In April 2014, Brittany Maynard's oncologist told her she had six months to live, due to an aggressive form of brain cancer.
Maynard, 29, of San Francisco, was a newlywed. Citing fear of intense pain, loss of bodily control and being a burden on her family, she decided to end her life under Oregon's Death With Dignity Act (DWDA). Signed into law on Oct. 27, 1997, it allows terminally ill Oregonians to end their lives with a voluntary lethal overdose of prescribed medications.
Last October, Maynard posted video on her website announcing she planned to kill herself on Nov. 1. A whirlwind of articles and interviews followed, including her own op-ed on CNN. She became the national spokesperson for the activist group Compassion and Choices—formerly known as the Hemlock Society.
This drew a strong response from the pro-life movement, which also took to the airwaves and the Internet to remind people that all life is precious—from natural birth to natural death, whatever the cause. Other young women fighting cancer spoke openly about why they were choosing to face their disease and all it entails with grace and faith. One of those was Kara Tippetts, a 38-year-old mother of four living in Colorado Springs, Colo., who has blogged about the details of her journey since being diagnosed with breast cancer two years ago.
"Suffering is not the absence of goodness, it is not the absence of beauty, but perhaps it can be the place where true beauty can be known," she wrote in an open letter to Maynard last October. "In choosing your own death,, you are robbing those that love you with such tenderness the opportunity of meeting you in your last moments and extending you love in your last breaths."
Those women's stories have escalated the debate over the so-called "right to die." As this issue of Citizen went to press, legislators in Alaska, California, Delaware, Hawaii, Iowa, Kansas, Maryland, Missouri, Montana, Nevada, New Hampshire, New Jersey, New York, Oklahoma, Pennsylvania and Wisconsin, along with the District of Columbia, were set to introduce or already were debating bills legalizing physician-assisted suicide (PAS) this session.
In establishing residency in Oregon—which can be done within 24 hours—Maynard worked to meet the law's other requirements: She requested the lethal prescription three times—twice orally, and once in writing— proving that she was capable of making her own health care decisions and communicating them.
As the media firestorm raged, Maynard filled a prescription from her doctor—and on Nov. 1, as she had planned, she ended her own life.
Tippetts, meanwhile, was receiving hospice care at home as this issue went to press.
"So, there it is. My little body has grown tired of battle and treatment is no longer helping," she wrote in a Dec. 29 blog post. "But what I see, what I know, what I have is Jesus. He has still given me breath, and with it I pray I would live well and fade well. By degrees doing both, living and dying, as I have moments left to live."
"The 'right' to die is a misnomer," says Rita Marker, executive director of the Patients Rights Council, an organization that addresses euthanasia, assisted suicide and end-of-life issues. "We're all going to die, so this is not a 'right' to be exercised. What we're talking about is whether or not the law should be changed to permit doctors to prescribe death."
Some claim assisted suicide is compassionate, but Wesley Smith, a senior fellow at the Discovery Institute's Center on Human Exceptionalism, disagrees.
"It's the opposite of compassion," he says. "The root meaning of 'compassion' is 'to suffer with.' True compassion is about bearing others' burdens yourself. Assisted suicide, in essence, discards the problem in a way that is the method of least resistance.
"I've talked to people with brain cancer," he continues. "When Brittany Maynard became an international celebrity because of suicide, these people have told me how hard it makes it to continue trying to live. The message from the assisted- suicide campaign is, 'Of course your life isn't worth living. Of course, if you want to die, we should give you the pills.' "
Others say unbearable pain is sufficient reason for patients to end their lives. But "if a patient is in excruciating pain, that doctor does not know what he or she is doing," Marker says. "A patient in pain doesn't have the energy to go around picking a new doctor. They need family and friends who will be courteous but firm and say, 'We want a pain-control specialist.' "
Fear of becoming disabled is another leading reason some seek assisted suicide. John Kelly—the New England regional director for the grassroots disability-rights group Not Dead Yet—has a unique perspective on that, having been wheelchair-bound since his mid-twenties.
"Not all disabled people are terminal," he explains, "but everyone with a terminal illness will become disabled."
Slippery Legal Slope
The fight against PAS has been raging since long before Brittany Maynard's became a household name.
In Washington v. Glucksberg (1997), the U.S. Supreme Court unanimously determined there is no constitutional right to kill one's self with a doctor's help. "The history of the law's treatment of assisted suicide in this country has been and continues to be one of the rejection of nearly all efforts to permit it," wrote Chief Justice William Rehnquist. "That being the case, our decisions lead us to conclude that the asserted 'right' to assistance in committing suicide is not a fundamental liberty interest protected by the Due Process Clause."
When Congress was considering the Pain Relief Promotion Act of 1999 (which passed the House but died in the Senate), then-Sen. Tom Coburn (R-OK) asked, "Do we want doctors deciding who lives and who dies? No, we do not want that. This is a slope, a real slope where we are going to become God. We do not have that power. The Declaration of Independence says that we should have the right to pursue life, liberty, and the pursuit of happiness. Nothing in it says we have the right to pursue death—nothing."
To date, three states have legalized PAS—Oregon in 1997, Washington in 2008 and Vermont in 2013.
According to the Oregon Public Health Division's 2013 annual report, since the DWDA passed, doctors in the Beaver State have written 1,173 prescriptions for lethal overdoses, resulting in the deaths of 752 patients.
But of those, only Maynard's story has gone viral—and Compassion and Choices (C&C) has had no qualms about using it to further its agenda.
"Brittany Maynard is transformative for our movement," C&C President Barbara Coombs Lee stated in the Nov. 1 issue of Time magazine. "I've never felt this energy or seen this level of engagement in any of our campaigns." A few weeks later, on The Today Show, she said, "The movement has spent 20 years preparing itself for Brittany Maynard to give it real life."
These "campaigns" are C&C's efforts to push legislation turning prescribed suicide into a legalized medical practice.
"Since Oregon's law," Marker says, "C&C has proposed more than 140 laws throughout the United States that are virtually identical to Oregon's. Only Washington and Vermont have passed them."
Another activist group, the Death With Dignity National Center, claims on its website that "after 16 years of data demonstrating Death with Dignity laws work as intended with no abuse, there is no rational reason for a legislator to oppose Death with Dignity policy reform."
Pro-life advocates say there's no way to tell whether the laws are being abused or not: They don't require doctors to be present when patients take the medications; death certificates don't list "assisted suicide" as a cause of death; autopsies are not performed. So there is no way to tell if all the people who have used PAS were terminally ill, or even whether they took the drugs voluntarily.
"The Oregon bill was intentionally written to allow the state no oversight or investigative authority," says Kelly of Not Dead Yet. "And everyone is given immunity. An heir could pick up the drugs, administer them and then make up a story about 'acting in good faith.'"
The laws in Oregon, Vermont and Washington laws require doctors to file a form for every assisted suicide, from which the state compiles an annual report.
"When Oregon's first annual report was issued," Marker says, "the document stated, 'We have no way of knowing if the information provided for the report is accurate or complete. For that matter, the entire account could have been a cock-and-bull story.' They went on to say, 'We assume, however, that physicians were their usual careful and accurate selves.'"
Death is Cheaper
On Feb. 6, a bill that would have legalized PAS in Colorado failed on an 8-5 bipartisan vote in a legislative committee. Lawmakers said it lacked sufficient safeguards preventing abuse, and witnesses said they were concerned that it contained potential incentives for health insurance companies to push assisted suicide over more expensive medical care. Smith estimates that on the average, PAS costs about $1,000 per patient, while the costs of caring for a terminally ill person through his or her natural demise might run into the hundreds of thousands of dollars.
Two Oregonians—Barbara Wagner of Springfield and Randy Stroop of Dexter—have personal experience with that. Both were diagnosed with terminal cancer. Although their doctors were optimistic about new treatments, in July 2008, the state Medicaid program in which they were both enrolled denied them coverage for the recommended treatment, but offered to pay for prescribed suicide.
Smith says that betrays the most basic underpinnings of modern medicine, which "is supposed to be about healing, about palliating pain," he explains. "Even five thousand years ago, when taking the Hippocratic Oath, doctors swore not to engage in assisted suicide, because it is in direct conflict with the proper role of the physician. Assisted suicide is killing.
"It has never been a 'medical treatment'—until the most recent years."
"Assisted suicide is always going to be a deadly mix with a profit-driven health care system," he insists. "Once assisted suicide is defined as a 'treatment,' it will be the cheapest one."
PAS activists predicted this very thing long ago. In his 1998 book Freedom to Die, Hemlock Society co-founder Derek Humphry wrote, "In the final analysis, economics, not the quest for broadened individual liberties or increased autonomy, will drive assisted suicide to the plateau of acceptable practice."
In the wake of Brittany Maynard's death, it's clear that our nation is now standing on the brink of that plateau. While pro-life advocates celebrate the recent victory in Colorado, they know only time will tell whether we continue to collectively stand firm for life, or stand aside.
For More Information
To learn more about the Patients Rights Council, visit patientsrightscouncil.org. For more on the Discovery Institute, go to discovery.org. Learn about Not Dead Yet at notdeadyet.org. For the latest statistics on PAS in Oregon, read "Oregon's Death With Dignity Act—2013," available at http://1.usa.gov/1g23d8G. Kara Tippetts' blog can be found at mundanefaithfulness.com. Her book, The Hardest Peace: Expecting Grace in the Midst of Life's Hard (David C Cook, October 2014) is available through Christian Book Distributors.