Hawaii Suicide Bill Abandons “Safeguards”

by Wesley J. Smith

Assisted suiciders are running a scam. They assure a wary public that legalization is designed to be a rare event, only resorted to by the terminally ill when nothing else can be done to eliminate suffering.

Then, they push the normalization of assisted suicide with all their might and the millions in PR spending. (See Brittany Maynard and suicide parties.)

And all the while, they assure us that “strict guidelines” will  prevent abuse.

That’s the honey to help the hemlock go down. In reality, the strict guidelines are ephemeral and even those are being abandoned as soon as politically feasible.

Case in point: Hawaii’s draft assisted suicide legalization bill, which continues the process of expanding the guidelines so as to make them fundamentally meaningless.

The Patients Rights Council (for which I am a paid consultant) has analyzed the proposal. Guidelines, schmidelines! From the analysis:

Provision of life-ending drugs (called “Medical Aid in Dying”) would become a “medical treatment.”
This would give insurance programs the opportunity to cut costs by denying payment of more expensive treatments while approving payment for the less costly prescription for a lethal drug overdose.  If the bill is approved, will health insurance programs do the right thing – or the cheap thing?

Oregon’s Medicaid health care rationing which has denied life-extending treatment but offered assisted suicide to cancer patients already answered that question.

The bill wants the despairing ill to have ready access to instant death:

There is no waiting period between the time that the patient is diagnosed and the time that the prescription is written.
A physician can give a patient the terminal diagnosis, deem the patient eligible for doctor-prescribed suicide, inform the patient of the availability of assisted suicide and write the prescription for the lethal dose of drugs on the same day – without the patient ever recovering from the initial shock of being terminally ill.

Suicidal people, including people wanting to kill themselves because of a terminal diagnosis, sometimes change their minds. I know. I have met them.

This rush to death right will mean some who would have decided to carry on will surely die by suicide instead–and we will never know who they are. 

As usual, the definitions are loosey-goosey to permit broader access than appearances would suggest:

“Terminally ill” is very broadly defined, making it possible for a doctor to prescribe the deadly drugs even though the patient could live for years.
A person who is in the undefined “final state” of an “incurable or irreversible condition” would be considered terminally ill if the condition would, within reasonable medical judgment, result in death within six months. 

But there is no requirement that the condition be uncontrollable.  There are many conditions (diabetes, certain types of leukemia and, even, alcoholism) that could meet this definition of terminal illness contained in the bill.

For example, diabetes can be both incurable and irreversible but it is controllable.  An insulin-dependent diabetic patient who stops taking insulin will, within reasonable medical judgment, die within six months.  Thus, under the bill, diabetics would be eligible for doctor-prescribed suicide even though they could live virtually normal lives with insulin.

Doctors would be required to lie on the death certificate about the cause of death–a corruption and bar to transparency, currently the law of Washington State:

The proposal requires that death certificates be falsified.
Although the manner of death resulting from an intentional overdose of drugs would be considered suicide, and the cause of death would be the lethal drugs, the proposal states that the cause of death listed on death certificates be the individual’s underlying terminal illness.

There’s much more, but you get the point.

The euthanasia/assisted suicide movement is not about restrictions. It is about normalizing death for all manner and causes of human suffering. The rest is crass incrementalism.  

If that clear truth doesn’t matter to you, it proves my point.  But for the sake of intellectual integrity and the honesty of democratic deliberation, we should have that debate, not continually pretend we believe the nonsense about strict limits preventing abuse.

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