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Scot Lehigh

Death with dignity in Mass.

By Scot Lehigh
Globe Columnist / September 23, 2011

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SOME MATTERS are so dicey for legislators that their best prospect for passage is as ballot questions.

One such issue may well confront voters next fall: Whether a terminally ill patient in his last six months of life can obtain a life-ending prescription from a willing physician.

An initiative petition to legalize physician-assisted suicide has been certified by Attorney General Martha Coakley. If backers collect enough signatures, and the Legislature fails to act, the question will go on the November 2012 ballot.

Modeled on the death-with-dignity law in Washington state, the measure says that if an adult state resident is judged terminally ill with less than six months to live by two physicians, he can get a lethal prescription.

The initial request has to be made in writing. Two people, one of whom is not a family member (and would not share in the estate), have to witness the signing of the request and attest that patient is capable and acting voluntarily. The terminally ill patient has to repeat the request twice verbally, at an interval of at least 15 days. He would be counseled about alternatives like hospice care and pain control. The lethal dose would not be administered by a physician; rather, the patient would swallow it himself.

If the initiative does make the ballot, expect determined opposition. Indeed, Cardinal Sean O’Malley focused on the ballot question during a recent Mass for Bay State lawmakers and jurists, saying he hoped that Massachusetts citizens would not be seduced by language like “dignity,’’ “mercy,’’ and “compassion.’’ Those words, he said, are a “means to disguise the sheer brutality of helping people to kill themselves. A vote for physician-assisted suicide is a vote for suicide.’’

But this really isn’t suicide as we typically think of it - that is, as a healthy person taking his life for reasons of despair, depression, or hopelessness.

So the real question becomes: Why should it be considered brutal to provide a terminally ill patient the means of ending his life a few months or weeks earlier than his illness otherwise would?

“The cardinal’s point is that the act of suicide is always regarded as tragic,’’ said Reverend J. Bryan Hehir, secretary for health and social services for the Boston Archdiocese.

Why is it tragic for a terminally ill person, who might be in considerable pain, to end his life at a time and in a setting of his choosing?

“It is tragic in the sense that the act of . . . intentionally taking innocent human life is something that is always seen as against the good of the human person,’’ said Peter J. Cataldo, chief health care ethicist for the archdiocese.

But if a terminally ill patient wants to end his life a little early, why is that against the good of his person?

“The foundation of human dignity is this human life that we possess,’’ said Cataldo. “We have a natural moral obligation to nurture it in appropriate ways.’’

I am sure Hehir and Cataldo offer those formulations sincerely, but they strike me more as restatements of Cardinal O’Malley’s premise than as cogent arguments as to why that premise is true.

Most other objections that have been raised so far are of the slippery-slope variety. That is, they are less about the proposed law itself than about what else might someday eventuate if it passes.

One such worry is the passage could lead to a situation like that in the Netherlands. Voluntary euthanasia is legal there - and according to a 1991 government report, doctors have also ended the lives of some terminal patients without their consent.

That’s a concern, certainly. And yet, it hasn’t happened in Oregon, where voters approved such an assisted-suicide law in 1994 and reaffirmed it in 1997. Indeed, a dispassionate look at the Oregon experience should allay the slippery-slope fears. The law hasn’t been abused. It hasn’t led to people being coerced to end their lives. And it hasn’t resulted in an influx of terminally ill sufferers seeking aid in ending their lives.

Instead, each year it has provided a relatively small number of terminally ill Oregonians a way to control their own destiny.

So far, there’s no compelling reason to think the situation would be any different here.

Scot Lehigh can be reached at