According to the Centers for Disease Control, more people in Massachusetts die annually from suicide than from motor vehicle accidents (National Vital Statistics Reports, April 24, 2008). In 2007, the state’s suicide rate (8.0 per 100,000 people) was almost three times higher than the homicide rate (2.9 per 1,000 people).
While these numbers are troubling, perhaps even more troubling are recent initiatives in Massachusetts to legalize physician-prescribed suicide (PPS).
The Pro-Life Legal Defense Fund (www.plldf.org), which has provided pro bono legal services protecting human life for over 40 years, stands ready to combat this disturbing trend.
On October 27, 2015, PLLDF testified at a hearing of the Massachusetts Joint Committee on Public Health regarding HB N. 1991, the so-called Massachusetts Compassionate Care for the Terminally Ill Act. PLLDF opposed HB N. 1991 on constitutional grounds, and because of the effect it would have on the human rights of terminally ill patients in Massachusetts—and on our institutions.
First, the constitutional problem:
Provisions in this bill—constitutionally analogous to the statutory burdens restrained by the Supreme Court in the challenge of the Little Sisters of the Poor to provisions of the Affordable Care Act—impermissibly burden faith-based health-care providers that refuse to participate, requiring them to refer patients to others who will provide lethal doses, and even requiring them to pay for the transfers.
Next, the effects on the human rights of terminally ill patients in Massachusetts:
Freedom from abuse is a human right. Reported cases of elder abuse in Massachusetts grew 33% in four years—to 21,300 in 2013—and there was an 8% increase in confirmed cases from 2012 to 2013.
Elder abuse includes financial exploitation. The weak witnessing provisions of the bill invite financial exploitation. Reasonable safeguards are not provided for when a request for physician-prescribed suicide is made, and no witnesses are required at its administration. If undue pressure occurs at this stage, who would even know?
Subtle financial exploitation is also a risk at the institutional level. On two occasions, PLLDF has stopped the Massachusetts General Hospital from withholding resuscitation and life-saving treatment from patients who wanted to live.
The high cost of end-of-life care, increasing insurance premiums, the demands on taxpayer resources, and the potential erosion of inheritances—all of these can threaten the human rights of elderly and/or disabled persons by potentially influencing the behavior of those who have a compelling financial interest in a patient’s premature death.
Furthermore, patients in Massachusetts are already under substantial pressure not to acquiesce in life-sustaining care. For example, Massachusetts General Hospital has an “Optimum Care Committee” that reportedly has denied resuscitation and/or life-sustaining care, on a unilateral basis, in 147 cases since 2006. Shockingly, 41 percent of those reported cases involved other-than-end-stage situations (i.e., cases deemed “potentially reversible”).
In truth, there are simply not enough courts, not enough social workers, and not enough lawyers to meet the abuse challenges this bill presents. It would be particularly harsh for elders who do not have loving families or who have lost their circle of friends and have no one to advocate for them, or who cannot finance a legal battle.
Massachusetts does not have a Religious Freedom Restoration Act like the federal statute that permitted some religious employers to avoid the Affordable Care Act’s (the so-called “Obamacare”) contraceptive mandate. However, the state Supreme Judicial Court has interpreted the Massachusetts Constitution as providing protection from state attempts to substantially burden the exercise of religion. To do so, the government would have to show that the burden serves a compelling or convincing state interest—in the least religiously restrictive way possible. H.B. 1991 would not satisfy that test.
In summation, the only way to effectively prevent a foreseeable increase in elder abuse in Massachusetts is to refuse to empower it with legislation legalizing physician-prescribed suicide.
With the growing financial and familial pressures attendant in modern culture, it is easy to lose sight of fundamental respect for life, friendship, even truth. The Pro-life Legal Defense Fund hopes that, through thoughtful and reasoned dialogue, differing segments of our society might once again become unified in the long-held conviction that in America all lives matter—at all stages of life. Acceptance of such an understanding is, quite simply, essential to the preservation of respect for human dignity.
The physician-prescribed suicide controversy gives Massachusetts citizens a wonderful opportunity, as the renowned Dr. Joseph Stanton once said, to fulfill “the highest privilege and most profound obligation of a caring and humane society” by protecting human life “at its so often dependent close.”
— Robert W. Joyce, Esq., is President of the Pro Life Legal Defense Fund. Lori Brannigan Kelly is a writer who lives in South Boston.