June 19, 2015
A bill that would legalize physician-assisted suicide in Tennessee would give doctors too much power, Dr. David Stevens of the American Academy of Medical Ethics in Bristol, Tenn., told the Senate Health and Welfare Committee during a hearing on the bill on Tuesday, June 9.
“This is not about giving patients the right to die, it’s about giving the physicians the right to kill,” said Stevens, who was one of eight witnesses to testify before the committee. “We don’t have to kill the patient to kill the suffering.”
The bill was introduced before the General Assembly last February, but was deferred for summer study before the Legislature adjourned for the year. The bill’s sponsor, Sen. Reginald Tate of Memphis, said he will likely reintroduced an amended version of the bill when the General Assembly reconvenes next January.
“A person has a right to choose for himself,” Tate said.
The senator introduced the bill at the urging of John Jay Hooker, a prominent Nashville attorney, former aide to Attorney General Robert F. Kennedy, and an unsuccessful candidate for governor. Hooker, who has been known in his later years as a political gadfly filing lawsuits challenging the constitutionality of the method for electing judges in Tennessee among other issues, has been diagnosed with terminal cancer.
As the hearing’s first witness Hooker told the committee he has testified before legislative committees in the past. “I was here then on behalf of justice. I’m here now for mercy. Not just for me but for all. … I believe this is the most important thing I’ve done in my lifetime.”
But Stevens, the last witness at the hearing told the committee, “If suffering is the criteria and mercy is the good, there is no logical limit. … The so called right to die will become the duty to die.”
Several advocates for those with disabilities made similar points to the committee.
The Tennessee Disability Coalition is a strong supporter of individual rights and self-determination, said Carol Westlake, the organization’s executive director. “But this law can become dangerous.”
“Our worry is it has the possibility to be a real danger because of mistakes, abuse or coercion,” Westlake said. “Not everybody with terminal illness has a loving family. Not every terminal diagnosis is correct.”
Her organization is worried that people with disabilities or terminal illnesses will be coerced by others to choose suicide, Westlake said. It’s difficult to see how the legislature can write a law with all the protections against abuse that would be needed, she added.
“Fear, bias and prejudice against disabilities drive bills like this,” Westlake said. “Pain is rarely the reason people choose suicide. They do it for fear of becoming a burden, or fear of the loss of autonomy, or fear of a loss of dignity. Those are things that can be addressed.”
“This bill is an illusion of choice,” said Will Brewer, an attorney and legislative liaison for Tennessee Right to Life. If the bill becomes law, he added, there will be less focus on extending life and alleviating pain and more focus on prescribing lethal medications.
“If doctor-prescribed suicide is legalized in Tennessee, it could become the only ‘medical treatment’ to which many people have equal access,” Brewer told the committee. “If the government or insurance companies decide they no longer wish to pay for legitimate care and medical treatments, there will be a pressure upon the elderly, ill and disabled to end their lives. Being coerced into ending their lives does not offer death with dignity, it only offers a frightening and dangerous future for elderly and ill Tennesseans.”
The committee heard testimony from Dr. Peter Reagan of Oregon, one of three states were physician-assisted suicide is legal. He wrote the first prescription under Oregon’s assisted suicide law after it took effect in 1997.
Under the Oregon law, after a patient makes a request for assisted suicide, two physicians must agree they have a terminal illness with six months or less to live, Reagan said. When a patient makes a request under the law, “it drastically deepens the doctor’s relationship with their patient,” Reagan said. “Consent is really important,” he added.
If the patient qualifies, the physician writes the prescription for a lethal dose of pain medication and the patient can take the medication when and where they want. The patient must be able physically to give themselves the medication, Reagan said.
“People have to do a lot to get to this spot,” Reagan told the committee. Since the law went into effect, about 1,500 prescriptions have been written and about 900 people have used the medication, Reagan said.
“We’re not looking for controversy. We’re not looking for the edges of the road. We want to be firmly in the mainstream,” Reagan said.
But Sen. Richard Briggs, a physician from Knoxville, said it’s not the obvious cases that the Legislature needs to worry about in writing such a law, but the cases on the edges.
Generally, Briggs said, he believes the Legislature should not be in the business of practicing medicine.
Briggs also asked if an assisted suicide bill is necessary as the movement toward hospice care at the end of life continues to grow.
“I hope what happens is this becomes a part of hospice care,” said Reagan, who noted that most of the patients who ask for a prescription under the law are already in hospice care.