NH has an assisted suicide bill (again); time to say no (again)

[An earlier version of this post had an incorrect time for the hearing.]

What better way to kick off February than with a life-issues extravaganza? That was apparently the thought somewhere in the State House when the the legislative calendar for the coming week was devised. And just to make things more interesting, the Powers that Be scheduled the House hearing for an assisted suicide bill the same time as a hearing on the fetal homicide bill: 1:30 p.m. this Tuesday, February 4 in the Legislative Office Building. I’ll be there. Sprinting between rooms 204 and 208 is not that hard.

The sponsors for assisted suicide legislation come and go, but the goal never changes: death on demand, as as a corollary, put to rest the silly notion that medicine is a healing art. This year’s bill is HB 1325. Text is here, complete with list of sponsors, led by Joel Winters of Concord.

On my desk, I have an inch-thick binder full of my notes and copies of old New Hampshire legislation on assisted suicide. The oldest bill I have is HB 339 from 1995. Do you know how much difference there is between the statement of purpose in the 1995 bill and the one in 2014? None. How about the difference in what the two bills define as “terminal condition”? Again, none.

Stephen Drake of the Not Dead Yet, a disability-rights group, wrote recently about this year’s New Hampshire bill in New Hampshire Assisted Suicide Bill Redefines “Terminal Condition” Broadly Enough to Make Anyone With a Significant Disability or Chronic Condition Eligible.

“[In the bill] ‘Terminal condition’ means an incurable and irreversible condition, for the end stage of which there is no known treatment which will alter its course to death, and which, in the opinion of the attending physician and consulting physician competent in that disease category, will result in premature death.

Read that definition carefully, terminality is defined as having a condition that is irreversible and will result in a premature death. My partner would fit that definition. Many people I work with also fit the definition.

None of them are dying.

Keep in mind that this definition is to be used only in terms of eligibility for assisted suicide. It doesn’t, for example, apply to hospice services which are limited by federal rules to those who are deemed as having six months or less to live.

So, no guarantee of palliative care for people with significant disabilities or conditions, unless they’re thought to be close to death. That would be expensive.

OTOH, this bill would offer help with easy and successful suicide for anyone with a serious, significant, potentially life-shortening condition/disability at any time at all.

So, no guarantee of medical support to make life easier, but a ‘hand out’ to those who want to die, even if they’re not dying.”

I’ve been involved in right-to-life work for too long to believe any longer that medicine is a healing art. The fact that assisted suicide hearings are not overrun by angry health care professionals – everyone from medical technicians to M.D.’s – speaks volumes.

I firmly believe that legalizing medical murder will be a huge disincentive to the development of effective palliative care strategies. The cheaper strategy will prevail, particularly in a government-run health care environment. Alleviating pain can be a complex, multispecialty endeavor. Compare that to the cost of a lethal-dose prescription.

I’ve been with a loved one who was dying in pain. In 2009, my mother died three excruciating weeks after taking a fall on an icy driveway and then being alone and helpless for an estimated 30 to 60 minutes. She was in poor health to begin with. The injury set off the failure of one organ after another, and she hung on as long as she did only because she didn’t want to leave her husband, my stepdad. It took three weeks for her body to get the better of her iron will. Those three weeks gave me plenty of time to consider how it feels to watch a loved one in pain. It also gave me plenty of time to consider how much less care she’d have gotten if prevailing medical wisdom had been about killing instead of caring.

She died in a hospice bed, where she belonged. Somewhere on a balance sheet, the transfer from hospital to hospice is counted as an expense. I shudder to think whether that expense would be considered worth it in a medical setting where assisted suicide is legal. Politics being downstream of culture, I wonder how long Medicare would cover such things as transfers to hospice if physician-prescribed death is accepted.

Someone is reading this and thinking But she didn’t ask for assisted suicide, and her case is irrelevant to the New Hampshire bill. Not so. Once it’s legal for a physician to prescribe a drug for the purpose of ending a patient’s life, it’s only a matter of time before other health care professionals are given the same authority. (Ask any nurse practitioner about “scope of practice.”) It will only be a matter of time before it’s clear how sloppy the law’s definition of “terminally ill” really is. And the minute an assisted suicide bill becomes law, and medically-administered death becomes just another therapeutic option, palliative care will be treated by the bean counters as a luxury.

Not that I have anything against bean counters, but medicine is no longer a matter between doctor and patient. It’s a matter between provider and patient and whoever is footing the insurance bill.

Aside from the substantive moral bankruptcy of assisted suicide, I’m offended by the violence that such legislation does to language. From HB 1325: “Nothing in this chapter shall be construed to authorize a physician or any other person to end a patient’s life by lethal injection, mercy killing, or active euthanasia. Actions taken in accordance with this chapter shall not, for any purpose, constitute suicide, assisted suicide, mercy killing, or homicide, under the law.” Really? A physician can prescribe a drug for the sole purpose of ending a patient’s life, and that’s not homicide on the physician’s part or suicide on the patient’s part?

“‘When I use a word,’ Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean – neither more nor less.’ — Lewis Carroll. Humpty Dumpty would have been right at home with HB 1325. We’ll soon know how many New Hampshire legislators want to be perched up on that shaky wall with him.