On Oct. 5 California became the fifth state to allow assisted suicide, after Gov. Jerry Brown signed State Assembly Bill ABx2-15 into law. With this decision 39 million people—roughly 12 percent of the population of the United States—gained the right to have a doctor prescribe life-ending medication for them if they are terminally ill and within six months of death.
Though assisted suicide has been debated here for decades, the movement gained considerable momentum last autumn, as Brittany Maynard, a 29-year-old native Californian, spent her final months of life advocating for the ability to die with dignity and without pain. “There is a difference,” she argued, “between a person who is dying and a person who is suicidal. I do not want to die. I am dying.”
Governor Brown, a lifelong Catholic, spent three weeks considering this decision, sifting through conversations with friends, doctors and a bishop and the arguments of different groups. “In the end,” he writes, “I was left to reflect on what I would want in the face of my own death.”
“I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to consider the options afforded by this bill. And I wouldn’t deny that right to others.”
His thoughtful sentiments will no doubt resonate with many. One might choose to face one’s final days in any number of ways. But who has the right to deny reasonable options to anyone else? His words highlight the great problem faced by many Catholic arguments against assisted suicide. They do not seem to be grounded in the mercy and compassion one expects of the church, especially at such a profound and difficult moment.
In point of fact, however, pain management is not the problem today that most of us fear it will be. In Oregon, in fact, where assisted suicide has been legal for decades, only 31 percent of those who chose a medically induced death in 2014 did so because of pain. (The overwhelming reason given was a loss of autonomy.) Still, there are cases like Ms. Maynard’s in which the pain cannot be managed. And the oft-proposed Catholic solution of medicating the patient into a near or total coma seems meaningless, even cruel.
Yet church officials and others in California have tried to point out the danger this law poses to the least among us. Assisted suicide could very easily become a cheap substitute for proper health care. Indeed, the legislation just passed was introduced during a special session in which Mr. Brown had specifically asked legislators to help him brainstorm ways of dealing with rising health care costs.
As Edward Dolejsi, executive director of the California Catholic Conference, pointed out, “To its promoters, ABx2-15 is about compassion and choice. Where is the compassion when Medi-Cal won’t pay for pain relief, but the Legislature responds by making physician assisted suicide ‘affordable’?”
“And where is the choice when literally millions of Californians are told there is no coverage for second opinions or their cancer care, but look, we’ve made suicide an affordable option?”
Justin Harford, a disability advocate in California, adds that Californians who live in poorer or rural communities, as he does, do not receive the same health care as elsewhere in the state. “They’re not as likely to get sufficient pain management, they’re not as likely to get sufficient testing—we see this in the disability community, too.” The obvious consequence is that there is no real choice: “If you don’t have the right to choose to get chemotherapy when you get cancer, then it’s rather a phony choice to say you can ‘choose’ assisted suicide.”
There are other concerns, too: that the terminally ill, the aged or disabled may end up feeling pressed to die; that making suicide legal for the terminally ill will encourage suicide among those who are depressed—as seems to have been the case in Oregon.
The combined population of the other four states that have legalized assisted suicide is just one-third that of California. Its bureaucracy, like its economy, is larger than most nations, and it has the largest number of uninsured in the country. The impact this new law will have is impossible to predict.
What is clear is that concern for the way a person dies without a commitment to their ability to thrive and receive proper care will not be compassion but absurdity.