In late January, opinion writer Charles Lane wrote in the Washington Post about a medical aid-in-dying case that happened in the Netherlands in 2016. Lane notes that a Dutch woman requested a medical aid-in-dying procedure in case she developed dementia, which sadly occurred. However, when the patient’s wishes were acted upon as dementia set in, the patient seemed to refuse the medicine, and it was forcibly administered by a physician while her family assisted in the procedure.
This case was eventually referred to the Dutch regulatory body, which deals with medical-aid-in dying, because of the peculiar and upsetting circumstances in which the procedure was carried out. Lane has used this tragic case to rightly discuss whether the procedure should occur when consent is in doubt.
The solution to Lane’s concerns seems to be in Washington, DC’s medical aid-in-dying legislation, the DC Death with Dignity Act of 2015. Under this law, only a select group of people are able to utilize the procedure, which means that one must be “a terminally-ill patient who is a resident of the District of Columbia, is at least eighteen (18) years or older, is under the care of a physician and is expected to live for no more than six (6) months. Further, the patient cannot be suffering from impaired judgment as a result of depression or a psychiatric or psychological condition and must be capable of making the decision, expressing an intent to take a medication that will cause death, and must be physically capable of taking the medication.”
As if that weren’t strict enough, “The patient must make an initial oral request, a written request, and then a second oral request. Furthermore, the second oral request cannot be made any sooner than fifteen (15) days after the first oral request.”
The American Humanist Association was proud to work on this bill and fight for its passage, not just because we support individual autonomy and the right to have a medical aid-in-dying procedure, but because this law can stand as a template for how such legislation should look. By requiring the patient to receive the consent of so many doctors, and by ensuring the patient’s mental acuity and ability to self-administer the medicine, concerns (like Lane’s) over patients being forced into the procedure or not understanding the consequences of ingesting the medicine are effectively eliminated.
And while the law might be more onerous than similar policies across America and around the world, the relative difficulty in participating in the procedure protects patients who might suffer from the law’s misapplication, regardless of whether that misapplication occurs for malevolent or benevolent reasons.
Human suffering should be mitigated when possible, and medical aid-in-dying procedures may be the last hope for people who are in constant pain and seek relief. But the human suffering that is caused by a misapplication of these procedures must also be acknowledged and combatted, which is why policies dealing with these procedures must be as well-thought out as the DC Death with Dignity Act of 2015.