Commentary: A physician’s perspective on House Bill 140

Christine Metzing

Life expectancy in the U.S. is decreasing for the second year in a row, partly due to an increase in the number of suicides. While experts work to decrease the effects of this epidemic, Delaware’s legislators are promoting assisted suicide, a policy that has been correlated with a rise in suicide even among healthy individuals. It causes one to think — how can we work hard to dissuade one person from committing suicide and hand suicide pills to another? What happened to valuing human life? This bill, which would force doctors to offer suicide as an option to all terminal patients (or to refer them to someone who will), works against physicians who are actively fighting the suicide epidemic.

Anticipation of suffering from a terminal disease is cited as the moral justification for assisted suicide. However, to be human is to experience suffering and ultimately, death. There are people who will experience prolonged suffering due to chronic, non-terminal illnesses. Should they be eligible for assisted suicide? Should assisted suicide gradually be expanded to those who suffer from chronic conditions as it has in the Netherlands, where assisted suicide was first legalized? It’s the natural progression of this logic. Now, using the criteria of “severe suffering,” even otherwise healthy teenagers with depression can receive suicide medication in the Netherlands, while devastated families can do nothing to stop it.

Doctors are supposed to save lives and comfort, not kill, the dying. Since suicide is technically legal, do we need to involve a physician and risk hardening the conscience of our medical community? Though assisted suicide was proposed so that people could determine the course of their own lives, the Remmelink Report showed that the death-hardened doctors in the Netherlands quietly took over the end-of-life decision making and chose death for certain infants, disabled, and elderly patients in spite of the lack of consent. Involuntary euthanasia — especially of the disabled — is increasingly practiced by those physicians and the laws gradually were changed to make it legal. Some disabled and older Dutch people carry cards in preparation for an emergency, which plead, “Doctor, Please do not kill me.” Do we want our medical practitioners to be hardened and also have so much power over us?

Just because legislators claim to want “to end life in a humane and dignified manner” does not, in fact, make those deaths humane and dignified. Prisoner executions are supposed to be humane and dignified, yet horrifying death scenes sometimes occur as each person’s reactions to medications are unique. Excellent palliative care is the real standard of humane and dignified end of life care. Unfortunately, we could become like the Netherlands, where, despite universal healthcare, access to quality end-of-life care is significantly diminished while people are subtly encouraged to kill themselves for the financial benefit of society.

The possible financial motivation in encouraging assisted suicide cannot be ignored. Advances in pain control and medical care are on the horizon, but will cost money. The government and health insurers are well aware that sick people are expensive, but balancing budgets on the backs of the suffering with laws that legitimize suicide is completely reprehensible. Why do doctors have to be part of the whitewashing of blood money for the financial gain of these institutions?

This legislation also mandates falsifying medical records, since the cause of death would be listed as the underlying illness, not as suicide. This practice has the convenient “side benefit” of preventing the public from quantifying the long-term impact this legislation.

After watching my father suffer severely for five years and eventually die from cancer, I know that better pain management is needed for people who face a terminal, painful illness. Instead of encouraging suicide, let’s work on giving all terminal patients access to better pain management. Doctors should receive better training in pain control. Legislative reforms that eliminate the possibility of lawsuits against doctors who want to respond to a terminal patient’s request (and consent) for more pain medication, but have concerns about the small possibility of an overdose, should be explored. Let’s control people’s pain, not promote suicide. Let’s protect patients, not the bottom line of health insurers.

Editor’s note: Christine Metzing, M.D., is a board-certified doctor of internal medicine who has received specialized training in social medicine. A Delaware resident for 18 years, she also teaches biology and chemistry at a local private high school.

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