Alaska has the highest suicide rate in the United States, and suicide has had a particularly devastating impact on rural and village Alaska, where so many young people, most of whom are Alaska Native, take their lives each year. During my six years in this state, I have been edified and encouraged by the efforts of Native elders, mental health professionals, teachers, parents, youths and religious leaders to help those who are most susceptible to suicide and encourage them to choose life over death.
Suicide prevention has also been a high priority of the state and federal governments, which have funded suicide prevention programs in urban and rural Alaska with bipartisan support. So, I was shocked and saddened to learn that a bill has been introduced in the state legislature that would make it legal for a doctor to prescribe death to terminally ill patients by providing physician-prescribed suicide.
This is a terrible idea in a state in which suicide has reached epidemic proportions. What kind of message does such a bill send to our young people and others, many of whom are already struggling with seemingly intractable problems such as depression and mental illness, drug and alcohol addiction and unemployment, all of which make suicide seem like an attractive “solution” to their difficulties?
It disturbs me too, that this proposed legislation would involve doctors in prescribing medicines intended to kill their patients. This directly contravenes the Hippocratic Oath, by which doctors pledge: “I will neither give a deadly drug to anybody who asks for it, nor will I make a suggestion to this effect.”
Although there may be some physicians who would, if permitted by law, prescribe deadly drugs to their patients, we expect our doctors to seek to heal us when we are sick and to provide us with palliative care and pain relief as needed during our final illnesses.
Because of our human nature, we can all be, at one time or another, weak and vulnerable because of age and illness. Some are even more vulnerable than others because of poverty or social isolation. Doctors, nurses and other health professionals who care for the sick, the elderly and the dying, act in the name of the entire community, which is called to act in solidarity with those who are in need.
One key example of this lived-out solidarity is the Hospice Movement. Here in Juneau, we are truly blessed by the work of the doctors, nurses, care attendants and volunteers of Hospice and Home Care of Juneau, which operates in our community under the auspices of Catholic Community Services. The mission of Hospice is to provide those who terminally ill with compassionate, professional care and support through their illness. In those situations in which a dying person is suffering discomfort and pain, effective and ongoing pain management is a central priority of those providing patient care.
The purpose of the palliative and comfort care provided by Hospice is to help them through the dying process until their natural death.
One grave concern raised by doctor-prescribed suicide is that those diagnosed with terminal illnesses will feel a responsibility to take their own lives so as not to be a ‘burden’ on their families or caregiving institutions. Patients may well feel a sense of obligation to expedite the dying process so as to spare their loved ones from having to witness their final days and hours.
Such legislation only increases the temptation for institutions or insurance agencies, consciously or unconsciously, to encourage doctor-prescribed suicide as a way of economically conserving medical or financial resources. This was the case for an Oregon woman whose cancer had returned. Her request for an expensive experimental treatment was rejected by her insurance company, but she was told that insurance would cover the cost of physician-assisted suicide.
In the 1994 Alaska Supreme Court decision that unanimously held that there is no constitutional right to assisted suicide, the court noted: “(The state) insists that the terminally ill are a class of persons who need protection from family, social and economic pressures, and who are often particularly vulnerable to such pressures because of chronic pain, depression and the effects of medication.” In the same opinion, the justices also noted: “Those who will be most vulnerable to abuse, error, or indifference are the poor, minorities, and those who are least educated and least empowered …”
We should commit ourselves as a community to providing the dying with good medical care and pain management to alleviate their physical suffering. It is important that we offer charitable companionship in order to provide them with emotional, spiritual, and loving support for them and for their relatives in their final days. Our family members, friends and neighbors deserve better from society than doctor-prescribed suicide which is being mistakenly proposed and presented in the name of compassion and dignity.