The plaintiff's case is powerful enough that some of the some of the Death with Dignity Act's supporters expressed hope that the Supreme Court would refuse to hear it. After all, if the law sees prescribing narcotics to give pleasure as wrong, how much worse is prescribing drugs to end life? Even the Hippocratic Oath, which states, "primum non nocere" (first, do no harm), is a solid reason to prohibit doctors from becoming involved in patients' self-destructive designs.
The issue, however, runs far deeper than the letter of the law. Advocates of assisted suicide hold that the right to die with professional help is intensely personal and should not be restricted by those who are not in a position to understand the patient's state of mind. I wholeheartedly agree that the government should protect its citizens' rights to self-determination and would even argue that this is the purpose of government. However, the fact that the stakes in this game are literally life and death requires a more complicated approach to the meaning of "self-determination" than simply "doing whatever you want with your life."
Dangerous factors can become involved in a patient's decision to die. Some may feel pressure not to let their loved ones see them suffer, and others may want to leave a larger inheritance by ending treatment. The definition of patient competence is also uncomfortably hazy, and in at least one instance a clinically depressed patient was allowed to request physician-assisted death. After being diagnosed with terminal lung cancer and told he had 6 months to live, Oregonian Michael Freeland was considered so unstable that all guns were removed from his home. But he was also given a lethal overdose of barbiturates to take at will. Fortunately, however, Freeland's prognosis was incorrect-another hairy issue for assisted suicide advocates. Freeland eventually chose to live out the remaining year and a half of his natural life, reconciled with his daughter and died peacefully at home.
Other practical problems arise with the implementation of assisted suicide. It is worth noting that modern doctors are armed with painkillers capable of controlling almost any amount of suffering. On the other hand, according to a New England study, complications such as vomiting, seizures, protracted death and failure to induce a complete coma occur in approximately seven percent of patients who choose to die by lethal overdose. In Oregon, where a doctor's presence is not required during the administration of the drug, the possibility for the "Death with Dignity Act" to lead to one of the most needlessly painful, undignified deaths imaginable is too strong to discount.
Furthermore, it is in everyone's best interest for the state to insist that the inherent value of human life outweighs all concerns about its quality. It is a short step from permitting people to end their own lives when they consider them meaningless, to allowing them to end the lives of their dependents, to policies like the Netherlands' Groningen Protocol in which an independent committee decides the fate of a disabled infant. By giving all lives a chance, we can halt our descent down this slippery slope before it begins.
The ultimate reason for our society's skittishness about assisted suicide is the utter finality of death. If a mistake is made-an erroneous diagnosis, a misunderstanding of the patient's wishes or a change of heart after drinking the poison-there is no going back and fixing it. In a choice between keeping 1,000 people unwillingly alive and allowing one to die unnecessarily, the former is therefore undoubtedly the lesser evil. Whatever may happen after death, the role of the living ceases at its threshold. What, then, gives anyone the inherent right to choose when or how to cross it? The natural rights listed in the Declaration of Independence include life and omit death for a reason: Our Founders had the humility to see that the death of a human being is simply too weighty a matter to be decided by mortals like us.
Petrik can be reached at epetrik08@amherst.edu