With the legalization of same-sex marriage and the opening of medical marijuana dispensaries, New Jersey joins an increasingly solid bloc of states from Maryland to Maine where progressive causes find a home. Public approval is soaring for the new policies and it is clear the changes are here to stay. Yet a cause also touted as progressive and compassionate – legalized assisted suicide – has not fared so well. As the New Jersey State Senate considers an assisted suicide bill ("Death with Dignity"), it should study why.
Last month, the New England Journal of Medicine summarized an online poll it conducted on assisted suicide. Two thirds of American respondents opposed legalization. Reflecting widespread opposition within the medical community, respondents cited the physician oath to "do no harm." The poll was refreshingly honest by not invoking the specter of physical pain as a justification. Under Oregon's assisted suicide program, prescribing doctors report patient concerns deal not with physical pain, but include such social factors as physical dependence on others, feeling like a burden, and incontinence.
In its years of polling on assisted suicide, the Gallup organization has based its question on severe physical pain, but even here, support is dropping. This year's results, released in May, marks the lowest point of support for assisted suicide since the survey began in 2001. And when it comes to whether people straight up approve or disapprove of assisted suicide, support has now flipped into opposition.
12 months ago, proponents of legalized assisted suicide saw a different future. Riding high in Massachusetts polls six weeks out from the election, proponents were predicting dominoes throughout the region, with Massachusetts once again the trailblazer. But a broad-based coalition of disability rights organizations and left of center voices persuaded voters to look again at the bill, not so progressive after all. The referendum failed. Legalization attempts were subsequently routed out of the Connecticut and Maine legislatures. (A strong-arming Vermont governor succeeded in forcing through a bastardized bill lacking the safeguards even proponents say are necessary.)
The bill in the New Jersey Senate is similar to the failed Massachusetts proposal, with the same flaws and loopholes. For example, an heir can be one of the witnesses at the request for assisted suicide; and no doctor is required to be present when the overdose is taken. This is a prescription for elder abuse, reports of which number in the thousands in every state. The bill can rip families apart by enabling someone to commit assisted suicide without their family's knowledge.
The people of New Jersey need to hear the names of Oregonians like Barbara Wagner and Randi Stroup, who were denied chemotherapy by the state's Medicaid program but offered assisted suicide as a covered "treatment." With all the talk regarding high medical costs incurred in the last year of life, it is inevitable that the cheaper alternative of assisted suicide would distort medical decision-making.
Indeed, a recent opinion piece in the San Francisco Chronicle by conservative Robert Leeson, "Euthanasia can be an economic decision made early," ghoulishly suggests financial incentives to promote euthanasia. What is to prevent a patient with limited resources or a disability from being steered toward physician assisted suicide through the denial of treatment or through financial incentives?
No alleged safeguard can protect patients from deciding to die based on a wrong prognosis or diagnosis. The notorious unreliability of terminal diagnoses hit home for Massachusetts when Senator Ted Kennedy's widow Victoria wrote about the course of his fatal cancer. She wrote that he was given a diagnosis of 2-4 months to live, but he confounded the doctors by living 15 more productive months. It seems everyone knows a person who was outlived a terminal diagnosis.
The New Jersey bill has no requirement for psychological screening to eliminate the possibility that a patient is acting out of depression or dementia. Oregon's statistics for the last four years show that only 2 percent of patients were referred for a psychological evaluation or counseling. Experts agree that most doctors are not capable of identifying such psychological problems. Oregonian Michael Freeland, despite a 43-year history of severe depression, suicide attempts and paranoia, got a lethal prescription without a psychiatric consultation. The prescribing doctor said he didn't think that a consult was "necessary."
I urge New Jersey to seriously consider all the flaws this bill. Abuses are inevitable, seniors and disabled people will be endangered. Stay progressive, reject this bill.