Extending right-to-die timeframe for Alzheimer’s patients is fraught with danger, controversy

The Los Angeles Times editorial published by the Bee on Sunday advocates the expansion of California’s 2015 law permitting physician-assisted suicide. Its chief proposal is to allow a patient with a one-year terminal diagnosis (rather than a six-month terminal diagnosis, the current legal requirement) to be eligible for a prescription for life-ending medication.

The editorial explicitly mentions those with ALS and Alzheimer’s as being able to take advantage of this program once such changes are made. The six-month time frame, they argue, is not long enough for someone with such conditions to be physically or mentally capable to take advantage of the law.

These proposals are alarmingly bad policy, and even more alarming coming from the editorial board of the state’s largest newspaper, one well-connected with policy advocates and lawmakers who could introduce these proposals legislatively. They deserve an emphatic, negative response.

After decades of defeats, legalized physician-assisted suicide barely passed the California Legislature in a special session (allegedly to deal with health care funding) in 2015. It was a hugely controversial bill that garnered the votes of the hardest-left members of the Legislature, and saw large numbers of moderate Democrats refuse to vote in favor.

However, in an obvious attempt to shift the political center, the Times characterizes that enormously contentious and controversial legislation as “conservative” and “reasonable.”

With that simple hand-wave, the Times also ignores almost all of the most compelling arguments against legalized assisted suicide that made the 2015 law so fiercely controversial: the uncertainty of terminal diagnoses, and the disproportionate economic pressures legalized suicide imposes on lower-income (often minority) persons and those with disabilities to kill themselves inexpensively, rather than seek costly end-of- life care.

The Times did manage to lazily repeat the party line that data from California and Oregon do not support critics’ fears of abuse in the system of assisted suicide prescription. In fact, disability rights advocates like the Disability Rights Education and Defense Fund have pointed out numerous instances of possible abuse from two decades of suicide legalization in Oregon and Washington, arguing that those states —models for California’s system — lack adequate mechanisms to collect data indicating abuse.

Speaking of abuse, the Times argues in favor of the 12-month timeline specifically to allow Alzheimer’s patients to make a decision regarding end-of- life treatment before they are no longer mentally capable to do so. If there isn’t significant evidence abuse of the system currently, opening assisted suicide to Alzheimer’s patients would guarantee its increase.

California’s system provides that the patient ingests the prescribed medication at his or her convenience, not in a clinical setting. This allows the patient to change his or her mind before taking the medication, and allows the patient to choose to ingest the medication in full freedom.

How can one in good conscience provide such medication to someone with Alzheimer’s, who may forget the purpose of the medication, may change his or her mind repeatedly about whether or not they wish to take it, and who has most of their medications provided to them by caretakers?

How can the state reliably ensure there will be no abuse from caretakers?

How can someone suffering with Alzheimer’s be deemed capable of freely “choosing” to ingest this medication? The potential for abuse — an abuse that ends in a murder that could easily go unnoticed — is staggering.

Another problem with this editorial is its advancement of a word it dares not breathe openly: euthanasia. The piece subtly mentions that the physical requirements for assisted suicide — specifically, the requirement that the patient ingest life-ending medication herself — may be excessive.

If the patient is not self-administering the medication, then it is no longer assisted suicide, but euthanasia, wherein medical personnel actively to kill their patients by directly administering fatal medication. This will radically alter doctor-patient relations and lead to yet another assault on the Hippocratic ideal to “first, do no harm.”

The Los Angeles Times acts like it is offering an incremental improvement to a reasonable policy advancement. In reality, it offers a reckless expansion to a bill already fraught with danger and controversy.

This story was originally published April 12, 2018 at 11:28 AM with the headline "Extending right-to-die timeframe for Alzheimer’s patients is fraught with danger, controversy."