As opposing sides gird for battle, states, feds and the courts will play major roles.
Following the death of Terri Schiavo, state officials, federal lawmakers and even the nation’s courts are closely examining physician-assisted suicide.
Feelings run hard and deep on both sides of this controversial topic. Much like the abortion debate, it pits the right to choose against the right to live.
But regardless of where lawmakers and the courts finally take the issue, providers will have to deal with the consequences.
Currently, only one state — Oregon — allows physician-assisted suicide.
One of the more remarkable features of the unique law is that relatively few people have actually used it. According to the Oregon Department of Human Services, 326 prescriptions for lethal doses were written from 1998 through 2004, leading to 208 deaths.
For many patients, the lethal drugs appear to be a form of insurance. The option exists if pain becomes too bad or if their deteriorating conditions become unbearable. This view is supported by the reasons they most often cited for seeking suicide prescriptions: a declining ability to enjoy life, loss of autonomy and loss of dignity.
If recent polls are to be believed, the public generally endorses Oregon’s approach. In a recent Time magazine poll, 52% of Americans surveyed said they agree with the Oregon law, vs. 41% who did not. In California, where opponents defeated assisted-suicide legislation just six years ago, a poll conducted last month showed 70% of residents agreeing that “incurably ill patients have the right to ask for and get life-ending medication.” More than two-thirds of those polled in California said they would want their doctor to help them die if they were expected to live less than six months.
Legislation similar to Oregon’s is moving forward in California. In mid-April, a legislative committee in California approved a measure allowing the terminally ill to end their lives with a doctor’s assistance. The bill next moves to the Assembly Appropriations Committee, and, if successful, to the full House floor. The Senate would then have to take up the legislation.
A similar Vermont bill was introduced in February but appears to be stalled.
In the eight years since Oregon’s law took effect, attempts to enact similar laws in Hawaii and Maine also were narrowly defeated.
Other efforts
Some recent proposals respond directly to the battle between Terri Schiavo’s parents and her husband. For example, the Alabama Starvation and Dehydration Prevention Act would forbid the removal of a feeding tube without a patient’s written instructions. In Michigan, legislation is being drafted that would prohibit adulterers from making decisions on behalf of an incapacitated spouse. In Kansas, a proposal that passed the House would require a guardian to get court approval before ending life support.
Other state measures seek to draw a line between a feeding tube and other life-sustaining measures. In Louisiana and Alabama, Republicans have introduced bills requiring a patient to continue receiving food and water absent written directives to the contrary.
In all, new end-of-life legislation has been introduced in at least 10 states. But polls indicating broad public opposition to government involvement in the Schiavo case may be giving some politicians reason to pause. With many legislatures approaching the end of their sessions, some bills — including those in Hawaii, Kansas and Kentucky — already have stalled. Recent legislation was also tabled in Arizona, Wisconsin and Wyoming.
All 50 states currently have laws that allow people to write an advance directive or living will that specifies their healthcare preferences if they are incapacitated, designates a healthcare proxy to make decisions for them, or both.
Congressional action
At the federal level, committees in the House and Senate plan post-Schiavo hearings, but it’s unclear how far Congress will go. Lawmakers on both sides are under pressure to introduce legislation that addresses the issue directly. But they are generally reluctant to sponsor measures th
