After going nowhere session after legislative session, bills to legalize physician-assisted suicide in
— or “medical aid in dying,” if you’re a supporter and prefer a softer descriptor — are advancing through committees this year in St. Paul. If legalization is finally going to happen, the time seems now, with the DFL in control of both the state House and Senate.
But not so fast, argues a coalition of doctors, disability advocates, mental health experts, and others. Legitimate concerns being raised by the Minnesota Alliance for Ethical Health Care, among others, demand lawmakers’ serious consideration before final votes.
While Minnesotans who are terminally ill and in pain deserve compassion and their wishes respected, ethical issues and unintended consequences very much also must be weighed.
“All people are of equal dignity,” the alliance’s president, Nancy Utoft, said in an interview this month with the Duluth News Tribune Opinion page. “And often in our society those who are vulnerable — the elderly, people with disabilities or chronic diseases or mental health issues — they’re typically not afforded their full dignity. So, in this conversation, we really believe equal dignity requires that we adhere to the principles of health equity and equality of care for all. Physician-assisted suicide will inevitably work against those goals.”
And isn’t necessary, she said, with other strategies and approaches already available to make end of life easier, including health care directives, palliative care, hospice, and the right to accept or refuse treatment.
“It’s pretty rare that we can’t take care of pain and symptoms at the end of life,” said fellow alliance member Dr. Dennis O’Hare, who works in Stillwater, Minnesota, with patients in assisted living, memory care, group homes, and elsewhere. “So, what drives this? It’s not pain. … It seems to be an autonomy issue. ‘I want to control the end of my life’.”
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That driver can lead to a dangerously slippery slope. End of life is already accompanied by worries over the mounting costs of health care and becoming a burden on family, especially for those with depression or other mental illness or who may feel their life lacks the value it once held.
What message does legalizing suicide send to teens and youths struggling with mental health, especially in the wake of the pandemic? A National Council on Disabilities study found that suicide rates spike following legalization, including in younger people ages 18 to 25.
“You have 1 million people with mental health issues in the state of Minnesota. You have 300,000 people with severe mental health issues. This is normalizing (suicide) for them,” said alliance member Jesse Bethke Gomez, the executive director of the Metropolitan Center for Independent Living in St. Paul. That can have dangerous results.
“I worry about the marginalization of human beings,” Bethke Gomez, also the former president of a mental health and chemical health outpatient treatment center, told the Opinion page. “This is about decency. This is about human dignity for all people. … We’re deeply concerned and troubled by what physician-assisted suicide means to people with disabilities, older adults, (and) children who become adults and learn of physician-assisted suicide (and its) normalization. This is not the Minnesota that I know. It’s not the Minnesota that really speaks to the care and the human dignity we have for everybody.”
The 29 authors of, all of them DFLers, include Duluth Reps. Liz Olson and Liish Kozlowski. Kozlowski didn’t respond to a request for comment from the News Tribune Opinion page. Olson responded with a written statement and then declined to answer specific follow-up questions.
“I’ve visited with many constituents who have shared their stories — compelling, personal stories,” Rep. Olson said. “People facing terminal illnesses deserve compassion, comfort, and dignity. After listening to their experiences, I believe it’s time for Minnesotans to have this option, and that’s why I’m a co-author of the bill.”
But what about the family members, doctors, and other health care providers involved in the decision to prescribe and administer drugs to bring about death? What of the impacts on their emotional well-being?
“Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer,” Dr. O’Hare said, citing the 2019 determination of the American Medical Association, which extensively studied and nationally debated the issue, including in the 10 states where it’s legal. “Is it good for our society? I spend my life with those at end of life, and they’re already having trouble with, ‘Do I have value?’ ‘Do I not have value?’ This would fundamentally change how we take care of the elderly. (Legalization) means I have to provide an option that’s unethical, which I think is a very difficult place to put physicians. …
“We shouldn’t abandon patients,” Dr. O’Hare also said. “We should provide good communication and support and good comfort and adequate pain control.”
And not drugs to bring about death, the alliance and others continue to argue, their concerns and points demanding to be a huge consideration in the decision-making this legislative session in St. Paul.