On November 6 Massachusetts voters will choose whether or not their state should legalize assisted suicide. If they vote Yes, it will become the third American state to approve it, after Oregon and Washington.
In a state with so many world-class universities and hospitals, the debate has been fierce. It has pitted civil libertarians like the ACLU, right-to-die groups, and AIDS activists against the Massachusetts Medical Society, disability activists, palliative care and hospice groups and the Catholic Church.
Recent polls suggest that the measure will pass handily.
The proposed law (see text) resembles Oregon’s and would come into effect on January 1. Doctors will be allowed to write a prescription for a lethal drug for Massachusetts residents who have less than six months to live. There are a number of safeguards to avoid abuse.
Two of the leading supporters of the measure are Marcia Angell, a former editor of the New England Journal of Medicine,and Dan Brock, a professor of medical ethics, both of Harvard Medical School.
However, the official position of the Massachusetts Medical Society, the publisher of the NEJM, opposes both this particular proposal and any legalization of assisted suicide. On its website, the MMS says that the proposed safeguards against abuse are inadequate and that predicting whether a patient will die within six months is difficult. it cites Lynda M. Young, a past president:
“Allowing physicians to participate in assisted suicide would cause more harm than good. Physician assisted suicide is fundamentally incompatible with the physician’s role as healer. “Instead of participating in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life. … Patients must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication.”
The issue was covered in the latest issue of The Economist, a consistent supporter of a libertarian approach to bioethical issues. It drew a very sympathetic picture of an unstoppable move towards legalisation throughout the Western world. “All this reflects a big shift towards secular thinking and individual autonomy as well as growing worries about the medicalised, miserable and costly way of death that awaits many people in rich countries,” says in its feature, “Over my dead body“.