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The desire for choice seems to be in America’s DNA. As a people, we demand a cornucopia of choices in virtually every aspect of our lives. We demand everything from 31 flavors to 800 channels. We go to The Cheesecake Factory to choose between 300 menu items, in a mall with 400 stores. Whole political and social movements have been built on the foundation of “Choice”. Yet we have, for the most part, passively accepted the denial of any choice in the one area of life where it perhaps means the most. In most places in this country, we can not choose how we want our lives to end.
Currently 46 states, including my own state of Pennsylvania, have laws which force us to die in ways most of us would not choose. We are forced to endure unbearable pain which will never improve until death. We are required to die at a time arbitrarily decided by fate when we might or might not be conscious, or hooked up to tubes, or alone. It is literally a crime, usually a felony, for our relatives to help us end our suffering or enable us to decide when to die. This is, quite simply, crazy.
We recognize the cruelty of causing unnecessary and gain-less pain in death in the context of our pets. We would never sit by and watch a beloved dog or capybara (I like unusual pets) suffer at the end of its life. We would mercifully put it to sleep. But it is criminal to extend the same mercy to grandma. In fact, as I write this article, the newspapers are filled with the story of a woman facing felony “Attempted Assisted Suicide” charges for giving morphine to her 93 year old father with the alleged intent to end his undisputed suffering as he died from end-stage renal failure. This woman not only lost her father, but now has to face the prospect, as she mourns, of losing her freedom.
I find the status quo to be unbearable. That is why I have introduced the Death with Dignity Act in Pennsylvania. My bill would provide an option to those who have no quality of life, but only intractable misery heading towards death. Such people could, if they follow the protocols in the bill, legally acquire medicine that will quickly and painlessly end their lives.
Some people are concerned that I am encouraging suicide among those who are merely depressed. So let me be clear: if my bill becomes law, the lethal medication would NOT be available to someone who was having a bad day at work, or had just broken up with his girlfriend. Nor would it be available even to those who are in severe pain if they are not clearly at the inevitable end of their lives.
The bill requires that any person wanting the medication fill out and sign a notarized form, indicating that they themselves were making the request. They would then need two separate doctors, a treating physician, and a non-treating independent physician to attest that the patient has a terminal disease and has less than 6 months to live. Only then would the medicine be disbursed.
In the states that have a similar law already on the books we have seen no evidence of fraud or coercion. Further, many of the people who successfully acquire the medicine never wind up taking it. The fact is that most people want to live as long as possible. And they find that just having the medicine, and the options it brings, is enough comfort to enable them to keep going.
Of those who do wind up choosing to end their lives, they typically do not do it with months of life left to live, but with days or hours. It is only at the very end, when real decisions have to be made about how much one can take, and when, and in whose company they wish to die, that the pills are swallowed.
Ideally, the end of life is a time filled with sadness, but also sweetness, reconciliations and meaningful goodbyes. It is an intensely personal time that should be choreographed and lived by the person and the family affected. The government has a legitimate role in assuring that all decisions made are knowing and voluntary. But government has no legitimate interest in actually making those decisions, nor may it inflict gratuitous pain and cruelty on the dying. This is what happens now, and this must change.