Assisted suicide, medical aid in dying, death with dignity— whatever you choose to call it, the idea of allowing terminally ill patients to decide the time and manner of their death is a concept that just came closer to reality in Massachusetts. After years and many attempts to pass such a law, and with various interested parties arguing against its passage on moral and religious grounds, a legislative committee once again has the matter under consideration. This time, however, the powerful Massachusetts Medical Society, which has traditionally thrown its weight against an assisted suicide bill, has opted to take a neutral stance.
An internal poll of MMS members earlier this year found that state doctors' collective opinions on the topic of physician assisted suicide have shifted, with 60 percent of respondents now favoring allowing doctors to prescribe a lethal dose of medication to patients who seek it, according to the Boston Globe. A plurality, 41 percent, wanted the group to actively support an assisted suicide bill in the Legislature.
Massachusetts is not blazing any new trails with this proposed law. Laws similar to the bill under consideration already exist in six states, all of which contain safeguards to ensure the law is not misapplied or abused. The Massachusetts bill, modeled after Oregon's, contains intentional hurdles, such as written declarations by the patient timed 15 days apart confirming their wishes; certification by more than one physician that their condition is terminal within six months, and a psychological evaluation to determine that the patient is of sound mind and is making the decision freely
One of the reasons such legislation has taken so long to get this far is its ethical thorniness. There are those — physicians as well as the general public — who sincerely believe that helping someone end his or her life is unethical, regardless of the pain and suffering that person is undergoing, or how much they may wish for it. For some, this is an injunction against physicians taking any role, passive or active, in assisted suicide. But for others, when all the applied art and science of medicine fail to alleviate suffering, terminating that misery is another way of performing an act of mercy and one's duty as a physician to help the patient.
Like so much other social legislation, the problem must be viewed through an individual prism. In the case of the MMS, the professional association has wisely chosen not to dictate a policy to its members, but instead allows them to follow a course that comports with their own consciences. In other words, if they don't want to take part in physician-assisted suicide, they won't be compelled to.
While this may sound like a less-than-ringing endorsement of the concept, the fact that the MMS no longer institutionally stands in the way of legislation is a significant development, creating an environment wherein politicians can discuss and decide upon the bill's enactment based on its intrinsic merits, rather than in the shadow of a highly respected professional group's condemnation. In effect, much of the stigma associated with such a law has been erased. The MMS opposed a 2012 ballot initiative legalizing assisted suicide that was narrowly defeated.
It's important to remember, too, that under this proposed law — along with all the built-in safeguards — the writing of a lethal prescription does not necessarily mean the end of the life in question, and there is no coercion when it comes to using or not using said drugs. The physician's responsibility ends with the prescribing of the drugs; the individual concerned may or may not choose to fill the order, and likewise postpone using them until he or she is ready. Some who suffer may find relief in the knowledge that they have the option to escape their misery if the going simply gets too tough.
Finally, it appears that physicians, as well as many laypeople, have come around to the conviction that what a person decides to do with the disposition of his own life when faced with a life-ending choice is an intensely personal issue. Religious groups have long objected to legalizing this option, and a precisely drawn law that guarantees that those who employ this option are of sound mind, have no realistic hope of recovery and are under no pressure to act, undermines all but the religious arguments. In a state and nation that guarantees separation of church and states, the views of one or more religious groups cannot be allowed to dictate government policies that affect all residents.
End-of-life decisions should be made by the individual, who should have the right to seek assistance from physicians willing to do so ethically and by following proper safeguards. Let us hope that this commendable move by the MMS hastens the arrival of the day when those rights are guaranteed in Massachusetts..