Physician-Assisted Suicide in Maryland

Today the Maryland House of Representatives will hold a hearing on a proposal to allow physician-assisted suicide. The proposal in Maryland is almost uniquely bad. For example, the bill does not even require a physician prescribing a lethal injection to order a psychological evaluation of the person requesting it. I do not believe there are any safeguards that would justify supporting the proposal, but without them, the possibilities of abuse should be obvious even to those who are sympathetic to physician-assisted suicide.

As is the case in most such efforts, the discussion here in Maryland is being driven by deeply emotional stories of personal suffering, stories that tug at our heartstrings but which, in the final analysis, cloud judgment instead of enlightening it, treating the grief we all feel in the face of death as if there were a solution at hand in the form of suicide. They label that solution “choice,” which in a consumer society is usually enough to win the argument, even if, in this instance, the “choice” is to end the possibility of further compassion in favor of a lethal dose of drugs.  

A few weeks back, DC radio talk show host Dian Rehm was the subject of a front page story on the issue in the Washington Post. I encourage everyone to read that story before proceeding. It was impossible not to be moved by Ms. Rehm’s comments about her beloved husband John’s death and how that experience shaped Rehm’s views on, and support for, physician-assisted suicide. She loved her husband of 54 years, that is clear, and his battle with Parkinson’s was unenviable. His decision to stop eating after a doctor refused to provide life-ending drugs was surely a difficult one.

Rehm’s account brought back memories for me. My mother, like John Rehm, had Parkinson’s and, on top of that, one afternoon she and my father were in a horrific car accident. (They also had been married for fifty-four years,) My mom broke her neck, back, both arms and both legs, and the doctors at the emergency room pulled off a miracle in keeping both of my parents alive. Once the blood thinners were reversed, my dad recovered quickly. My mom did not speak ever again, nor did she eat real food. But, on the first day my dad was well enough to cross the Intensive Care Unit and see her, he leaned over and said, “Claire, I am going to steal a kiss. I am going to steal 54 kisses, one for each of our wonderful years together.” It was a moment so filled with love and holiness, I cannot recall it even now, seven years later, without tears.

My mother lived for another six months after the accident. Each morning, I would drive my dad to the hospital (later, to the nursing home after she was discharged) and he would spend the day with her. I would visit both morning and night, going to work in between. During my visits, I sat on the bed with her and do the things we had always done together: we watched “Law & Order” reruns, prayed the “Hail Mary,” and I would tell her about what was going on. It was hard seeing this once vivacious and talkative woman able only to register a smile and a tug on my hand. The nurses and other staff could not have been kinder to my mom and to our family. My dad and I would frequently wheel my mother into the chapel for Mass.

After gastrointestinal complications, the doctors, in consultation with the ethics board at the Catholic nursing home where she was living, recommended that we not re-insert the feeding tube for fear another bout of the complications would cause her pain. The image of Catholic hospitals inflicting otherwise avoidable suffering on people is quite worng. My dad asked every day: “Is this a mercy killing?” I assured him that it was not. She died eighteen days later, very peacefully, with my dad and me at her side.

The situation is similar to that of the Rehms, but my conclusions from that experience were very different. Ms. Rehm says, “That’s all I kept thinking about. Why can’t we make this more peaceful and humane?” In my mother’s case, and from what Ms. Rehm describes about the extraordinary care her husband received and the love she showered upon him, Mr. Rehm’s death was very humane. That is what we humans do in the face of suffering, which is really only the face of love amidst dreadful circumstances, we try and make it humane, to make sure the person dying does not suffer. Until there is a remedy for death itself, the family will always suffer because we do not want to let go of a person upon we whom we depend for our own sense of well-being.

I do not how making physician-assisted suicide an option furthers the goal of a more humane way to die. Indeed, unlike Ms. Rehm’s situation, I was terribly worried that financial pressures would be brought to bear on the quality of care my mother received. One member of our family was somewhat estranged from my parents and could easily have manipulated my father into making bad decisions. I am horrified that in states which permit physician-assisted suicide, an insurance company may deny an expensive treatment for a disease and include a pamphlet from the Hemlock Society with the letter denying coverage. Ms. Rehm undoubtedly did not have to worry about people with a financial interest in her husband’s death pressuring him or the family to choose a less expensive option, but many families would. In such situations, arguing that physician-assisted suicide is an example of providing choice is like observing that the rich and the homeless alike are free to forage through a dumpster for their dinner.

I hope Ms. Rehm will recognize what shines through in her own account: She gave her husband a wonderful life and a dignified death. She may not have been there at the moment of his death, which clearly upset her, but I am confident he died knowing how much he was loved. We don’t get to live forever. We don’t get to live without ailments and illnesses. But, we can help each other feel loved, not expendable, at the hour of our death. My dad and I did it for my mom. And, it appears that Ms. Rehm did it for her husband. When Pope Francis talks about a “throwaway culture” he is urging us all, as a culture, a society and as individuals, to do for all of our elderly what Ms. Rehm did: Give those who are dying love and compassion. The so-called “compassionate choice” of physician-assisted suicide stops compassion and brings death. That is not much of a choice.