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A conundrum

A majority of reasonable people would prefer to control their destiny as the end of life approaches. After all, “choice” and “dignity” in such circumstances are quite enticing. They are, as a matter of fact, concepts with which I agree.

As a relatively sophisticated individual, I could not and would not self-righteously intrude, “sitting in judgment” over an individual’s last, noble attempt at self-determination. Moreover, there indeed exists presently intractable pain (e.g. certain types of late-stage cancer metastasized to bone) beyond the scope of medical relief. Furthermore, were I in such an end-of-life situation, I would want to be afforded such a choice; it would be my decision – very personal, very discreet.

That being said, is it good and prudent public policy at this time to institute legalized physician-assisted suicide as per intent of both Vermont State Senate and House current legislation? Quite a conundrum! My concern arises not from the obvious intent, but from the more subtle, perhaps insidious and even dangerous, issues that could very possibly arise.

Health costs continue to rise. Creditable attempts to make affordable health care available to all are under way. States are in the midst of serious budget crunches. As a humane alternative to many instances of requested suicide, acceptable hospice and end-of-life palliative care and counseling would serve to increase such expenditures. So, should society, exasperatedly, offer the much less expensive alternative of suicide as an option when it need not be?

As difficult as it may be, should we concentrate first on working out a humane public policy which attempts to offer the palliative medical care that can be given to alleviate so much of the physical and psychological trauma associated with dying? Secondly, though I realize that frivolous litigation is unwelcome – burdening our legal system and penalizing good intentions, would removing, carte blanche, all liability from physicians in such circumstances – essentially a specific attempt at tort reform – be in society’s best interests? (Indeed, the current legislation appears more substantially concerned with rendering physicians harmless than with end-of-life choice.)

Could not a “slippery slope” mentality arise whereby disabled individuals not necessarily terminally ill, but with conditions that cannot be successfully treated medically at the present time – those upon whom pity and patronization wrongly lay – be influenced to end their lives rather than “suffer?” (My tenure on the board of directors of Vermont Center for Independent Living has raised my awareness of such important societal concerns.)

As excellent as medical science is, it is neither exact nor accurate. I, personally, have known many individuals afforded a prognosis of “six months or less” who have defied the perceived odds and have lived productively many years afterward. Should this point not be recognized?

The current state legislation also presents quite a paradox. An individual must be judged “sane” or “competent” for the purpose of a substantiated end-of-life request. Does this mean that an individual with a serious and legitimate psychiatric diagnosis is not entitled to the same reasonable choices as others in our society? I would ask all involved to seriously consider the issues I have raised before proceeding to a conclusion. Then … let democracy prevail.