The Maine Legislature voted this week to legalize assisted suicide. The measure passed by a one-vote margin, and, at this writing, sits on the governor’s desk awaiting signature. The bill would allow doctors to prescribe terminally-ill patients with less than six months to live a fatal dose of medication. The assisted suicide bill provides for numerous procedural safeguards, including the need for a second opinion by a consulting doctor, two verbal requests and one written request for the medication, with a 48-hour wait following the written request before the medication is granted. All this is to ensure that the patient really is terminally ill and certain about the decision to end their life on their own terms.
Maine appears to be part of a trend with regard to assisted suicide bills; seven other states and the District of Columbia have laws authorizing assisted suicide; at least eighteen states considered such bills recently. Senate Bill 249, an aid-in-dying bill, was introduced (but did not pass) in Ohio last year.
Seven states have pending legislation on what is also called “death with dignity” or “the right to die.” In Maine, seven assisted suicide bills were introduced, but failed to pass, in the Maine Legislature before this most recent one squeaked through.
Assisted suicide bills are, of course, controversial. On the one hand, proponents assert that patients whose impending death is certain should be able to take control of their deaths and avoid needless suffering. Those opposed to the bills argue that doctors can be wrong, and people may be able to live longer and better lives than they have been told to expect.
Whether you come down on the side of those who favor the option of assisted suicide, or those who oppose it, it is an issue to which you should pay attention. Even if your state doesn’t have assisted suicide laws on the books, you may still have to confront the issue that gives rise to them: the need for end-of-life care.
You may be fortunate enough to live in good health to a ripe old age and die peacefully in your sleep. Unfortunately, you cannot count on that. You may suffer an accident that renders you incapable of making or voicing medical decisions. A sudden health crisis, such as a stroke, could do the same. Or you could be one of the hundreds of thousands of Americans who die of cancer each year. If you cannot choose to end your life with a doctor’s help, what kind of care do you want? And how will you make that known in a way that will be honored?
The answer is through the use of advance directives.
“Advance directives” is an umbrella term that includes durable powers of attorney, do not resuscitate orders, and living wills. In Ohio, you can use these documents to make sure your family and health care providers understand your wishes and abide by them so far as the law allows.
A durable medical power of attorney allows you to designate a person (your agent) to make medical decisions on behalf if you are legally incapacitated. You should choose an agent whom you trust, like spouse or an adult child, to abide by your wishes and discuss those wishes with them in advance. A living will is a document that expresses your medical wishes regarding the types of care you do or do not want. Your agent under a durable medical power of attorney can use this document to guide his or decisions on your behalf.
A do-not-resuscitate, or DNR order, is a medical order that your doctor can write at your request. A DNR orders your health care providers not to do cardiopulmonary resuscitation (CPR) if your heart stops beating or if you stop breathing. Many people would prefer to be allowed to pass away in peace in those situations, but without a DNR, doctors will do everything possible to resuscitate them—even though CPR can be very painful and the patient may be close to the end of life anyway.
These documents should be a part of everyone’s estate plan, because no one knows how or when they will die. Especially since Ohio does not yet have an assisted suicide or death with dignity law on the books, advance directives offer the best opportunity for taking control of your end-of-life care.