Would legalizing physician-assisted suicide endanger the elderly?
Felicia Cohn, PhD, Associate Professor at University of California Irvine and Joanne Lynn, MD, Director of The Washington Home Center for Palliative Care Studies in Washington DC wrote in their chapter "Vulnerable People: Practical Rejoinders to Claims in Favor of Assisted Suicide" that appeared in the 2002 book The Case Against Assisted Suicide: For the Right to End-of-Life Care:
"Physician-assisted suicide conjures fear that someone else will determine what is to be considered excessive suffering or costs, and that others might seek to eliminate the suffering or the costs by eliminating those persons who are perceived to be suffering or costly. The elderly...are particularly vulnerable to the effects of inadequate health care resources and the attendant constraints on medical decision making...
Care of those who are elderly, particularly those approaching the end of life, has proven to be expensive...
In an era when resources are increasingly being squeezed while the population ages and health care needs increase, the elderly and the dying compete against other portions of the population for health care services. Given the high and seemingly disproportionate costs of health care for the elderly and those in the final phase of life, these 'users of excessive medical resources' may be the targets of cost-saving efforts...
The calls for legalizing physician-assisted suicide arise in a social system that is inattentive to the complex physical, emotional, and spiritual needs of people as they near the end of life. Additionally, abuse is a real risk, especially among those who are elderly..."
Wesley Smith, JD, Consultant to the International Anti-Euthanasia Task Force, wrote in his Oct. 17, 2003 article "Euthanasia World," that appeared in the National Review Online:
"Bring up the issue of assisted suicide, and we suddenly are transported to Euthanasia World, an idealized land where euthanasia's dark side is conveniently ignored. In Euthanasia World, money is never an issue, doctors make house calls, no one is ever abandoned or coerced, and every 'death with dignity' is freely and carefully chosen just before natural death occurs and there is no other way to relieve unbearable suffering.
In fact, legalized assisted suicide and euthanasia would take place in the context of a harsher real world of abuse and neglect of the elderly, family dysfunction, relatives' desiring to inherit property or collect on fat life insurance policies, and subtle pressures on the...elderly to cease being a burden ('Gee Grandma, because of the nursing home bills, we can't send little Timmy to college')."
Susan Okie, MD, wrote in her Apr. 21, 2005 article "Physician-Assisted Suicide - Oregon and Beyond" that appeared in the New England Journal of Medicine:
"The [Oregon assisted suicide] law has not had the the dire social consequences that some opponents predicted. There is no evidence that it has been used to coerce elderly, poor, or depressed patients to end their lives, nor has it caused any significant migration of terminally ill people to Oregon. As compared with Oregonians who died naturally from similar diseases in 2004, those who died by means of physician-assisted suicide tended to be younger (median age, 64 vs 76 years)."
In Compassion in Dying v. Washington (1996), the United States 9th Circuit Court of Appeals, in a decision delivered by Circuit Judge Stephen Reinhardt, stated:
"There is a far more serious concern regarding third parties that we must consider…the fear that infirm, elderly persons will come under undue pressure to end their lives from callous, financially burdened, or self-interested relatives, or others who have influence over them... While we do not minimize the concern, the temptation to exert undue pressure is ordinarily tempered to a substantial degree in the case of the terminally ill by the knowledge that the person will die shortly in any event. Given the possibility of undue influence that already exists, the recognition of the right to physician-assisted suicide would not increase that risk unduly. In fact, the direct involvement of an impartial and professional third party in the decision-making process would more likely provide an important safeguard against such abuse."
Michael White, JD, On the Board of Directors of Death With Dignity National Center, wrote in his Apr. 22, 1997 "Yes" column to the question "Should Physician-Assisted Suicide Be Legalized?," which appeared on the website Before I Die: Medical Care and Personal Choices:
"In a workable system, the option of physician-assisted suicide would arise only after all treatment options are exhausted, the best of hospice and palliative care has failed to relieve unbearable suffering, and if a mentally competent patient continues to request assistance in dying. Then, with outside opinion concurring, a physician would be permitted to prescribe medication that the patient could use to hasten death at a time of the patient's choice.
These safeguards would preclude abuse of...the elderly, or other vulnerable populations."