This is the second in a five-part series contrasting the ways our society could handle end-of-life care moving forward.
The right to die is an odd concept. Everyone will inevitably die. Many people fear what sort of condition they may be when they are older or suffering from a terminal disease. Some people express that fear in these exact words: "I don't want to be hooked up to all of those machines."
Patients certainly have a right to refuse unwanted medical treatment. But when people speak of the "right to die," they don't mean allowing someone at the end of life to let life take its natural course. People have had that right for a long time, even before the advent of modern palliative care and adequate pain control. No, the "right to die" means euthanasia or suicide: the right to kill a suffering person or to kill oneself.
Autonomy is given as the reason we need to have a "right to die," but embracing a "right to die" quickly ends with sacrificing patient autonomy. "I don't want to be hooked up to all of those machines" turns into, "You shouldn't be hooked up to all of those machines."
It's a slippery slope. Some accuse people who refuse to embrace euthanasia of committing a logical fallacy by saying it's a slippery slope. It's not a fallacy, however, and real world experience backs up the simple observation that people will often take the easy way out instead of the right way through a problem.
The Alfie Evans case is a prime example. Courts in Britain thought that death was preferable to Alfie living, despite his loving parents' decision to let his life continue with palliative care. The court ordered he must die now, because of his "quality of life." Alfie's autonomy, as expressed and protected by his parents? Ruled irrelevant, not in his best interest, in the opinion of a judge who never has to visit Alfie's grave.
In countries that have embraced a legalized "right to die," a "duty to die" is quickly taking hold. In the Netherlands and Belgium, involuntary euthanasia—we call that "murder" here—is a significant proportion of euthanasia deaths. Efforts to prosecute doctors who decide to kill their patients—for their own good they say—fail. The autonomy of patients who want to live but are killed anyway? Unprotected, of little value.
Here in Michigan, we know of cases where patients who request medical treatments have them denied in secret and have secret orders placed into their charts, because the doctors believe the patient is better off dead. Imagine the horror of learning a hospital has placed a do-not-resuscitate order in your file, even though you expressed your wishes for life-saving care. What can you do when your life depends on those who think you need to die? The autonomy of those with the will to live? Not just ignored, but undermined in secret.
As we pointed out in part one, what happens when health insurance costs combine with a "right to die"? Patients find themselves being encouraged to exercise their cheaper "right to die" than their right to life. The autonomy to choose your own medical care? Rejected, some rights are apparently better than others (and cheaper).
A society that protects patient autonomy and gives them the compassionate care they deserve simply cannot be a society that embraces suicide or killing as a solution for the sick and disabled. They don't go together, today or in the future. Caring for the sick and disabled can be hard and places demands on the healthy and able. It's cheap and easy to lethally inject someone or give them a lethal dose of drugs. The "right to die" gives moral window-dressing to taking the easy road at the expense of the good road.
Patients deserve protection, from food and water to the right to refuse unwanted medical treatment. Killing patients isn’t a right, however, it’s wrong.