By Shanalee Gallagher, MPP candidate 2018
Brittany Maynard was a 29-year-old woman who took social media by storm in 2014 when she publicly shared her choice to die on her own terms. She did this in the hope that others could have the same option. In the months before her death, she strongly advocated for terminally ill individuals, instigating policy change in California and 24 other states. The right to die is an issue of public value and medical accessibility. As a nation, we must support a patient’s right to make the decision that is best for them and their family, with the support of their medical team.
Death with Dignity (DWD) laws allow a person who has a diagnosis of six months or less to live to legally end their life on their own terms. These laws have passed in Oregon, Washington, Vermont, Montana, California, and most recently in Colorado. Oregon was the first state to pass the law and has been a model for several subsequent bills.
Fighting for the Right to Live: Death Row Prisoners
Perhaps, in light of these new DWD laws, California and other states that allow lethal injection under the death penalty could find it in their hearts to afford that same dignity to those on death row? In 2006, the courts found the three-drug cocktail used for lethal injection as cruel and unusual punishment in comparison to other methods. Due to the frequent failures of lethal injection, pharmaceutical companies do not wish to be associated with the death penalty any longer and therefore stopped supplying to states like California. Today, California’s death penalty is on an official ‘hold’ moving towards alternative methods.
Most importantly, the DWD drug is not equally accessible. Gee, thanks Eli Lilly, for creating a painless pill to die. And thanks for creating a method that allows patients to do it themselves. Can we not show the same respect for death row inmates? Are inmates so undeserving of human compassion we need to torture them by administering hateful, grotesque methods?
The 2016 California ballot presented solutions to address the hold status, yet Californians voted yes on 66, a measure written to expedite executions. How might this happen unless another, equally horrific, option is given to prisoners; such as being hanged, the electric chair, or firing squad, which are available in other states. Terminally ill patients would never choose these options, and… is dying not punishment enough?. Are all death row inmates so inhuman we cannot extend human kindness to them as well? Before you answer that question, I would like to remind you that the State hands out death sentences for nonviolent crimes such as drug trafficking.
Fighting for the Right to Die: Terminally Ill Patients
Governor Jerry Brown of California signed the End of Life Option bill in October of 2015, and it has the strictest criteria for eligibility among all states. Patients wishing to end their life are required to provide proof of lease or ownership of property, be registered to vote, and pay all state income taxes in full before they are allowed to make their final decision.
Moreover, should a Californian end their life illegally, outside of the above requirements, the government could seize their assets. This stipulation also prohibits the surviving family members any right to the deceased’s belongings, regardless of whether or not they have a will.
In any state with DWD, should a family member assist a terminally ill patient with ending their suffering, they are likely to be charged with a felony. This has proved problematic for people who do not meet the DWD criteria, or cannot afford the necessary drugs required for legal death. This also limits accessibility to those who cannot afford to relocate to a DWD state. Of course, such drugs are not considered therapeutic by any means, and therefore cannot, and most likely will not ever be covered by insurance.
The Cost of Dying
One year after Washington passed its DWD law, JAMA Oncology network produced a study on the drug price inflation and costs of dying with dignity. This study indicated near instant market shifts after Washington’s law passed. Opportunistic pharmaceutical companies quickly began to hinder accessibility to the end of-life drugs. The study found a steady increase in price from $387 in 2010 to $2878 in 2016 for Secobarbital or Pentobarbital, the one-dose pill used for DWD. Drug companies did this by capitalizing on the niche market for manufacturing.
The original manufacturer, Eli Lilly, sold its rights to the pill to Ranbaxy, who eventually sold to Marathon Pharmaceuticals, and the price rose with each sale.
Opposition and Hope in the Policy Debate
Opposition to DWD laws is often spearheaded by fundamentalist religious groups attempting to impose their moral dogma on others who support DWD laws. Even so, there were some arguments made in opposition of Colorado’s recent Prop 106 that are entertaining enough to explore.
Colorado’s Vote No on Prop 106 website, titled “Fatal Flaws,” lists six compelling “arguments”:
- 250,000 Americans die each year from medical errors, so you should not trust your doctor if they tell you that you are dying.
- A professional therapist should assess your state of mind (Prop 106 has no such requirement).
- Prop 106 is a really bad idea.
- Prop 106 creates fuzziness with respect to the details of the law, just as the cannabis laws do.
- DWD laws do not protect patients or loved ones.
- Prop 106 deters you from seeking out the finest specialist around, and instead encourages suicide.
Despite these unscholarly and willfully ignorant arguments, Colorado was still able to find it in their hearts to give terminally ill people the right to decide. Prop 106 passed with overwhelming support, giving hope that the DWD bills still pending in 24 other states will pass as well. Frankly, with America’s preoccupation with upholding the Constitution and protecting our civil liberties, the decision to restrict choices such as these appears at odds with our own values. The Constitution affords everyone the right to life, liberty, and the pursuit of happiness. It should follow that forcing the terminally ill to remain alive is in violation of these inalienable rights. The other traditionally American value at conflict with the right to die with dignity is the separation of church and state. Our right to freedom of religion, when applied to DWD legislation seems to be impinged by the application of dominant Christian values over such policy decisions. We have been given a fundamental human right to live. Should that not include the right to die, if one so chooses?
It is amazing that in a century defined by technological advancements in science and medicine, which have led to the creation of a humane way to die with dignity, that we continue to ban such options for the terminally ill and continue to rely on grotesque and archaic methods of murder for those on death row. We must defend the right of the terminally ill to die with dignity. The advocacy group Death with Dignity is currently running campaigns in 24 states. I urge you to visit their website and educate yourself on this issue.