The Dying Need TLC, Not Rulings

Tuesday’s 6-3 decision by the U.S. Supreme Court preventing the federal government from punishing doctors who prescribe federally controlled substances — narcotics — for suicide is being spun by euthanasia advocates as a big boost for their cause.

Never mind that the ruling was very narrow and did not, as proponents claim, “uphold” Oregon’s law. And never mind that Justice Anthony Kennedy’s majority opinion indicated that the federal government probably could prevent narcotics from being prescribed by doctors to intentionally cause death — just not in the way chosen by former Attorney General John Ashcroft. What mattered most to proponents was the political spin they were able to place on the decision.

But spin can only take you so far. It is the real world in which assisted suicide would be carried out — not threats from the federal government — that has kept the practice from being legalized beyond Oregon.

Consider the following: We are told by backers that assisted suicide would be restricted to cases of unbearable suffering. Yet legislation in California to legalize assisted suicide — AB651 by Assemblywoman Patty Berg, D-Eureka — contains no such requirement. Nor does the law in Oregon, where doctors who assist suicides report that most patients do not seek death because of pain, but because they fear being a burden, can no longer engage in enjoyable activities or fear losing dignity.

Don’t get me wrong. These are important issues that cry out for proper care. Thankfully, we have hospice — the true death with dignity — to treat these needs. Indeed, studies show that when these problems are dealt with, suicidal desires almost always disappear even in people who are imminently dying.

That is true, assisted suicide proponents admit, but there will always be a few people who want assisted suicide anyway. But placing California’s seal of approval on some suicides, while opposing others, would send insidious messages to dying patients that they are a burden; that their illness does make them less worthy of being loved; that they will die in agony. And it would signal the broader society, including young people, that in some cases, suicide is right.

Legalizing assisted suicide would also be very risky. The Netherlands proves that once mercy killing is allowed for the few, it steadily spreads. In the past 30 years, Dutch doctors have gone from killing the terminally ill, to the disabled, and even to the depressed that aren’t physically sick. Recent headlines report that infanticide of dying and disabled babies will soon be legalized by the Dutch Parliament.

Assisted suicide boosters claim it would be different here, and point to Oregon, to show that there is no “slippery slope.” But nobody knows what is actually going on in Oregon. The state conducts no independent reviews of assisted suicide deaths. Moreover, almost all of the published data about Oregon cited by advocates are based primarily on information provided by death-prescribing doctors — who are as likely to report violating the law as they are to tell the IRS that they cheated on their taxes.

Still, abuses have been revealed. In the only case in which the medical records of a potential assisted suicide were independently examined, a peer-reviewed report in the Journal of the American Psychiatric Association disclosed that a patient received a lethal prescription almost two years before he died naturally.

Yet, Oregon law requires that a patient be likely to die within six months. Not only that, but the patient whose death was reviewed was permitted to keep his pills even after being hospitalized as delusional.

In another case reported in the Oregonian newspaper, a woman with Alzheimer’s disease and cancer received assisted suicide even after a psychiatrist reported that she didn’t know what she was asking for and that her daughter was the driving force behind the request.

We must also take heed of the real world in which assisted suicide would be conducted. California health services for the poor are being cut to the bone. The number of medically uninsured Californians exceeds the entire population of Oregon, and those with coverage usually are in health maintenance organizations that make profits by limiting costs. The drugs used in an assisted suicide would cost less than $100. Yet, it could cost $100,000 to provide quality care to the patient who doesn’t want suicide. Then, there are issues of inheritance and life insurance. Elder abuse and neglect are terrible concerns. These and other problems of cultural dysfunction would make assisted suicide especially dangerous for the most vulnerable among us.

People who are dying need love, inclusion and medical care that value their lives, not hasten their deaths. Legalizing assisted suicide in California would be bad medicine and even worse public policy. Last week’s decision by the Supreme Court cannot change that reality.

Wesley J. Smith is a senior fellow at the Discovery Institute, a lawyer for the International Task Force on Euthanasia and Assisted Suicide and a special consultant to the Center for Bioethics and Culture. His Web site is www.wesleyjsmith.com. A version of this article ran in the Orange County Register. Contact us at insight@sfchronicle.com.