Separating MAiD from “assisted suicide.”
CW: Please be advised - this article discusses the topics of suicide, medical-aid-in-dying, and associated issues.
In 2015, the campaign for legislation providing dignity- and choice-based options at the end of life was well underway in California. Medical Aid in Dying (MAiD) had garnered support from medical bodies and humanitarian organizations from all corners of the country. Opposition was also strong and very vocal in challenging the proposed legislation’s merit and argued against the idea of encoding it into law. Both sides had a common problem: the world thought of the idea as “assisted suicide.”
The phrase “assisted suicide” was used on both sides, arguing for and against the proposed legislation. Media ran with the phrase. The word “suicide” engenders strong reactions and makes it difficult to discuss medical aid in dying without heightened emotions entering the fray. To this day, the phrase is still commonly used interchangeably with more specifically descriptive phrases such as “medical aid in dying”, “physician assisted death” (PAD), and so on. The legislation passed in 2015 and took effect in 2016 as the California End of Life Option Act. Perhaps one key to its passage was in the shift of language used as conversations around the topic began to take place in the media. So how do we continue to talk about these topics and further understand the differences? How do we change that language and the entrenched public perceptions permanently?
Language surrounding death becomes charged, by default, because strong feelings tend to color our impressions of end-of-life options. It’s hard to avoid. Still, nuance is important and so is accuracy. “Dignity in death” is the rallying call of proponents of medical aid in dying and that phrase points out the difference nicely: the element of choice is what supports dignity, but also choice as an informed and rational component in end-of-life decisions. Without legal, safe, and comprehensive choices, end-of-life patients are left in the dark, in despair, in pain, and without dignity. With these nuances in mind, MAiD is plainly differentiated from suicide. MAiD offers informed, science-based, medical alternatives to needless pain and suffering for terminally ill patients.
It is so important to clarify that (under the law), eligible patients must already have a prognosis of 6 months or fewer to live. Death is inevitable and imminent. Under those criteria, suicide has no relation to MAiD. A person who is eligible for MAiD will be deceased within 6 months, regardless of any other circumstances which may enter the situation.
Suicide however has no such criteria. Anyone may choose to commit suicide regardless of life expectancy. Circumstances can greatly influence a person’s choice to die by suicide. Death is not inevitable nor imminent when interventions are available, accessible, and utilized. While choice may be a common component of both MAiD and suicide, they are vastly different situations and deserve separate understanding and compassionate treatment, both under the law and within society.
Moving on, as we gain more understanding and education on these topics, it becomes important to separate out the varying mindsets on dignity with death. Decades ago, Dr. Kevorkian was a regular news subject. Charged words & phrases like “euthanasia” and “assisted suicide” created a public outcry, but they also created awareness of this question: How can we achieve dignity in death? (For the purposes of this article, “euthanasia” is immediately tossed from this discussion, as it requires someone other than the patient to administer the life-ending drugs.) The specter of “Dr. Death” remains in the zeitgeist but the language is changing, public perception & understanding of the issues involved are becoming more nuanced, all while the stigmas still persist. The best way to dispel stigma is by discussion, education, and exposure to a topic. Years later, we are well on our way toward that goal.
For further clarification, Medical Aid in Dying (MAiD) is also very specific in its parameters. Under the 2016 law, MAiD requires that patients must administer the life-ending medications to themselves. They must be of sound mind, 18 years or older, a resident of California, and must have a prognosis of 6 months or fewer to live, achieved by doctor consultations. Doctors are not obligated to provide MAiD; however, if they opt not to provide MAiD when patients request the service, they are obligated to record the request and refer the patient to a physician who will provide MAiD.
The goal is to provide options, care, and dignity to end-of-life patients and, most of all, avoid prolonged suffering and fear. When terminally ill patients are met instead with information, compassion, and clinically sound choices, they can meet their end on their terms. This is the optimal outcome for patients and their families. ~m
Further reading:
https://compassionandchoices.org/our-issues/medical-aid-in-dying/
