I am walking in downtown Colorado Springs to pick up a pizza for dinner when a young woman with a clipboard stops me for a signature. Her placard says “Prop 106.” “Do you want to sign here to allow Colorado citizens the right to a peaceful death?” she asks.
I was expecting something different. Maybe a raise in the minimum wage, or a tax increase for roads. When I think of a ballot initiative, I do not think about irreversible life and death decisions. My stomach drops. My heart is racing. I was just going to pick up dinner.
“Do you want to sign here to allow Colorado citizens the right to a peaceful death?” It sounds so benign. How could anyone be against a peaceful death? Why is she speaking euphemistically? I look at her in silence as I come to understand the gravity of the question. “A peaceful death of their own choosing,” she says.
The woman with the clipboard has just asked me to give physicians the right to end their patient’s lives. She has asked me to redefine the practice of medicine, to remove “do no harm” from the Hippocratic Oath, to change the way my children and future grandchildren will die. I shake my head.
“No, I’m on the other side of this issue,” I say quietly, and cross the street.
Why am I so shaken? All she wanted was a scribble, a couple of letters on a page, and then voters in Colorado could make helping terminally ill people kill themselves part of what physicians routinely do. What difference does it make? They are dying anyway.
And yet I have grave concerns. In Western European countries, like the Netherlands, where physician-assisted suicide has been legalized, the practice has increased by double digits every year for over a decade. “Aid in dying” has been extended to children, the mentally ill, people with autism, even victims of sexual abuse whose suffering was deemed “unbearable.” The Dutch are now in the process of potentially legalizing assisted suicide for those who are not terminal but nevertheless feel they have “completed life.”
And suicide, we know, can be contagious. People who know a suicide victim are twice as likely as the general population to develop suicidal thoughts. Between 2013 and 2015, 29 teenagers in my hometown of Colorado Springs killed themselves; what they had in common was knowing of another teenager who had done the same.
Walking across the street, however, I feel guilty because the organization sponsoring Prop 106 is called “Compassion and Choices.” Who could be against either of those? Such is the power of branding.
For there is a more compassionate way. And there are better choices. My friend Cassie is a hospice nurse. She once helped a woman fulfill her dying wish to marry her boyfriend of 30 years, with a white dress and everything, right there in the hospital. Mostly, she helps people live as comfortably and fully as possible, as nature takes its course. She makes sure patients are not alone or suffering.
If they ask her, Cassie reads aloud to them until they fall asleep. She gives powerful pain medications, as much as her patients want or need. If they do not want to eat or drink, that’s O.K. They are passively dying. If they want off their ventilator, if they want to go home, if they want to never have another round of chemo, that is what hospice is about. Not hastening people’s deaths but supporting them as they are dying. To help patients live as they wish, for as long as they are able. To be present to them and their loved ones, in their joy and in their pain.
Indeed, this kind of palliative care is costly and 24/7. There is no guarantee that in a post-Prop 106 world insurers would continue covering expensive treatments for terminal patients. Under Prop 106, vulnerable patients already worried about burdening their families with the cost of their care would be counseled about their end of life options—by the same doctor who would be in charge of prescribing their fatal and inexpensive cocktail.
It is disheartening that we live in a society that has devalued caring for others and allowing others to care for us. Maybe in a hundred years we will not need hospice or family care anymore. Death will always be self-administered. The stigma will be gone. We will be fully autonomous individuals, even in our last moments. We will take care of it, as we always do, by ourselves. But “a happy death” requires more than a prescription. It requires community and loving kindness.
Whose Life Has Value?
If I went to see my doctor tomorrow and told her that I wanted to kill myself, and insisted that she help me, I am certain that she would say no. She could even have me placed, against my will, in a psychiatric hospital. At the very least she would try to convince me that my life was worth living. Why? Because I am a human being, or because I am a young, healthy, educated, white woman? Because all lives have value, or because I have a husband and children, a career, friends, a lot to look forward to? If my doctor gave me an overdose of sleeping pills and instructed me on how to take them, she would lose her license. People would find it tragic, or disturbing, at best.
But if I were poor, old, disabled and terminally ill, or otherwise perceived to be of little value, and I told my doctor that I wanted to kill myself, under Prop 106, she would be able to “assist” me. She would not even need to know me or have treated me in the past in order to meet with another doctor and then prescribe me a lethal injection and teach me how to take it at home. It is no wonder that disability activists, the poor and racial minorities are the most vocal opponents of physician-assisted suicide. They will be offered this “option” first. Then again, we will never know how equally or unequally Prop 106 is administered because the law does not require the keeping of detailed statistics about who is using it and why.
We live in a culture that values productivity and success and makes the weak feel that their lives have no purpose. If Prop 106 is passed, it will irreversibly change the way we think and live in Colorado. If suicide is now referred to as “death with dignity,” has the person in the wheelchair with the feeding tube who stubbornly refuses to die, somehow forfeited their own? Can there be no dignity in suffering? Is there no dignity in a natural death if our “useful” years have passed? Are people who do not make money of no value?
But Prop 106 in Colorado is not about any of that. It is about the continued marginalization of the most vulnerable.
Anna Keating is the co-author of The Catholic Catalogue: A Field Guide to the Daily Acts That Make Up a Catholic Life (Penguin Random House). She and her husband own Keating Woodworks, a handmade furniture studio in Colorado Springs. She blogs at thecatholiccatalogue.com.