Monday, September 7, 2015

John B. Kelly: Second Thoughts Against ABX2-15


I [John Kelly, pictured here] -hope you will have second thoughts about legalizing assisted suicide in California. Now especially that the California Medical Association secured the removal of any liability clause from  AB2x 15, in the words of the committee staff’s analysis (see page 17), “wanton misconduct” and “gross negligence” will go unpunished.

The replacement clause, that professional licensing boards “may sanction” professional misconduct, is toothless. As we have seen across society, self-interested institutions cannot be trusted to police themselves. Please see the case of Wendy Melcher, who was illegally injected with lethal drugs by two Oregon nurses, completely outside the scope of the law. The nurses were not referred for prosecution, but were secretly dealt with by the state nursing board. The nurses continue to practice today. 

In important ways assisted suicide laws are like death penalty laws: innocent people inevitably lose their lives. A strong consensus is now emerging against the death penalty because mistakes (witness misidentification, false confession) and abuse of the system (prosecutorial and police misconduct) lead to wrongful convictions and executions.

Mistakes and abuse in the medical system are common. People who are misdiagnosed (see John Norton), people who would respond to more treatment (Jeanette Hall), or who would live years longer  (some participants in Oregon have lived almost 3 years after being judged “terminal”) will be led to tragically “choose” death. Assisted suicide programs have offered lethal drugs to patients with severe depression (Michael Freeland) and to people denied treatment (Barbara Wagner). And because not all families are loving or financially secure, innocent people will be bullied or worse by abusive families and beneficiaries.

Just like the death penalty, assisted suicide exacerbates existing inequalities across race and class. It has been shown repeatedly that patients of color receive substandard, often deadly lack of medical care, and are the targets of educational campaigns to give up on treatment. Distrust of the medical system is widespread among more vulnerable populations. It’s no surprise that people of color (and poorer people generally) oppose legalized assisted suicide (Pew Research Center on End-Of-Life). The 4 most Latino cities in Massachusetts  (Lawrence, Holyoke, Chelsea, and Springfield) voted heavily against the 2012 assisted suicide ballot measure. And as the Oregon and Washington statistics reveal, there is been almost no participation in the program outside of non-Hispanic whites.

Cost savings are a major driver of today’s end-of-life policy recommendations, as Barbara Wagner learned to her horror. We poorer people and disabled people are already under increasing pressure to refuse life-saving treatment (even antibiotics or temporary ventilation). For people who are often viewed as “better off dead,” assisted suicide will become a recommended option.

Proponents of “aid in dying” have compelling individual stories, but represent a more well-to-do, better educated and whiter portion of the general population.  One social group’s particular views on end of life dignity should not be imposed on such a diverse state as California.

Please think about the profound social implications of enshrining in policy the belief that sometimes it is more dignified, more respectable, to die early. Rather than aid in dying, please focus on aid in living and ending the vast inequalities that are distorting our society.

John B. Kelly
Second Thoughts Massachusetts