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%AM, %16 %041 %2015 %00:%Feb

The OC Register: Assisted suicide places most vulnerable at risk

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February 12, 2015

By AARON KHERIATY and PAUL MCHUGH / Contributing Writers

In the wake of Brittany Maynard’s highly publicized death, many advocates are pressing for the legalization of physician-assisted suicide for patients in the throes of terminal illness, as in California’s recently introduced Senate Bill 128, a “death-with-dignity” measure. The claim to such a right raises many questions. For instance, if there is a “right to assisted suicide,” why would such a right be restricted only to those in the throes of terminal illness? What about the elderly person suffering a slow but nonterminal decline, or the young adult in the throes of depression, demoralization or despair?

Once we adopt the principle that assisted suicide is acceptable, then the fences erected around it – having six months to live, or having mental capacity, for example – are inevitably arbitrary.

These restrictions will eventually be abandoned, as the situation with assisted suicide in Belgium and the Netherlands demonstrates. In Belgium assisted suicide has been granted to a man with “untreatable depression” and to a prisoner suffering “psychological anguish.” In the Netherlands, assisted suicide has been granted to a woman because she did not want to live in a nursing home.

The debates on physician-assisted suicide have largely ignored what research in psychiatry and the social sciences has demonstrated about suicide. We know that suicide is typically an impulsive and ambivalent act. It requires not just suicidal intent, but easy access to means.

The No. 1 suicide “hot spot” in the world is the Golden Gate Bridge in San Francisco, where over 1,400 people have died. A journalist tracked down the handful of individuals who had survived the jump and asked them what was going through their mind during the four seconds when they were falling. Every one of them responded that they regretted the decision to jump, with one saying, “I realized that all the problems in my life that I thought were unsolvable were actually solvable – except for having just jumped.”

Suicidal individuals typically do not want to die, but want to escape what they perceive as intolerable suffering.

There are marvelous models for better palliative care and more effective care for the elderly, as described in Dr. Atul Gawande’s splendid new best-selling book, “Being Mortal.” When death becomes inevitable and further medical interventions become excessively burdensome, hospice and palliative care offer compassionate and medically sound alternatives to assisted suicide or euthanasia.

We know that the vast majority of suicides are associated with clinical depression or other treatable mental disorders. Alarmingly, less than 6 percent of the 752 individuals who have died by assisted suicide under Oregon’s law were referred for psychiatric evaluation prior to their death. This constitutes gross medical negligence. We also know that there is a “social contagion” aspect to suicide, which leads to copycat suicides – particularly for well-publicized cases portrayed by the media with romanticized overtones.

Some have called Maynard’s death “courageous” and “inspiring.” We worry that her death will indeed “inspire” others to follow her example. Many would like to believe that Maynard’s death was a purely private and personal affair, but given what we know about suicide’s social effects and the media portrayal around her death, we anticipate that her decision will influence other vulnerable individuals to choose likewise, whether or not they suffer from a terminal illness.

Suicide is the second leading cause of death among adolescents and young adults. It’s also the eleventh leading cause of death overall in the U.S. Not all suicides can be prevented, but many can. Social acceptance of physician-assisted suicide will undermine these efforts and place vulnerable individuals at risk.

Aaron Kheriaty, M.D., is an associate professor of psychiatry and director of the Program in Medical Ethics at UC Irvine School of Medicine. Paul McHugh, M.D., is a university distinguished professor of psychiatry at Johns Hopkins University.

Source:  OC Register

Last modified on %AM, %21 %349 %2015 %07:%Sep


We Oppose Assisted Suicide

  • Access to Independence – San Diego
  • American Disabled for Attendant Programs Today – Northern California (ADAPT)
  • American Disabled for Attendant Programs Today – Southern California (ADAPT)
  • Alliance of Catholic Healthcare
  • American Academy of Medical Ethics (AAME)
  • American College of Physicians – American Society of Internal Medicine
  • American College of Pediatricians
  • American Medical Association
  • American Nursing Association
  • Association of Northern California Oncologists (ANCO)
  • Association of Programs for Rural Independent Living (APRIL)
  • Autistic Self Advocacy Network (ASAN)
  • Berkeley Commission on Disability
  • California Catholic Conference
  • California Chapter of TASH (CalTASH)
  • California Disability Alliance (CDA)
  • California Family Alliance
  • California Family Council
  • California Foundation for Independent Living Centers (CFILC)
  • California Latino Medical Association
  • California Nurses for Ethical Standards (CNES)
  • California ProLife Council
  • California Right to Life Education Fund
  • California State Council on Developmental Disabilities
  • Californians for Disability Rights (CDR)
  • Catholics for the Common Good
  • Center for Independence of Individuals with Disabilities (CID)
  • Christian Medical and Dental Association
  • Coalition for Concerned Medical Professionals
  • Communities Actively Living Independents and Free (CALIF)
  • Crusade for Life
  • De La Salle Institute
  • Disability Rights Center
  • Disability Rights Education & Defense Fund (DREDF)
  • Disability Rights Enforcement Education Services (DREES)
  • Disability Section of the American Public Health Association
  • FREED, Center for Independent Living
  • Hispanics for Life
  • Independent Living Center of Southern California (ILCSC)
  • Independent Living Resource Center San Francisco (ILRCSF)
  • Independent Living Services of Northern California (ILSNC)
  • International Life Services
  • Joni and Friends
  • Justice for All (JFA)
  • La Raza Roundtable of Santa Clara County
  • League of United Latin American Citizens (LULAC)
  • Life Priority Network
  • Life Legal Defense Foundation
  • Medical Oncology Association of Southern California (MOASC)
  • National Council on Disability
  • National Council on Independent Living (NCIL)
  • National Spinal Cord Injury Association
  • Not Dead Yet – California Chapter
  • Not Dead Yet (NDY)
  • Oakland Mayors Commission on Human Relations
  • Patients Rights Council
  • Physicians for Compassionate Care
  • Placer Independent Resource Services, Inc.
  • Pro-Life America
  • Right to Life League of Southern California
  • San Mateo County, CA
  • Scholl Institute of Bioethics
  • Second Thoughts, People Living with Disabilities Opposing Assisted Suicide
  • Southern California Cancer Pain Initiative
  • TASH
  • The Arc of California
  • The California Catholic Conference
  • The Center for Bioethics and Culture Network (CBC Network)
  • The Oaks Group
  • West Coast Pro Life
  • Western Service Workers Association
  • World Association of Persons with Disabilities (WAPD)