Life or death: An important moment for the assisted suicide movement

Assisted-Suicide_Jacky-Lu
Jacky Lu/Staff

Soft light flows gently onto the stage, illuminating a sparsely but thoughtfully curated courtroom. A jury bench, a witness stand, two opposing tables and an elevated judge’s podium frame the space where discussion begins. The jury enters, the defense followed by the prosecution and finally the presiding judge of the court. With a resounding “All rise,” our trial, Annette Braxon v. People of the State of Oregon, begins.

This was the scene for Entity Contemporary Dance’s innovative performance “Braxon vs Oregon,” which was performed at the intimate Dance Mission Theater in San Francisco last week. The performance, narrated by dance and the occasional spoken word, explored the heated issue of assisted suicide.

Annette Braxon, the protagonist, is charged with first-degree murder for assisting the suicide of her terminally ill partner, Charles Monroe. Through verbal testimonies and expressive choreography, the most crucial facts are established: Monroe had a legitimate desire to die and had consented to receive lethal medication, but his forms to request the lethal medication lacked consent from a family member. Without this signature from a family member, Monroe’s assisted suicide could not legally proceed. Braxon, wishing only to end her partner’s suffering, helps Monroe commit suicide anyway.

This is the debate that breathes life into the dance: Is assisted suicide ethical, and in what circumstances? In this particular case, there was an undeniable breach of policy, yet Braxon was acting upon selfless intentions. The questions the jury — and the audience — must grapple with in the theater are not just confined to the world of performance art. Entity Contemporary Dance’s performance is impeccably timed, as assisted suicide has once again surfaced into public conversation, particularly in California.

This month, Gov. Jerry Brown signed the “End of Life Option Act,” making California the fifth state to legalize the practice of physician aid in dying. The bill gives terminally ill patients who are mentally competent and have six months or less to live the option to request lethal pills from his or her physician. The pills have to be requested once in writing and twice orally, with a waiting period of 15 days between each step of the process. The bill’s passage will give an unprecedented number of Americans access to the option of assisted suicide and will set a precedent for other states.

I wholeheartedly side with supporters of assisted suicide, and lots of Americans do, too.
According to a Gallup poll conducted this year, 70 percent of Americans support assisted suicide, and support within the 18-34 age range has increased from 62 to 81 percent in the past year. An overwhelming majority agree that the patient has the right to an autonomous decision about how he or she will die. The practice of assisted suicide allows patients to decide how they want to live the last days of their lives — something that an unbeatable illness threatens to take away.

This is an issue that’s widely debated among all sorts of social circles and on the media. It entered our everyday discourse last year when Brittany Maynard, a terminally ill brain cancer patient given less than six months to live, moved to Oregon to take advantage of the state’s Death with Dignity Act. But the discourse somehow often fails to talk about the dangers of this incredible freedom.

Barbara Wagner and Randy Stroup, both residents of Oregon who have cancer, faced these dangers just a few years ago. Their respective health plans offered to pay for assisted suicide pills and not for potentially beneficial chemotherapy treatments. While supporters of assisted suicide argue that having the option of lethal pills provides a sense of peace, this is not the case if the pills are offered as the patient’s only option. With a decision that truly comes down to life and death, there’s a fine line between offering the option and steering a patient toward it.

The latter scenario, in particular, is the main concern of many opponents of assisted suicide. If the “End of Life Option Act” intends to protect terminally ill patient rights, it must also ensure that every eligible patient is uninfluenced by outside factors when choosing between life and death. California’s bill includes safeguards that go beyond the previous examples set by other states: The patient has to be deemed mentally competent enough to make an individual decision, two physicians have to approve the patient diagnosis, insurance providers and doctors cannot bring up the option of assisted suicide unless the patient voluntarily requests information, pre-existing health plans cannot be altered once the medication is requested, and the patient at any point in the process can rescind his or her request for the necessary drugs.

Implementation of these measures will determine not only the bill’s success but also its ethics.

The horrendous pain that comes with terminal illness is not always the factor that pushes patients to acquire lethal medication. Data from Oregon’s Death with Dignity Annual Report shows that doctors issue lethal medication most often to patients who feel a lack of autonomy (91 percent) and less of an ability to engage in the world (89 percent).

These symptoms alone, however, shouldn’t necessitate assisted suicide. In fact, opponents claim that these metrics target the mentally disabled community, which already lives with a lack of autonomy and a struggle to engage. California’s bill must protect people with mental disabilities from being forced into a situation that requires a decision they may not be mentally equipped to make.

Similarly, terminally ill patients in tight financial circumstances, most of whom are of a lower socioeconomic status, might choose to die to make financial situations easier on their families. Proper implementation of the bill is essential to prevent the state from unintentionally endorsing death.

The most substantial safeguard the “End of Life Option Act” includes is a 10-year sunset provision on the legislation, meaning that in 10 years, the bill will be revoked unless extended through further legislation. How the state will regulate the practice of assisted suicide will be by far the biggest challenge. If the legislation gives all eligible patients a fair choice to choose either option, then perhaps more states will consider allowing physician-assisted suicides. If this legislation fails to provide adequate safeguards, however, many people will find themselves in courtrooms — such as Braxon — dealing with policy issues that seem trivial compared to the intense grief and longing that comes with losing someone.