Jack Kevorkian, America’s most notorious (and notoriously successful) serial killer finally came to justice in late March when a Michigan jury convicted him of killing Thomas Youk. In three prior cases, juries pulled out their hankies and gave Kevorkian the benefit of the doubt for a practice they didn’t like but couldn’t bring themselves to condemn. The new verdict, which follows the overwhelming rejection (70-30 percent) of a 1998 referendum to legalize assisted suicide, suggests that the citizens of Michigan have finally figured out that there is a better way to treat the afflicted than to kill them.
The lesson has not yet reached California, where Assemblywoman Dion Aroner (D-Berkeley) has introduced legislation, modeled after Oregon’s Death With Dignity Act, to authorize physician-assisted suicide. Her bill was narrowly approved, 8-7, by the Assembly Judiciary Committee on April 20, and some time this session will be debated on the floor. Opponents are not optimistic, and for good reason. California voters seem to be clinically preoccupied with sensationalism, witness the television news shows, whose police car chases and scandalous exposes are a caricature of a Hollywood caricature of themselves. And even when Californians do pay attention, they have a habit of reducing grave issues to solipsistic bathos. To listen to almost any California call-in show makes one despair for the prospects of self-government. (“I mean, who’s to say what I can do with my body, right?”)
The proposed legislation seems therefore made to order. It feeds, even as it feeds upon, a culture that celebrates an omnipresent present in which the prospect of one’s own death, not to mention suffering, is a remote and unlikely rumor. The possibility of anything other than a serene, well planned death seems to come as a shock to those who are too comfortable for their own good. Appropriately enough, Aroner’s bill sneaks in on little cat feet: It is designed, she says, for that small class of mentally competent, terminally ill adults “whose suffering is extreme and cannot be palliated despite our best efforts.” No sooner does the specter of suffering enter, however, than it quickly disappears: Under Aroner’s proposal, experience of pain is not a pre-condition for assisted suicide. One has merely to have a terminal disease, which is defined as a condition that “will, within reasonable medical judgment, produce death within six months.”
Aroner further believes that her legislation contains sufficient safe-guards to prevent abuse. The request for assisted suicide must be “voluntary” and confirmed in writing; there is a waiting period of 15 days, during which the patient can rescind the request; and the attending physician must seek a second opinion. These procedural niceties, however, will not withstand close scrutiny. Patients in extremis are seldom in a position to make truly autonomous choices. Doctors, for their part, are notoriously inaccurate when it comes to defining terminal illness; most are ill-trained in state-of-the- art palliative care, and absent special training, they have shown themselves inept at diagnosing the symptoms of depression in their patients. If Aroner is serious about wishing to limit assisted suicide to, as she says, “those relatively few” for whom all other options have been exhausted, she would insist on two pre-conditions: (a) that all reasonable measures to eliminate pain have been undertaken by palliative care experts, and (b) that there be consultation and treatment by specialists skilled at diagnosing depression. Then again, if those steps were taken, the ostensible justification for assisted suicide would evaporate almost overnight.
Proponents of the legislation, however, seem less interested in solving a small and manageable medical problem than in advancing the ideological cause of moral autonomy. Their emphasis is almost always on “choice-in-dying” rather than on effective pain management. They pander to ignorant, popular fears concerning “intractable” pain and “loss of control.” Someone once said that, if you want to see what America will look like in 10 years, spend a month in California. If Aroner’s bill becomes law, you will find its counterparts cropping up all across the country. The time to stop it is now.