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‘Death With Dignity’ Gains Steam, Remains Divisive

Brittany Maynard sparked headlines across the globe
The death of Brittany Maynard sparked headlines across the globe

Support for physician-assisted suicide is proliferating in state legislatures across the nation as proponents contend the practice enhances patient freedom at the end of life and guarantees terminally ill adults a way out of pain and suffering.

Physician-assisted suicide is legal in only a handful of states including Oregon (the first state to legalize the practice in 1997), Washington (passed by ballot measure), Vermont (passed by state Legislature), New Mexico and Montana (allowed by the courts).

However, support for so-called “Death with Dignity” legislation has grown in recent years as advocates, including Compassion & Choices and the Death with Dignity National Center, work to turn the issue into a political and social movement. It seems to be working in California, the nation’s most populous state.

Senate Bill 128 (The End Of Life Option Act) by State Senators Bill Monning and Lois Wolk recently passed through the Senate 23 to 15. The legislation is now in the Assembly and will be voted on in early July.

“I’m cautiously optimistic that it will pass, but you never ever know for certain until the day of the vote,” George Eighmey, vice president of the Death With Dignity National Center, told Life Matters Media. “There are many people who are facing death who wish to have one more option in considering how their life is going to end, in addition to palliative care, hospice care, taking medicine or not taking medicine.”

On the East Coast, Maine’s “Death with Dignity” bill, LD 1270, was narrowly defeated by a single vote in the Senate in June. In 2012, voters in Massachusetts, one of nation’s most Catholic states, narrowly voted down a similar referendum.

Shortly after the Vermont legislation became law, Peg Sandeen, executive director of the Death with Dignity National Center in Oregon, told LMM she believes Midwestern states, including Illinois, may be 10 years away from passing some form of “Death with Dignity” legislation.

Mark P Sheldon, PhD Lecturer in Weinberg College of Arts and Sciences
Mark P Sheldon,
Lecturer in Weinberg College of Arts and Sciences

Mark Sheldon, distinguished senior lecturer in the Medical Humanities and Bioethics Program at Northwestern University, said he is evolving on the issue as he grows older.

“For a very long time I was very opposed to assisted death, but in the last decade or so I became a supporter of it under certain circumstances,” Sheldon said. He would support aid-in-dying for patients seeking a sense of control over their death and facing extreme pain.

“I’m aware of the arguments against it, and palliative (comfort) care is important, but there are instances when adequate pain control is not available,” he added. “Sometimes adequate pain control is very heavy sedation, and that’s something that makes me uncomfortable.”

Sheldon, who does not wish to be a financial burden to his family if he ever becomes seriously ill, told LMM that assisted-death is a viable option for him. He would rather save resources for his children.

Still, the public remains closely divided on the issue, with 47 percent in favor of laws that would allow doctor-assisted suicide for terminally ill patients and 49 percent opposed, according to PEW Research.

Opposition remains

Despite calls for legalization from a growing number of proponents, the American Medical Association remains firmly opposed to such policy. The Chicago-based AMA is the nation’s largest organization of physicians, representing nearly 200,000 doctors, medical students and residents.

“It is understandable, though tragic, that some patients in extreme duress – such as those suffering from a terminal, painful, debilitating illness – may come to decide that death is preferable to life,” according to a statement sent to LMM. “However, allowing physicians to participate in assisted suicide would cause more harm than good.”

Many physicians, bioethicists and religious leaders caution that physician-assisted suicide is incompatible with physicians’ primary role as healer and would foster resentment towards sick people hoping to live as long as possible, no matter the costs.

Mark Kuczewski, director of the Neiswanger Institute
Mark Kuczewski, director of the Neiswanger Institute

Mark Kuczewski, director of the Neiswanger Bioethics Institute at Loyola University Chicago, is concerned that society and medical providers have become too focused on making dying patients “productive” and not content with just “being.” That mindset, Kuczewski added, leads some to view dying patients as unnecessary and even weak.

“Once we go down that road, it’s very hard for us to retain the alternate option: to help people live every moment of their remaining life with quality and dignity. There’s a tendency, once you institutionalize it, for the right-to-die to become the duty to die,” Kuczewski said. “Once you have a society that facilitates this, once you have that, it’s so easy the way that mixes with our culture, for it to be hard for anybody to be a healer in those situations or have an alternate point-of-view.”

Others point to advances in hospice and palliative medicine that can help to alleviate pain. But proponents of physician-assisted suicide, including Eighmey, say just knowing the option to end life is available can serve as a source of comfort.

The Brittany Maynard effect

Many right-to-die advocates credit the recent high-profile death of 29-year-old Brittany Maynard for raising awareness about the issue amongst so-called Millenials (adults 18 to 32).

In 2014, Maynard was diagnosed with an aggressive glioblastoma brain tumor and was later given six months to live. Maynard and her husband, Dan Diaz, moved from California to Oregon because that state did not allow terminally ill adults to end their lives with doctor-prescribed barbiturates.

Working with Compassion & Choices, Maynard used her story to raise awareness about the practice and inspire other terminally ill Americans to end their lives on similar terms. She ended her life later that year, sparking headlines across the world.

“I don’t wake up every day and look at it, I know it’s in a safe spot,” Maynard said in a Compassion & Choices-produced video about her life-ending drugs. That video has been viewed more than ten million times via YouTube. “I will pass peacefully with some music I like in the background.”

Like Eighmey, Compassion & Choices President Barbara Coombs Lee said Maynard “changed everything,” partly because she introduced Americans to the human side of the issue.

“She has single-handedly transformed our whole movement from from one organization working actively in the field to a broad movement where all kinds of people are introducing bills and filing lawsuits and becoming active,” she said last year in Chicago. “We will see bills advancing in many, many states. Her brazen visibility helped to increase momentum.”