By Rene Trabanino M.D./ Ph.D.
4/17/2024
In 1999, Dr. Jack Kevorkian was on trial, ultimately convicted of 2nd degree murder, and was sentenced to 10-25 years in prison for killing Thomas Youk (who had Lou Gehrig’s disease and was requesting assisted suicide) by lethal injection (after Dr. Kevorkian had taped the killing of the patient which aired on 60 minutes ). The media had given Kevorkian the title of “Dr. Death”. Now in recent years, these acts are being legalized around the world. In particular, our own California state lawmakers passed the first physician-assisted suicide bill in 2015 for terminally ill patients. In 2021, in the height of the COVID pandemic, an expansion of assisted suicide (SB 380) passed, which removed the 15 day waiting period in order for someone to be killed by assisted suicide, removed oversight and evaluation of annual reports of these assisted suicide cases, and ended the sunset date of 2025 for the original bill.
Now our California lawmakers are pushing through an even more extreme expansion, which is now beyond the practices of Dr. Kevorkian, CA Senate Bill 1196. Whereas, the assisted suicide of patient was allowed for cases of terminally ill patient, this bill expands the assisted suicide to cases of a:
“grievous and irremediable medical condition” defined as “a medical condition that meets all the following criteria:
(A) The condition is a serious and incurable illness or disease.
(B) The condition has placed the individual in a state of irreversible decline in capability and the individual’s suffering is palpable without prospect of improvement.
(C) The condition is causing the individual to endure physical suffering due to the illness, disease, or state of decline that is intolerable to the individual and cannot be relieved in a manner the individual deems acceptable, and there is no proven treatment for the individual’s situation that the individual has not attempted or is willing to attempt due to the nature or side effects of the treatment.
(D) After taking into account all of the individual’s medical circumstances, it is reasonably foreseeable that the condition will become the individual’s natural cause of death. A specific prognosis as to the length of time the person has left to live shall not be required to meet this criteria.”
The expansion would include a variety of non-terminal conditions and dementia. And as the data has shown, there is a high rate of elderly abuse, 1 in 10 according to the National Council on Aging. In this context, and with the lack of sufficient oversight, there is a foreseeable factor of coercion by family and other caregiver, perhaps in some cases for personal gain. In Oregon, there have been many reported cases of abuse and complaints, including a case of apparent lack of competence for a patient to consent to assisted suicide, but was killed anyways, and the statistic that around only 3 % of patients requesting to die by assisted suicide had gotten a psychological evaluation from 2011-2014.
According to Oregon data, the top 5 reasons for someone requesting assisted suicide do not include pain or fear of pain, but other factors such losing autonomy, losing dignity, or burden on the family. These concerns can be addressed in home health resources and education and therapy, but assisted suicide offers a way to not have to address these important issues.
Secondly, the waiting period would be completely eliminated, so someone wanting to kill themselves can have it take place the same day. Someone with depression in despair can foreseeably use assisted suicide. In the general California population, according to the Kaiser Foundation, around 31.7% of adults reported symptoms of anxiety and/or depression and of those, around 28.5% had an unmet need for counseling or therapy. In this setting of high rates of mental illness and high rates of lack of mental health care, why would lawmakers want to allow someone to be able to have themselves be killed the same day?
Thirdly the bill would allow for the use of intravenous administration of the lethal drugs, with no independent witness to check that someone else is not administrating the drugs. This would not be assisted suicide but plain government sanctioned suicide. In addition, this would open the door for more abuse by someone motivated to kill the patient.
Physicians are bound by an oath to “do not harm” but this bill expands the ability of the physician to do the opposite. This bill further corrupts the healing profession of medicine and its noble goals. As a physician myself, I accompany people through suffering (which inevitably comes to patients in their lifetimes) and strive to help them alleviate their suffering and cope with it with inner peace and strength, and true dignity. Many times, patient have moments of despair, but through support from family, myself and their faith practice, they are able to seek hope out of this and true inner joy.
This bill further degrades the dignity of our fellow human beings who are in need of our support and compassion, and not a push into the grave. Let us return to the appropriate shock and disgust we had at the practices of “Dr. Death.” As the American Solidarity Party principles state, “Human life is sacred from conception to natural death.” To uphold the sacredness of life, urge your state senator to vote no on SB 1196.