MPs are due to debate an Assisted Dying Bill next month – tabled by Labour MP Rob Marris – and so we have the usual commentary in the media in the run-up to the debate. Because here in America we have a few states which have legalised assisted dying – with Oregon and Washington being perhaps the most notable – the experiences of these states is often held up as an example of what a wonderful, compassionate, autonomous society might look like, where Free Choice and Dignity reign.
Indeed, Dr Jonathan Romain, Rabbi of Maidenhead Synagogue and chairman of the group ‘Inter-Faith Leaders for Dying in Dignity’, has argued recently that he is quite happy to support the Assisted Dying bill because ‘we can see the future’ in regards to euthanasia. ‘The Marris Bill’, he writes, ‘is exactly the same as the law in Oregon.’ Apparently the Oregon experience has been just dandy, so there’s no reason why the UK shouldn’t pass the same law.
Well, hold on. If you’re going to use Oregon as your fail-safe reason for passing the Assisted Dying Bill, allow me to offer a few reflections from this side of the pond.
The Assisted Dying campaign is actually in retreat here in the US. It’s been nearly 20 years since the Dying with Dignity Act was passed in Oregon, and there has been nothing in the Oregon experience that has inspired the rest of the country to go down the same route. On the contrary – earlier this year, Assisted Dying Bills were rejected in the state legislatures of Connecticut, Maryland, and Colorado. These states are not known for being particularly conservative, or dominated by the Christian right. In 2012, the state of Massachusetts – that great paragon of progressive liberalism – rejected an Assisted Dying Bill, with none other than Victoria Reggie Kennedy, widow of the late Democratic Senator Edward Kennedy, campaigning against it. And, a few months ago, an Assisted Dying Bill was stalled in the California legislature, being placed in what is called a ‘suspense file’ – the place where Bills go to die, or significantly watered down.
Why? No doubt there are many reasons, but let’s point to the more obvious ones. First, financial incentives in the US health care industry – in other words, money. The rejection of assisted dying by a growing number of US lawmakers is based on the fear that health care and insurance companies will see it as a cheap alternative to providing expensive treatment to those who are diagnosed with terminal illnesses.
And here’s the kicker: this is not an irrational, hypothetical fear. As Dr Aaron Kheriaty of the University of California Irvine School of Medicine argues in the Wall Street Journal, there have been cases in Oregon where health care companies have ‘refused to pay for more expensive potentially life-extending cancer treatments, but offered to pay instead for the $50 assisted-suicide pills.’
This, in itself, should be proof enough that the assisted dying movement does not automatically lead to greater ‘choice’. If anything, Dr Kheriarty argues, legalised assisted dying has been shown to reduce ‘end-of-life’ medical options, most especially for the poor and the vulnerable. Indeed, last year over 50 per cent of people in Oregon who went for ‘assisted dying’ had government-sponsored health care, or no health care at all. And 75 per cent of assisted dying patients in Washington state were either partially or wholly dependent on the government for health care.
There is no reason to think that that the UK will not be subject to the same financial pressures just because it has a nationalised health care system. Medical care costs money, and early ‘chosen’ death means no more medical care.
There are other reasons, too, why assisted dying is losing traction here. Dr Kheriaty points out that suicide is now considered a public health crisis in the US. And the tricky thing about suicide is that is often ‘catching’ – that is, it is a social contagion, leading to ‘copycat’ suicides. It just so happens that after Oregon passed Dying with Dignity, the suicide rates there started to rise, after falling in the 1990s. It now has a suicide rate that is 35 per cent higher than the national average. Other countries with legalised assisted dying, like Belgium and Switzerland, have the highest suicide rates in Western Europe.
All this points toward the inevitable cultural changes that come with legalising assisted dying – that is, the cultural changes toward death in general, and the notion of a ‘life worth living’. Reports from the Netherlands and Belgium regarding legalised assisted dying show an appalling, heartbreaking disregard for life, where people can ‘choose’ death for conditions far less serious than a terminal illness. For instance, earlier this year, a 47-year-old divorced mother of two, suffering from tinnitus – which is a ringing in the ears – was allowed a physician-assisted suicide. This is by no means an isolated case. Furthermore, studies on assisted death in these countries show a shocking disregard for the ‘consent’ of the patient. Perhaps it is an open secret that, in both the Netherlands and Belgium, ‘the incidence of legally assisted death without explicit request … is strikingly high.’
So, perhaps, there is a sense in which you can see the future with assisted dying. Politicians here on both the right and the left have seen it, and have decided, wisely, to reject it. I strongly suggest that when MPs debate assisted dying next month, they do the same.