of assisted suicide and
euthanasia, where physicians have been prosecuted for helping
kill people who were merely “tired of life.” And in
Oregon there have been reports of cancer specialists making terminal
diagnoses of people with neurological problems.
A far safer
middle ground is to focus on improvements in pain control. Model
guidelines were promulgated in 1998, but many physicians may not
be aware of them or reluctant to prescribe high doses of narcotics
for fear of inducing addiction. As the New York Times
Jane Brody wrote recently, they may also worry about getting busted
by the Drug Enforcement Administration if the medicine falls into
the wrong hands.
court may be right to leave the matter of assisted suicide to
the states. But out in the states, most voters are smart enough
to sense the legal and moral thickets surrounding assisted suicide.
When it takes 12,000 words to explain a ballot proposal, as the
Michigan assisted suicide referendum did in 1998, you tend not
to be reassured – much less think the state has any business
authorizing mere men and women to exercise the God-like powers
of life and death.