Physician assisted suicide is now an option for terminally ill patients in several US states. Is Arizona one of those states? Is it likely to join the list soon?
What do we mean by physician assisted suicide?
First, some definition of terms. Doctors, of course, are usually in the business of saving lives and curing diseases. Sometimes, though, a patient has little or no hope of recovery, and is unwilling to undergo continuing treatment. If there is an easy, painless way to end life, can the physician prescribe, or even counsel, life-ending treatment?
In most states, a physician who assists his or her patient with suicide may face criminal charges or loss of medical license. What if the physician wants to honor the patient’s choice? In those states, it doesn’t matter what the patient wants.
A movement to permit physicians to counsel and assist patients began in Oregon in 1994. When the state legislature declined to authorize physician assisted suicide, voters adopted the measure by referendum. The voter-approved measure imposed a number of restrictions, but the procedure has been an option for more than two decades.
Over the ensuing years, a number of other states have considered, and sometimes adopted, similar measures. Those proposals sometimes go by “medical aid in dying.” The movement has spread to a number of other states — mostly in the western US.
States permitting physician assisted suicide
At this point, physician assisted suicide is legally available in California, Colorado, Montana, Oregon, Vermont, Washington and the District of Columbia. The pathway to approval was different in each of the states, though several of them adopted their laws by voter referendum.
Requirements are similar across the various states. Residency requirements are in place to discourage patients from moving to the state just to take advantage of the law. Reports must be filed so that the states can keep track of utilization. Patients can turn to the law only if they are terminally ill and competent. None of the states permits life-ending decisions for a patient who has become unconscious or incompetent.
Arizona is not on the list of states with assisted suicide laws. A bill has been introduced in each legislative session for several years, but has never gotten a hearing in either chamber of the Arizona legislature. This year, four nearly-identical bills were introduced; not one of them received so much as a committee hearing. While it is theoretically still possible for one of the bills to be considered, it is effectively too late under Arizona legislative rules.
So can an Arizonan consider physician assisted suicide?
Sort of. It is illegal for an Arizona physician to provide life-ending prescriptions or services to a patient, but the patient can move to a state that permits the procedure. That’s what Californian Brittany Maynard did in 2014. Less than one year after Ms. Maynard’s well-publicized death, California had adopted its End of Life Option Act.
Ms. Maynard had to wait for months in her new Oregon home before taking advantage of that state’s law. Though she was terminally ill and in pain, she had enough time to make the move and utilize her new state’s law. She probably would not have had enough time to wait for California’s legislature to act.
Short of moving to California, Colorado, or one of the other states with the option, a terminally ill Arizonan would not have any opportunity for a physician to assist with the life-ending process. There are groups that help counsel such individuals. One leading organization is Compassion & Choices Arizona, which offers a confidential End of Life Counseling program to those interested in more information and direction.
Should you put something in your advance directives?
Many clients ask that we include language about assisted suicide in their living will or health care power of attorney. We can include language like that, but it is ultimately unhelpful. A key element of all assisted suicide bills has always been patient involvement. No American assisted suicide law has authorized euthanization of incompetent or unconscious patients. That means that your advance directives — which only operate when you are unable to communicate your own wishes — will not be effective even if there Arizona does adopt a new law.
Do you feel strongly about physician assisted suicide for yourself? You should get involved with advocates and organizations providing information and help. You can put language into your advance directives, and it should help your family understand your wishes. But you should not expect that language to change how your physician acts (or doesn’t) to help you end your life.
On the other side of the divide, you might feel very strongly that you would not want to have your life shortened at all. In that case, you should include language in your living will and/or health care power of attorney. You will want to make your wishes clear, and choose your health care agent wisely.
In fact, that’s the lesson for everyone. Be thoughtful about who you choose to act on your behalf. Talk with that person. Write down how you feel and what you would want, and share those writings with your agent, your family, and the friends and professionals who are likely to be involved at the end of your life.
We can help. It’s what we do.