Probing the Gaps in ‘Safeguards’ of Assisted Suicide Laws

HB 1283 assisted-dying

Laws permitting physician-assisted suicide (PAS), also referred to by proponents as medical-assistance in dying (MAID), typically include a number of legal requirements such as  minimum age limits, a terminal diagnosis, waiting periods, and determination of mental competence. 

However, there is evidence that these safeguards do not offer the protection that supporters of this life-ending practice claim. Furthermore, once PAS legislation is passed, it can be amended to include other populations like those with MS, ALS and even mental health issues.  We have seen other states in the U.S. expand the type of medical professionals able to dispense pills that kill.  Dangerous stuff.

The NH Coalition for Suicide Prevention is opposing HB 1283, otherwise known as End-of-Life Options.  No matter what it is called, it is an attempt to enact a physician-assisted suicide law in New Hampshire.  This bill was heard on Wed. Feb. 7th by the House Judiciary Committee in a hearing filled with emotional testimony from both sides of the issue.  The NH Coalition for Suicide Prevention and its members werethere to voice their opinion – this bill is a huge mistake and could undo the progress this state has made on suicide prevention.  

People with disabilities would be negatively impacted by this bill.  The National Council on Disability (NCD), an independent federal agency with a mission to enhance the quality of life for all Americans with disabilities and their families, published a report in 2019, Assisted Suicide Laws and their Danger to People with Disabilities. This detailed report concludes that there exists a  “probability that any law, procedures and standards that can be imposed to regulate physician-assisted suicide will be misapplied to unnecessarily end the lives of people with disabilities.”

The report identifies several shortcomings: 

Assisted suicide replaces medical treatment. The NCD report notes that “when assisted suicide is legalized in the context of the US healthcare system, it immediately becomes the cheapest treatment. Direct coercion is not necessary.” The report also cites cases of cases where health insurers have denied approval of expensive life-sustaining treatment and instead indicated that they would cover the costs of assisted suicide.

Uncertainty of terminal disease diagnoses. According to a Journal of the American Medical Association article surveying Oregon physicians’ attitudes on end-of-life care, more than one-quarter of physicians who were willing to write lethal prescriptions under Oregon’s assisted suicide law acknowledged that they were not confident of their ability to determine a patient had less than 6 months to live.  In its report, NCD writes; “Misdiagnosis of terminal disease can also cause frightened patients to hasten their deaths.”

Little or no screening for depression. Most laws, including the proposed law in NH, cite that patients must be “mentally competent” to ask for medication-assisted death. The NCD report cites several studies indicating that terminally ill patients frequently suffer from depression and notes that in Oregon, less than 2 percent of patients who died under the Oregon law were referred by the prescribing doctor for a psychological evaluation before receiving the prescription. The NCD notes that most assisted suicide laws only require a finding of legal competence. “Thus, patients with depression may be considered legally competent to decide to end their lives merely because the depression doesn’t impair their legal competency.”

People with disabilities are known to be at a higher risk of suicide than the general population, and studies have shown that a risk factor for this group is societal attitudes towards their “burdensomeness” rather than their own perceptions of their capabilities.  HB1283, if passed, paves the way for more ableism in our society. 

For more information about the NH Coalition for Suicide Prevention, visit www.zerosuicidesnh.org.