QuickTakes: End of Life Act

A week ago, gov. Jerry Brown signed the end of life act into law. with this bill passing, California is the fifth state to allow terminally ill patients the option to choose physician-assisted death.

California’s End of Life Act is an Important New Law That Fairly Protects the Rights of Terminally Ill Patients

Everybody dies eventually. While most people convince themselves they have long lives ahead of them, terminally ill patients have foreknowledge of their death closely looming over them. Thanks to California’s End of Life Act, patients have more power over the exact circumstances in which their lives will end. Aid-in-dying certainly does not deserve the same stigma as suicide, as it allows patients to have agency over the remainder of their fleeting lives. Despite being a depressing topic, the End of Life Act is an important and necessary bill.

The New England Journal of Medicine published a study showing that in Oregon, which passed its Death with Dignity Act in 1997, physicians deny five out of six requests for aid-in-dying due to issues with consent, symptoms of depression or coercive feelings of burdening family or society. Of those granted their request, roughly a third decide against it. Statistics like these illustrate not only the emphasis placed on informed consent but also the ultimate autonomy of the patients to make their own uncoerced decisions, up to the very last moment.

With California following in Oregon’s footsteps, we can clearly see the differences between suicide and aid-in-dying for terminally ill patients. The National Institute of Mental Health reports that 90 percent of those who commit suicide suffer from a mental illness, primarily depression. Also, according to the Suicide Awareness Voices of Education, 50 percent of those with major depression receive no treatment, but 90 percent of those who seek professional help are successfully treated. 

Clearly, suicide is preventable; if people only seek treatment, they can still live out long, healthy lives. One cannot say the same of terminally ill patients, who often deteriorate significantly in physical health, despite treatment, before passing away within six months. Furthermore, physicians must screen for mental illnesses, like depression, before granting a terminally ill patient aid-in-dying.

Unlike aid-in-dying, a healthcare professional does not sign off on a suicide victim’s ability to give informed consent. Aid-in-dying empowers people who have already lost their life to illness but who seeks to maintain autonomy and control over their remaining time, if not to end it, than simply to know they possess that power.

— THOMAS FINN Senior Staff Writer

The Legislation Regarding This Bill May Impose Patients with Unfortunate Pressure to Opt Out of Life

While death is not typically planned out, having the choice between a slow, painful death and a relatively short, painless death is an option most people would certainly not mind having. Ideally, the manner in which an individual dies should be a choice made by the individual, if she is capable of rationally making that choice. California’s End of Life Option Act allows terminally ill patients to decide how they will die and allows them to receive assistance from a medical professional to do so. The law gives patients more control over their deaths, but at the same time, it may encourage them to end their lives prematurely. 

The law explicitly prohibits physicians from administering the lethal doses and requires patients to be the final participants in the process. Patients may ultimately change their minds, but in cases where the physician administers the final dose, it would be difficult to monitor whether or not patients’ final wishes were ultimately adhered to. University of Pittsburgh bioethicist Alan Meisel described how, regardless of the law, physicians can legally assist dying patients by denying them water, for example. However, once patients begin requesting water, it is unclear if they want to end the procedure or are simply making delirious appeals.

Although scientific research does not support the notion that a positive attitude lengthens a cancer patient’s life, the American Cancer Society recognizes that emotional support and mental healthcare can improve how cancer patients manage the disease. Patients who are told they have a limited amount of time to live may prematurely give up on life altogether, rather than focus on other options for quality-of-life improvement. In particular, vulnerable populations such as low-income and elderly patients may be directly or indirectly encouraged to forgo other options in order to save their families expensive medical bills.

Patients have an ample amount of time and multiple opportunities to reconsider their decisions before a doctor prescribes them the sedatives. Yet these requirements do not ensure that physicians are behaving ethically. The government should not interfere with an individual’s rational choices regarding their own lives and personal health. Nonetheless, it is the responsibility of legislators to be cautious and to safeguard against potential abuses when enacting laws.

—  TINA BUTOIU Senior Staff Writer

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