(Death with Dignity National Center is a leader in end-of-life advocacy and policy reform. Its mission focuses on improving how people with terminal illness die. It is a nonpartisan, nonprofit organization headquartered in Portland that has led the legal defense of, and education about, Death-with-Dignity laws throughout the United States for more than 25 years. Used with permission, this blog post appeared online at: https://deathwithdignity.org/resources/debunking-myths/.)
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Opponents of Death-with-Dignity (DWD) laws use several falsehoods in their attempts to prevent legislation from passing. We believe policy decisions affecting people with terminal illness should be made based on evidence and the actual content of the legislation.
False: “It’s (physician-assisted) suicide.”
Truth: Use of the term “suicide” when referring to DWD is offensive and inaccurate.
Causes of suicide vary and are complex. Generally speaking, people who die by suicide would go on living if they have not ended their lives.
By contrast, requesting and taking medication under a DWD law results in the end of a life already ending. A patient’s primary objective is not to end an otherwise open-ended span of life, but to find personal meaning and dignity in their approaching death. By taking medication, they are acting to shorten their final hours or days.
False: “It’s (active) euthanasia.”
Truth: Euthanasia refers to the act of deliberately causing the death of another person who may be suffering from an incurable disease or condition, commonly performed with a lethal injection. Euthanasia for humans is not legal anywhere in the United States.
False: “The law is a slippery slope (toward euthanasia).”
Truth: There is no evidence of this. Again, euthanasia for humans is against the law in the United States.
False: “Vulnerable populations will be coerced to use the law.” / “The law encourages vulnerable people to kill themselves.”
Truth: In another popular, scare-mongering, false claim, opponents allege that older folks, people with disabilities, low-income people, or ethnic/racial minorities will be encouraged or even coerced to use Death-with-Dignity laws. They claim that the existence of these laws encourages vulnerable or marginalized populations to prematurely end their lives. These are the lies.
DWD laws provide a voluntary, patient-driven, end-of-life option to those who qualify and wish to use it. Participation in assisted dying is strictly voluntary for both patients and their providers. These laws exist only for patients who meet the eligibility requirements and who choose this option. The safeguards are effective and work exactly as intended.
In 2007, testifying before the American Public Health Association, Robert Joondeph, executive director of Disability Rights Oregon (DRO), said the only complaints his organization receives about Oregon’s Death with Dignity Act are “focused on the concern that the Act might discriminate against persons with disabilities who would seek to make use of the Act but have disabilities which would prevent self-administration, thereby denying these persons the ability to use the Dignity Act.”
In a 2016 update, Joondeph wrote that DRO “has still not received a complaint of exploitation or coercion of an individual with disabilities in the use of Oregon’s Death with Dignity Act.”
False: “Insurance companies will deny coverage for life-saving treatments and offer lethal medication instead.”
Truth: This has never happened, and it is not within the jurisdiction of an insurance company to offer any kind of medical treatment to replace another treatment. The State of Oregon investigated this allegation, and Gov. Kitzhaber – a physician himself – found the accusations baseless:
“… [S]ome have twisted the story of one woman on the health plan, making the appalling insinuation that services covered under Oregon’s Death with Dignity Act are prioritized over chemotherapy because it costs less for patients to die than to live … Nothing could be further from the truth.” Gov. Kitzhaber concluded, “No treatment has ever been denied because death would be more cost effective. The very idea is both abhorrent and a blatant distortion of the facts.”
False: “Doctors will be forced to write lethal prescriptions.”
Truth: All providers may opt out of participating. No one is ever coerced.
False: “People suffering from depression or other psychiatric conditions will use the law.”
Truth: The allegation ignores an important safeguard provision of assisted-dying laws.
All patients qualifying for a prescription must pass medical screenings to demonstrate that they have the capacity to make healthcare decisions. Physicians must follow the standard of care for diagnosing capacity to make healthcare decisions, which includes screening tools.
Providers are required to refer patients with capacity concerns for a mental health assessment. A confirmation of impaired decision-making disqualifies the patient from the process.
False: “Unused medications may fall into the wrong hands.”
Truth: Medications prescribed under DWD laws are regulated by federal statutes. These medications are carefully tracked from the date they are prescribed to the date the person for whom they are prescribed dies. Anyone who chooses not to ingest a prescribed dose or anyone in possession of any portion of the unused drug must dispose of it in a legal manner according to local laws.
False: “If a physician refuses to write a prescription, patients will go doctor shopping until they find a willing physician.”
Truth: This is a bogus, red-herring argument. Every person has a right to choose the kind of healthcare they want. If a physician won’t or can’t prescribe for a person who qualifies, that person has every right to get a referral to someone who will help them.
False: “These laws lead to rise in suicides.”
Truth: This is another red-herring argument. There is no correlation between suicide rates and the use of medical aid in dying.
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Final Exit Network (FEN) is a network of dedicated professionals and caring, trained volunteers who support mentally competent adults as they navigate their end-of-life journey. Established in 2004, FEN seeks to educate qualified individuals in practical, peaceful ways to end their lives, offer a compassionate bedside presence and defend a person’s right to choose. For more information, go to www.finalexitnetwork.org.
Payments and donations are tax deductible to the full extent allowed by law. Final Exit Network is a 501(c)3 nonprofit organization.
Thanks for getting us to focus on the basic truths about the death-with-dignity laws.
Very useful information to have. Thank you for providing it.