CTIR Episode 76: the Right to Die

CTIR Episode 76: The Right to Die

Introduction

CTIR Book Fundraiser.
Advice for focus.

Why talk about it?

Play ALL CLIP.
Brittany Maynard, terminally ill woman was diagnosed with terminal brain cancer last year and given six months to live. She moved from CA to OR to access the state's right to die options. Celebrated her husband's birthday and died a few days later.

The Right to Die

Legal ability to die with the assistance of a physician.
Legal in only five states.
Oregon, Vermont, and Washington (have specific laws).
Montana and New Mexico have court rulings that protect it.
Oregon was the first state to make it an option (1994).
Oregon procedures:
Doctors certify that the patient qualifies under the law by fulfilling certain criteria; after appropriate waiting periods (15 days), physician writes prescription for life ending chemicals.
Two people have to witness the writing of the request by the patient, one of them cannot be a beneficiary of their estate; but no one is required to be with the patient when taking the prescription.
18 yoa or older.
"Informed decision" = "a decision by a qualifying patient...that is based on an appreciation of the relevant facts and after being fully informed by the attending physician of his or her medical diagnosis...potential risks...probable result...the feasible alternatives."
"Terminal disease" = "incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months."

Polls

In a 2013 poll of more than 1,700 medical experts, 67% were against it.
In 2013, 47% of adults supported, 49% opposed.
Possible problem with way questions posed.
70% in favor of allowing physicians to "end the patient's life by some painless means."
But only 51% were in support of allowing doctors to help a patient commit suicide.
The power of language: right to die VS assisted suicide.

Statistics

Median age in Oregon who uses it is 71; only six people younger than 34.
According to a report published by the Oregon Public Health Division in 2014 (for a 16 year period):
1,173 patients have received it; 752 of those, died from using it.
In 2013, of the 122 people prescribed medication to induce death, 71 took it.
In 2010, 16% of hospice patients were eventually discharged from hospice care.

Jack Kevorkian

Good movie with Al Pacino.
Claimed to have helped 130 people die.
Studies by the Detroit Free Press showed that about 60% of those who died with his help were NOT terminally ill and 13 did NOT have pain.
In one case, the dead woman's husband made the arrangements and Kevorkian met her just two days before the assisted suicide.
In 1998, he allowed TV to broadcast the euthanasia of a 52 year old man said to be in the final stages of Lou Gehrig's disease. He administered it himself, rather than the patient.
In 1999, he was charged with second degree murder; convicted; sentenced to 10-25 years; served 8.

Supreme Court

Cruzan v. Director, Missouri Department of Public Health (1990).
Nancy Cruzan was in a vegetative state for five years and her parents asked that her feeding tube be removed.
5-4 decision; Recognized a constitutional right to refuse treatment in extraordinary circumstances.
However, the state has interests in intervening and prohibiting withdrawal by family members.
Must be informed and voluntary. Competent. Based on consent issues.
Washington v. Glucksberg (1997).
The state prohibited assisted suicide.
9-0, though multiple concurrences for various reasons.
While the Constitution guarantees a right to refuse medical treatment, it does NOT give patients the right to assisted suicide.
Suicide is disfavored by government. Cruzan does NOT apply as NOT all personal liberty interests are protected (think child porn).
Looked at tradition: "longstanding expressions of the States' commitment to the protection and preservation of all human life." "For over 700 years, the Anglo-American common law tradition has punished or otherwise disapproved of both suicide and assisting suicide."
Reluctant to intervene (though the Court did in establishing right to marry, have children, direct education and upbringing of one's children, abortion, marital privacy, etc.
Gonzales v. Oregon (2006).
US attorney general tried to use a federal drug law to prohibit doctors in Oregon from prescribing lethal doses of drugs to terminally ill patients under the Death with Dignity Act.
Ruled rejected this.
More of an administrative holding; attorney general exceeded his powers; regulation of medical practices is primarily a job for the states.

Solutions

NOT looking at the law; just the broad concept of the right to die.
PLAY ALL Clip:
Maybe some deep personal issues; goes to consent; free will; voluntary action; choice; depression; misery; life; religion; spirituality.
Conservatives.
Religious arguments; all life is sacred and should be preserved.
What about the problem of coercion? Relatives? Insurance/money problems?
How can someone consent to death? Maybe to contracts or war, but not death...
Slippery slope: what about other illnesses like depression? Or ringing of the ears?
Liberals.
Adult should be allowed to choose to end his life, painlessly and surrounded by loved ones.
Progressives.
Some believe right to die as civil right.
Others believe in social compact; social policy shouldn't support ending lives of others as it is between two people (thus government can step in); does nothing to address the deficiencies in medical practice, health care financing, or social services that bring ill people to want to kill themselves.
Libertarians.
Property rights: ownership of oneself.
Non aggression principle.
Could get complicated with children.
My view.
Golden rule.
Non aggression principle.
Life is sacred, but who determines when it is and isn't? Shouldn't the individual? If society, slippery slope.
Contract/agency rules.
Issues of consent remain.
Why is the state (outside of issues of consent) even involved?

In Episode 76 of CTIR, I discuss the right to die. Specifically, whether an individual should have a right to commit assisted suicide.

Critical Thinking is Required is a political and educational podcast for individuals with endless curiosity.

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The intro song is titled "I Disagree" by 20 Riverside.

The outro song is titled "Good Medicine" by 20 Riverside.

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