The proponents of physician-assisted suicide as an end-of-life option for California residents diagnosed with terminal illnesses are again advancing a bill –SB128 (Wolk and Manning)– through the state legislature. With each attempt, legislators and the public are becoming more knowledgeable and more approving of this form of aid in dying. Should the bill fail passage this time, its sponsors are prepared to ask voters to approve a ballot measure next year. Either way, even its most ardent opponents agree that California is poised to become the fifth state in our nation to adopt medical treatment protocols to proactively end human life.
The good thing about SB 128 is that the protocols it prescribes have been vetted by all the experts in Oregon, Vermont, and Washington where similar laws have been enacted. Montana is the fourth state that allows physician-assisted suicide, but the authorization came by way of a court ruling, not legislation. Similarly, a court ruling that is being appealed could add New Mexico to this list.
I, too, believe that approval of this end-of-life option is long overdue; that we as autonomous individuals should have the right to decide how our lives will end if confronted with a terminal illness. I neither dismiss nor deny effective pain management, hospice and palliative acre, the Advance Health Care Directive, or Physician Orders for Life Sustaining Treatment (POLST) as worthy options, but these are all passive end-of-life choices. Proactive choice should be allowed because persons are entitled to be self-determining without interference. As Kant and other philosophers argued from the earliest days of civilization, this is a fundamental human right.
SB 128 does, however, fall short in one key area; it fails to specify any special training requirements for physicians who want to counsel and advise patients on this end-of-life option. As do the laws in the states that allow physicians to aid in proactively ending a person’s life, this bill would deny doctors their humanity. That can be corrected by adding diversity training and a fellowship in end-of-life care requirement for participating physicians.
A plethora of studies can be found in medical literature to underscore the degree of influence that race, ethnicity, gender, socio-economic status and lifestyle choices have on physician-patient relationships and the medical treatment options prescribed by doctors. This serves to underscore the reality that doctors are no less flawed in their socialization than any of the rest of us. But the rest of us are not given a license to kill. Neither should anyone with just a medical degree, especially in a state with so diverse a population as California.