No Aid in Dying In CT This Year

The Public Health Committee of the Connecticut Legislature has no plans to bring an Oregon-style bill for Aid-in-Dying (aka physician-assisted suicide) to the floor of the legislature for a vote, in spite of 61% public support for the bill. Serious opposition by religious groups and by disability activists have kept legislators from moving the bill forward. But, the failure of the Aid-in-Dying bill seems to have resulted in some substitute enthusiasm for a Medical Orders for Life-Sustaining Treatment (MOLST) bill for Connecticut. (Some states call MOLST "POLST," for Physician Order for Life-Sustaining Treatment. It's the same thing.) Under MOLST, terminally-ill patients and their physicians can frame orders to be entered onto the patients chart, from "do everything" to orders restricting intubation, antibiotics, resuscitation, ventilation or artificial feeding; such orders would be legally binding on all caregivers. It's like an advance directive on steroids, because it's both an expression of the patient's desires and a physician's medical order in the patient's chart.

Commission Report on Assisted Dying in UK

Here is the final report of the UK's Commission on Assisted Dying. The private commission was funded by author-turned-end-of-life activist Terry Pratchett, who suffers from Alzheimer's disease and founded the UK's Dignity in Dying organization. It was led by Lord Falconer, a vocal proponent of liberalization of laws prohibiting assisted suicide. No one expected the Commission to come out with anything other than a pro-assisted-suicide view, Falconer's protestations of independence and neutrality notwithstanding. The Church of England has condemned the report, as have many (sometimes predictable) others.

But it is perhaps interesting to notice what the Commission actually ends up recommending: a relatively modest assisted suicide program rather similar to those in place in the US states of Oregon and Washington. The proposed program would help only competent adults with terminal diagnoses verified by two physicians. ("Terminal" means under a year to live, as opposed to the 6-month requirement in place in Oregon and Washington.) The patient's decision would have to be voluntary, not subject to undue influence, and not the result of a treatable mental condition such as depression. All requesting patients would be told about available social services and about other end-of-life treatment options such as palliative care. And the program would be open only to patients who are physically capable of taking the lethal medication themselves.

The report doesn't advocate euthanasia, though Falconer is often condemned by the other side as "pro-euthanasia." The program it recommends won't help Mr. Pratchett, whose Alzheimer's will likely render him incompetent before he has the report's recommended 12-month terminal diagnosis. Nor, as the Guardian points out, would the recommended program help Debbie Purdy, whose litigation forced prosecutorial authorities in England and Wales to issue guidelines backing away from criminal prosecution of those who assist their loved ones to die. Purdy has MS--a chronic, rather than a terminal, illness, and one that will likely make it impossible for her to take her own lethal medication within a year of her forecast death.

GMC Will Draft Guidance on Assisted Suicide

According to this report in The Guardian, the UK's General Medical Council is planning to issue new guidance for investigation of physicians who've allegedly assisted a patient in suicide. The problem is in part with uncertainty over what sorts of actions by doctors really count as assisting in suicide. Is a sympathetic conversation enough to count as "assisting"? How about a factual assertion about the availability of assisted suicide in Switzerland? Some physicians' words or actions may not lead to criminal charges, but may nonetheless lead to complaints about their fitness to practice; a handful of investigations of this sort have already been conducted.

GMC plans to publish the guidelines for public comment next month.

Physician Assisted Suicide in Massachusetts?

This weekend the delegates at the annual meeting of the Massachusetts Medical Society affirmed their longstanding opposition to physician-assisted suicide. Lynda Young, M.D., president of the Society, described physician-assisted suicide as "inconsistent with the physician’s role as healer and health care provider."

Meanwhile it appears that Dignity 2012 will succeed in its efforts to get a "Massachusetts Death With Dignity Act" on the next state ballot. The Act, if approved by voters, would establish an Oregon-style assisted suicide regime in the state.