Assisted suicide expands

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More states are considering the legalization of assisted suicide, which may present new caregiving challenges.
More states are considering the legalization of assisted suicide, which may present new caregiving challenges.

While assisted suicide remains highly controversial, it appears that more states are inclined to make the option legal for those beset by terminal conditions.

California recently became the fifth state to enact a law allowing assisted suicide for the terminally ill. By all indications, other states will continue to pursue this option. As a result, many senior living operators may need to confront challenging  moral, religious and caregiving questions.

Roughly 20 additional states are considering legalizing physician-assisted death. Among them are Arizona, Colorado, Massachusetts, New Jersey and New York, according to Death with Dignity, a group that advocates for aid in dying.

The California law was spurred by the death of Brittany Maynard, a 29-year-old schoolteacher who had brain cancer. Maynard opted to move to Oregon, where assisted suicide has been legal since 1997. Her final weeks alive were marked by videos in which she said she should have been legally allowed to get physician-prescribed medications to end her life in California.

“The end-of-life option that Brittany supported will now become law in our home state of California. This means a terminally ill individual will not have to leave home like we did, and that individual can pursue this option of a gentle passing if it becomes necessary for them,” said her husband, Dan Diaz.

The California law mandates that two doctors agree, before prescribing the drugs, that a patient has six months or less to live. Patients must be able to swallow the medication themselves and must affirm in writing, 48 hours before taking the medication, that they will do so.

Other states with similar laws in place: Montana, Oregon, Vermont and Washington.

But if euthanasia and physician-assisted suicide are becoming increasingly legal, their use remains fairly rare, according to JAMA

Ezekiel J. Emanuel, M.D., Ph.D., of the University of Pennsylvania in Philadelphia, examined the legal status of euthanasia and physician-assisted suicide as well as data on attitudes and practices. 

He found that less than 20% of physicians in the United States had received requests for euthanasia or physician-assisted suicide, and 5% or less have complied. More than 70% of cases of euthanasia or physician-assisted suicide were cancer-related. 

The option remains largely used by patients who are white, wealthy and well-educated, investigators found.

Emanuel noted that fear of losing autonomy, no longer enjoying activities and other psychological concerns are the main drivers. Surprisingly, pain is not, he added. 


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