Assisted Suicide Proposed in Michigan
Rebutting advocates and defending death with true dignity
Michigan once again may become the center of a debate about assisted suicide.
In the 1990s, Michigan-based Dr. Jack Kevorkian made national headlines by enabling his “patients” to commit suicide by lethal injection. It sparked a statewide ballot proposal to legalize assisted suicide in 1998, which was rejected by Michiganders with 71% of the vote.
Now Michigan Democrats have introduced a new legislative proposal to legalize assisted suicide, again raising practical questions as to how it would be implemented – as well as ethical and moral concerns.
Advocates of assisted suicide are attempting to repeal Michigan’s current law prohibiting the practice. They intend to replace it with what they call the “Death with Dignity Act.” Before diving into the topic more deeply, it is worth giving due consideration to this proposal’s title.
The refrain “death with dignity” has been used for decades by assisted suicide advocates as an appeal to one’s sense of compassion and an attempt to shift public sentiment. I would contend this shallow talking point masked in clever alliteration is pure hypocrisy.
Dignity is a word derived from the Latin word “dignus” which means “worth.” Merriam Webster defines dignity as “the quality or state of being worthy.” This dignity, or worth, is not earned, purchased or otherwise attained, but rather is innate and received merely from one’s existence. It is universally true that all individuals have value no matter their specific circumstances – and this value cannot be diminished. It is a principle that applies equally to those who may be disabled, sick or dying.
Once a person comes into being, justice requires this dignity to be respected. This respect applies both to oneself and in our relationships with others. This is why violations of this due respect shake one’s conscience - like in cases of self-harm or any number of situations where a person is wounded by another. Assisted suicide is no exception to the rule.
When a society legalizes assisted suicide, it sends a message to vulnerable people that they are a burden and, in effect, welcomes them to be ‘thrown away.’ This is a grave violation of one’s dignity because the worthiness of their life is not reduced simply because they may be relatively close to death.
Death is a very difficult part of the human condition and there is no escaping the fact that it is the cause of much suffering. This is true for both the one dying and their loved ones. True dignity is found when this hardship is met with love and compassion, not with ending life through artificial means.
Titles aside, it is necessary to understand just how this law would work. In a nutshell, after a 15-day waiting period, a legal adult could be prescribed lethal medication if that adult is deemed terminally ill, is considered capable of making decisions, and makes three voluntary requests (2 oral and 1 written). This person would then pick up their prescription at a pharmacy, mix the pills into a cocktail, drink the mixture under their own direction, and would likely die within 3 hours. The bill package also mandates assisted suicide in medical insurance coverage and makes it a criminal offense to forge documents related to the Act or to coerce another into assisted suicide.
The practical problems of this proposal are many. First off, there is no requirement for a mental health screening to ensure a person is in fact capable of making a sound judgment. There is no requirement for the screening to occur in person, making it very difficult to detect or prevent coercion – forcing a person into suicide against their will. The lethal drugs will not be administered in a controlled setting, which means they could easily be administered improperly and lead to great suffering. It also opens the door to people killing themselves in public – the bill even requires the state to reimburse local governments who “incur costs” resulting from an individual terminating their life in a “public place.”
There are also glaring medical concerns. First off, there is no lethal cocktail of drugs that is approved by the U.S. Food and Drug Administration. The relatively few states that have legalized assisted suicide are in effect merely experimenting to find the most “efficient” way for terminally ill patients to kill themselves. Secondly, doctors often cannot accurately determine when a person is going to die. Roughly 12-15% of hospice patients will outlive a six-month prognosis and there are cases when individuals will continue to live for many years.
A third, and most problematic medically related problem, is ethical. Doctors are trained to be healers and medical insurance companies are designed to cover the costs of medical care. Assisted suicide upends these relationships. If a doctor has the capability to recommend death, then a patient will become suspect of a doctor’s genuine motivations. A patient wants a doctor that is in their corner. While this can also mean hearing hard truths at times, at the end of the day a patient needs a doctor who is focused on giving honest medical advice directed toward a patient’s best interest. The Michigan State Medical Society and the American Medical Association say: “Physician assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.” Clearly, assisted suicide poses a great risk to a rightly ordered doctor-patient relationship.
It is even easier to see how the relationship of a patient and their insurance company would be upended because one prescription of lethal medication is going to be monumentally less expensive than long-term care. Trust with insurance companies is already relatively low for many people and this would all but erase what trust is left.
If all issues mentioned thus far were not enough, there are future concerns which will arise from the ‘slippery slope’ of legalizing assisted suicide. In other states and countries that have allowed assisted suicide, measures originally adopted as “safeguards” are later characterized as “barriers” and discarded. Examples include the elimination or weakening of waiting periods, age limitations, residency requirements and self-administration of medication. Advocates may push for allowing less qualified medical personnel to prescribe lethal medication, such as physician’s assistants and nurse practitioners. Of course, the greatest concern is potential expansion of what constitutes a “terminal illness.” Other countries have expanded the definition beyond those expected to die relatively soon and include mental illnesses. It is worth noting that, based on surveys in states where assisted suicide is legal, pain is not typically the primary motivator behind requests. It is more often loss of autonomy and inability to engage in enjoyable activities.
Looking at these slippery slope concerns brings to light a larger ethical consideration. It is that advocates of assisted suicide are devoid of a unifying principle. They cannot draw consistent lines as to when assisted suicide may be permissible. At the end of the day, they are using their own fallible judgment. Just a few decades ago advocates of assisted suicide supported Dr. Jack Kevorkian’s preferred method of lethal injection, which now is expressly prohibited in proposed Michigan legislation. Their ethical reasoning is grounded in nothing permanent and is subject to being carried away to unthinkable ends. The precursor to the Nazis’ horrifying genocide, known as the “Final Solution,” was their Euthanasia Program and Aktion T4, which itself led to the deaths of untold numbers of adults and children deemed unworthy of the dignity of life. Once a society becomes comfortable with throwing away human lives, the consequences will reverberate throughout the entire social structure in ways that cannot be predicted.
The issues listed above are all important reasons leading to my firm opposition to assisted suicide, but they pale in comparison to the moral consideration. I firmly believe every individual life has value, or worth, or “dignity.” There may be different words which can be used to describe this first principle, but they all point to the same aspect of our human nature. That dignity is inherent in our being and applies to all equally. All human life has purpose regardless of whether they may be disabled, sick or dying. These are not conditions established by mankind, but rather they are timeless and part of a human condition we have no choice but to accept. There is a certain order to our human nature and rejecting these ultimate truths results in disorder and human suffering.
Do not be fooled by the clever rhetoricians who propagate the false idea of individual freedom and autonomy being found in assisted suicide. True dignity is in life -- not death.