Oregon is the only state in the Nation to permit physician-assisted suicide. Oregon’s Death with Dignity Act was approved by the citizenry of that state in 1997.
Recently, the State’s Department of Human Services reported that forty-two patients had utilized physician-assisted suicide in 2003, an increase from the thirty-eight cases in 2002. Under the provisions of the Death with Dignity Act, Oregon’s Department of Human Services is required to report the number of deaths.
On another, similar front, the Pope recently indicated that in his opinion, the withholding or withdrawal of food or hydration to an individual in a “vegetative state” was immoral. The Pope indicated that in his opinion, the providing of food and water to individuals in such a state was a moral imperative. His Holiness was dismayed by the fact that people in such a condition were referred to as if they were a vegetable, instead of a living individual.
The Pope’s opinion on this subject is not, however, Church law. The mere fact that the Pope expresses an opinion on an issue does not mean that such an opinion is the official doctrine of the Church.
Yet, the Pope’s opinion and the Oregon statute provide food for thought. Is the withholding of medical treatment under the terms of a living will tantamount to assisted suicide? If I, as a person’s health care proxy, direct a doctor to withhold or withdraw “life sustaining treatment” am I assisting that person in a pre-conceived plan of suicide? After all, the state of medical science today is such that many people who in the days of yore would have passed away quickly can be sustained for months or years using what many laypersons would dub “extraordinary means.”
Now, admittedly, I’m reading more into what the Pope said then is there. The Pope only opined that the provision of food and water – the basic necessities of life – was a moral imperative. He did not indicate that a person should undergo every conceivable medical procedure in order to cling to life for the longest time possible.
Personally, I’m not sure I agree with the Pope’s opinion. The case of a woman in Florida who was the subject of a recent right to die debate that made national headlines and spawned a new law in Florida designed specifically to provide her with food and water gives me tremendous pause on saying that the provision of food and water is a moral imperative.
That woman was “brain dead.” Her parents wanted her to receive food and water, which kept her alive. Her husband did not, and he indicated that the woman herself had expressed an opinion that she would never want to live in such a state.
The husband’s credibility was brought into question because he was the beneficiary of a life insurance policy on the woman’s life, but the fact remains that the woman, who has been living for ten years in a persistent vegetative state, has no quality or dignity of life. In my opinion, just because someone is breathing does not make them “alive.”
In our state, advanced health care directives, that is, living wills, must be honored. An individual doctor or hospital does not have to carry-out your wish that life sustaining treatment be removed or withheld, but the provider must then find another provider who will carry-out your wish.
Many of my clients question the efficacy of advanced health care directives. It would appear that everyone has had some experience were a family member or friend had a living will, yet the hospital placed the person on a respirator against his wishes.
While I do not disbelieve such stories, the fact remains that a health care provider is legally obligated to honor an advanced health care directive. A provider that fails to honor the directive or to comply with the law that created such directives by transferring the patient to a provider who will honor the directive could very well find himself the subject of a lawsuit.
In New Jersey, an individual can indicate that he does or does not want food and hydration to be provided. Undoubtedly, the debate as to where to draw the line on “extraordinary measures” and ordinary care will continue, and theologians will continue to lead that debate. But in our state, a State that has a long and deep history with right-to-die cases, the law on the issue is rather clear.