Bills have been introduced in the Iowa House and Iowa Senate to legalize doctor-prescribed suicide, also called “physician-assisted suicide.” The Iowa Catholic Conference opposes the bills. Click on the link for a flier regarding our opposition to the bill along with the Iowa Coalition for Ethical Care.

Iowa-AssistedSuicide-final 2017

The Iowa Catholic Conference opposes the legalization of doctor-prescribed suicide, also called physician-assisted suicide. Many people are understandably concerned about what they may face as they near the end of their life. People don’t want to suffer and are concerned they’ll be forced to endure life-support machines indefinitely. Many wrongly believe that life-support systems can never be removed.

From the perspective of our religious faith, the Catholic Church supports the protection of human life from conception until a natural death. The dignity of the human person is the foundation of a moral vision for society and fundamental to Catholic social teaching. Each and every person is created in the image and likeness of God. The Catholic Church teaches that consciously choosing to end one’s life is wrong, and assisting with someone’s suicide cannot be condoned. We should not eliminate suffering by eliminating the one who suffers.

Aside from faith-based concerns, there are many reasons to question whether legalizing doctor-prescribed suicide (physician assisted suicide) is good health care or good public policy. Unfortunately, the intent of this legislation does not protect vulnerable people from its dangerous content.

Advocates of physician assisted suicide argue that it is an act of compassion giving relief to patients who are experiencing excruciating physical pain. But does it really address the needs of the terminally ill patient? In an editorial in the New York Times, Ezekiel Emanuel, M.D., Ph.D., pointed out that “patients themselves say that the primary motive [for requesting assisted suicide] is not to escape physical pain but psychological distress; the main drivers are depression, hopelessness and fear of loss of autonomy and control.” (“Four Myths About Doctor-Assisted Suicide,” New York Times Oct. 27, 2012) Should we not offer these patients counseling and caring rather than death? In this bill, a counseling referral is not required unless the doctor believes depression is causing impaired judgment.

Will this proposal ensure a “good death” that is quick and painless? Assisted suicides can go wrong. Citing a study in the Netherlands, Ezekiel Emanuel, M.D., Ph.D., has reported that “patients…vomited up their medications in 7 percent of cases; in 15 percent of cases, patients either did not die or took a very long time to die – hours, even days; in 18 percent, doctors had to intervene to administer a lethal medication themselves, converting a physician-assisted suicide into euthanasia.” (“Four Myths About Doctor-Assisted Suicide,” New York Times Oct. 27, 2012)

What would this proposal ultimately mean to those who are diagnosed with a terminal disease? Will they be pressured? Do you think it’s possible that patients – particularly the elderly – might feel pressured into choosing assisted suicide to avoid being a burden or a financial liability to loved ones? What kind of demands will ultimately be put on patients who are a financial drain on the health care system.

What will this mean for suicide rates in general? A recent report on suicide trends and risk factors for the Oregon Health Authority (where they have doctor-prescribed suicide) found the state’s overall suicide rate was 41 percent higher than the national rate. (AP, May 2, 2013)

What will doctor-prescribed suicide mean to the medical profession? We believe it brings a new dimension to the healing profession – that of enabling death. Does it lower the standard of care by only requiring a person to act in “good-faith compliance” with the provisions of the bill? “Good faith” is a loose legal standard and it’s much weaker than the negligence standard physicians are generally held to.

Can we trust health insurance companies or government-provided insurance to do the right thing, or the least-costly thing? Cost containment in health care is already a much-discussed goal. Already in Oregon, in some situations the state will call the patient and deny medical coverage the patient wants and may need, but instead offer coverage for a prescription which causes death. Once doctor-prescribed suicide becomes a “medical treatment,” it becomes the most cost-effective “treatment” available.

Why are the so-called safeguards in this bill only applied to the requests for a prescription and not to the act of suicide itself? Who else will have access to the medication while it’s in the home? There’s no way to know if a person was pressured into taking the lethal drugs. There’s no way to know if the drugs were mixed into the patient’s food without their knowledge.

Why is the only reporting about doctor-prescribed suicide self-reporting by the doctors prescribing lethal drugs? As the Oregon Health Division noted on the issue in 1999: “There are several limitations that should be kept in mind when considering these findings…. For that matter, the entire account [by prescribing physicians] could have been a cock-and-bull story. We assume, however, that physicians were their usual careful and accurate selves.” Center for Disease Prevention & Epidemiology, Oregon Health Division, CD Reports, March 16, 1999, at 2.

We are fortunate to live during a time when the advances in drug therapy and technology, particularly in palliative care, are developing rapidly and making great strides in pain management. Medical and hospice care is such today that much pain and suffering can be relieved. Medical professionals in Iowa are well-qualified to address the top concerns of those who support prescribed suicide. Because of the possibility of coercion and abuse, passage of this legislation would make life more perilous for those who are very sick and elderly.