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Assisted Suicide Cases Highlight Public Support for Physician Aid in Dying

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Media outlets from coast to coast and even abroad are covering Wednesday's arrest of leaders of Final Exit Network, (FEN) an organization that helps people die. An eight month investigation led to a sting operation that caught 2 people in Georgia telling an undercover agent how his death would be accomplished. Two arrests followed quickly in Baltimore and more are sure to come. The investigation continues across seven states.

Compassion & Choices has no affiliation with FEN. But as the nation's largest advocacy organization for end-of-life choice, we are fielding lots of calls. "Does your organization condemn the conduct of Final Exit Network?" That's the first question.

Let's be clear. The policies on end-of-life decisions in every state except Oregon, Washington and Montana are merciless and irrational. Dying patients are abandoned to their agonies and any talk of assistance in their dying occurs in hushed, confused tones. A decent society must do better.

If there's any condemnation dished out, let it be directed toward lawmakers who turn their backs on the prolonged suffering of patients who battle cancer for years and finally beg for assurance of a peaceful end. Last year I heard a California lawmaker tell Tom McDonald, dying of cancer and pleading for passage of a death with dignity bill, that he could just put a gun to his head if his suffering became unbearable. Shame on any elected official who chooses violence over compassion.

Lawmakers' inaction led to citizen initiatives for Death with Dignity laws in Oregon and Washington to define a medical practice of aid in dying, lay out guidelines and set up regulatory oversight. The citizens had to adopt rational, merciful laws to legalize aid in dying because lawmakers weren't up to the task.

Assisting a suicide is still a felony in Oregon and Washington. Opponents of choice try to blur this distinction and media complies by calling everything "assisted suicide." But the difference between assisted suicide and aid in dying tracks public opinion on the subject.

Opinions about any kind of assistance in dying falls into three categories: Never ... Always ... and "sometimes."

To the "never" school FEN's mission is appalling and criminal. In this line of thinking no one has the right to choose the time and manner of dying and helping is always wrong. About 25% of Americans think this way.

The "always" school see FEN's mission as heroic, whether their clients are terminally ill or not. The belief is humans hold sovereign rights over their own bodies, and suffering of any kind is reason enough to receive assistance in dying. This probably accounts for another 20% of public opinion.

Most people's views bridge the gap between these two groups. Most believe that sometimes a chosen death is merciful and necessary should be legal. They know every dying person will be comforted knowing the choice is available if they should need it. Most never do need it. That's where my organization, Compassion & Choices, is. We passionately believe aid in dying should be one option among many others in good end-of-life care.

Depending on the poll, as much as 74% of Americans, and an increasing number of medical professionals and associations, agree with the principles behind the law in Oregon and Washington. A recent court ruling in Montana adopts the same parameters. Patients stuck in a prolonged, miserable dying process deserve help from their doctor. The legal practice known as "aid in dying" is limited to mentally competent, terminally ill adults. The term "aid in dying" says it all --- Americans favor "aid" for dying, suffering patients making a reasoned decision about when and where they will die.

That said, assisting a mentally ill or chronically ill person to die does not enjoy the support of most Americans. This is where FEN may have exceeded the nation's tolerance for civil disobedience. Assisting a healthy person, or a mentally ill person to commit suicide is as illegal in Oregon and Washington as it is in Georgia or Arizona.

The upcoming FEN trials will be a clarifying experience for America. They will highlight the circumstances under which assistance in dying is socially acceptable, and those where it is socially unacceptable. And hopefully, it will spur lawmakers to ratify that distinction and pass compassionate, sensible laws in every state.