Although I have spoken about this elsewhere, I wanted to post some ideas about Oregon’s Death with Dignity Act here.
Via healthlawblog, anop/ed piece in the New York Times this summer discussed Oregon’s Death with Dignity Act. After telling one of the horrific stories typical of those who support Oregon’s experiment (capable man incapacitated with crippling painful terminal disease, doesn’t want to go on living like that, able to “die with dignity” by taking a lethal dosage of medication prescribed by OR doctor under OR law…) and ranting about Attorney General Ashcroft’s attempts to get the law overturned, here is what Mr. Kristof concludes:
The Oregon law deserves to be upheld. It forces us to examine the question of what is special about human life. The answer, I think, is the autonomy and dignity inherent in our individuality — in making hard decisions for ourselves and determining our own destinies. Oregon honors that vision of what is sacred about life.
Autonomy (one of the four basic principles of biomedical ethics proposed by Beauchamp & Childress) is important, and I also believe it is inherent in our individuality. But life (as well as the ethical obligations of non-maleficence and beneficence) is also important, and there are many religious and philosophical reasons for protecting it. I think most religious and philosophical traditions would allow a person to exercise autonomy in refusing medical treatment for terminal illnesses (and legal precedent in the United States supports this idea as well).
However, refusing medical treatment is a far cry from intentionally drinking a lethal dose of medicine to end it all (“with dignity”, mind you). When one drinks a lethal cocktail like the one prescribed to the patient in Kristof’s piece, one drinks with the intention of ending life. When one decides not to allow medical treatment for a terminal (or other disease), although the result may be the cessation of life, the intention is often to simply let nature take its course and live for another 2 years or die tomorrow. Indeed, intentionally bringing about one’s own death by drinking a lethal concoction or otherwise is different enough from refusing medical treatment or demanding that medical treatment be stopped that in that instance our concern for protecting against the intentional ending of human life ought to outweigh the concern for personal autonomy. We let it happen in outlawing suicide– and as I mentioned I fail to see a reason (or value) to allow autonomy to outweigh protection of life in this situation as well.
If the reason for allowing a patient to hasten death by drinking a lethal cocktail of drugs is to palliate pain and not have to undergo futile treatment that would sap dignity, that concern is addressed by allowing a patient to forego medical treatment and take pain killers (though not in a lethal amount) to alleviate the suffering.
I think the Oregon law is a travesty and that it ought to be repealed. It allows what no other state has ever allowed under any circumstances- suicide. The intentional killing of oneself. It excuses physicians from what has typically been a crime- assisted suicide. Finally, it seems to me to be against a doctor’s ethical obligation of non-maleficence to engage in such a behavior.
The so-called “Oregon experiment” was not even worth trying in the first place. The law seems unjustifiable and contrary to normative values in the United States. It should be repealed.