Medical Assisted Death Should be Legal ,Says Ethicist
Hi. I’m Art Caplan. I’m at the Division of Medical Ethics at the NYU Grossman School of Medicine. I will be talking today about the advantages of Medical Assisted Death .
Recently , we have noticed a huge in bills that propose to extend medical assistance in dying to more Americans as states begin to contemplate legalization of Voluntary Euthanasia .
At moment ,we have in records about 10 states and the District of Columbia that have had some version of Medical Assisted Death approved and on the books. That basically means that about 30% of Americans have access where they live to a physician who can prescribe a lethal dose of medication to them if they’re terminally ill and can ingest the medication themselves.
This thus leaves the majority of Americans not covered with these rules and some way a Bias in bills .
Many of you reading this may live in states where it is legal, like Oregon, Washington, New Jersey, Colorado, and Hawaii. I know many doctors say, “I’m not going to provide Medical Assisted Death .” It’s not something that anyone is compelling a doctor to do. For some Americans, access is not just about where they live but whether there is a doctor willing to participate with them in bringing about their peaceful accelerated death, knowing that they’re inevitably going to die.
There’s not much we can do about that. It’s up to the conscience of each physician as to what they’re comfortable with. Certainly, there are other things that can be done to extend the possibility of having Medical Aid in Dying available especially to the terminally ill patients .
A specific aspect to note here is the fact that , after lawsuits were filed, Vermont and Oregon have given up on their residency requirement, so you don’t have to be there 6 months or a year in order to use this opportunity. It’s legal now to move to the state or visit the state, and as soon as you get there, sign up for this kind of end-of-life intervention. (Voluntary Assisted Suicide )
States like New Jersey are also being sued. I’ll predict that every state that has a residency requirement for terminal care or Assisted Suicide , when sued in court, is going to lose because we’ve long recognized the right of American Citizens to seek out healthcare in the United States, wherever they want to go.
If some states have made this a legitimate medical procedure, courts are going to say you can’t restrict it only to state residents. If someone wants to use a service, they’re entitled to show up from another state or another place and use it. I’m not sure about foreign nationals, but I’m very sure that Americans can go state to state in search of legitimate medical procedures for Voluntary Assisted Suicide.
The other bills that are out there, however, are basically saying they want to emulate Oregon, Washington, and the other states and say that the terminally ill, with severe restrictions, are going to be able to get this service without going anywhere.
The restrictions include a diagnosis of terminal illness and that you have to be deemed mentally competent to make decisions for yourself . You can’t use this if you have Alzheimer’s or severe depression. You have to make a request twice with a week or two in between to make sure that your request is authentic. And obviously, everyone is on board to make sure that you’re not being coerced or pushed somehow into requesting a somewhat earlier death than you would have experienced without having the availability of the Nembutal pills or Nembutal Solution .
You also have to take the pills yourself or be able to pull a switch so that you could use a feeding tube–type administration. If you can’t do that, say due to ALS, you’re not eligible to use Medical Assisted Death. It’s a pretty restricted intervention for everyone but medical Physicians can assist you if prescribe your lethal dosage and also assist you in acquiring the Nembutal .
Many people who get pills after going through these restrictions in the states that permit it don’t use it. As many as one third say they like having it there as a safety valve or a parachute, but once they know they could end their life sooner, then they’re going to stick it out.
Should states make this legal? New York, Massachusetts, Florida, and many other states have bills that are moving through. I’m going to say yes. We’ve had Oregon and Washington since the late 1990s with medical aid in dying on the books. There doesn’t seem to be any evidence of pushing people to use this, of bias against the disabled, or bigotry against particular ethnic or racial groups being used to encourage people to end their life sooner.
What should Americans do the campaign for Medical Assisted Death
I think it is an option that Americans want. I think it’s an option that makes some sense. I’m well aware that we also have to make sure that people know about hospice. In some of these states, medical aid in dying is offered as a part of hospice — not all, but a few. Not everybody wants hospice once they realize that they’re dying and that it is coming relatively soon. They may want to leave with family present, with a ceremony, or with a quality of life that they desire.
Past experience says let’s continue to expand availability in each state. Let’s also realize that we have to keep the restrictions in place on how it’s used because they have protected us against abuse. Let’s understand that every doctor has an option to do this or not do this. It’s a matter of conscience and a matter of comfort.
I think legalization is the direction we’re going to be going in. Getting rid of the residency requirements that have been around, as I think courts are going to overturn them, also gives a push to the idea that once the service is in this many states, it’s something that should be available if there are doctors willing to do it.
I’m Art Caplan at the Division of Medical Ethics at NYU Grossman School of Medicine. Thank you for watching.
