Go west, old man! Go west!

Michael Cook
Oct 6, 2015
Reproduced with Permission

Ten percent of Americans now have access to assisted suicide after Jerry Brown, governor of California, approved Assembly Bill 15 yesterday . "This is the biggest victory for the death-with-dignity movement since Oregon passed the nation's first law two decades ago," said Barbara Coombs Lee , the head of America's leading right-to-die group Compassion & Choices.

With assisted suicide now legal in California, Oregon, Washington, Montana and Vermont, as well as throughout Canada, other states are bound to follow. The pattern of the campaign for same-sex marriage - state-by-state conquest through the courts, followed by an appeal to the US Supreme Court - is an ominous template.

Assisted suicide had failed in California six times since 1988. But exactly one year ago, on October 6, Compassion & Choices released a superbly-crafted video about Brittany Maynard, a winsome 29-year-old Californian woman with a brain tumour, who had to move to Oregon because assisted suicide was illegal in her own state. It became a YouTube sensation; the tears trickling down her cheeks drowned opposing arguments in a flood of emotion.

After the bill was passed by both the Senate and the Legislative Assembly, only a veto by Governor Jerry Brown, a one-time Jesuit seminarian, could have stopped it. He declined.

In an unusual move, he explained why he had signed the bill in a brief note yesterday - which must have left some Californians wondering whether he had actually read the legislation. He wrote:

"The crux of the matter is whether the State of California should continue to make it a crime for a dying person to end his life." Not true. The crux of the bill is not whether the patient is committing a crime, but whether those assisting him will be prosecuted. Suicide is not a crime in California.

"No matter how great his pain or suffering." Not true. Pain and suffering are not qualifications for assisted suicide in this bill. Only a "terminal disease" is and this may not involve any pain at all. In any case, loss of autonomy, decreasing ability to enjoy life and loss of dignity were the three top reasons for requests for assisted suicide in Oregon, not pain and suffering.

"In the end, I was left to reflect on what I would want in the face of my own death." Not sensible. Legislators are supposed to benchmark legislation against society's welfare, not their own. Governor Brown's blinkered focus on his own feelings blinds him to the effects upon the rest of society - the dangers of elder abuse and cost-driven health care.

"There is a deadly mix when you combine our broken healthcare system with assisted suicide, which immediately becomes the cheapest treatment," says Marilyn Golden , a senior policy analyst at the Disability Rights Education & Defense Fund in Berkeley. "The so-called protections written into the bill really amount to very little."

California's new law is modelled on Oregon's, but the land of fruits and nuts is different from its northern neighbour. California is America's most unequal state in terms of well-being. The well-to-do in Silicon Valley will enjoy all the safeguards of the law; the strugglers in Central Valley will fall through its cracks. California is also the most litigious state -- a "judicial hell-hole", according to some critics. The law's restrictions will almost certainly be wedged open with lawsuits fought over exceptional cases. Why is there an age limit of 18? Why does a patient have to be terminally ill? Why can't he be suffering from a mental disorder? If the right to die is a can of worms, California's lawyers have big can-openers.

And will the new law actually result in fewer people committing suicide as its supporters have promised?

Dramatic new findings about the Oregon experience with physician-assisted suicide (PAS) were published today in the Southern Medical Journal which suggest that this is not true. In a fine-grained statistical analysis of the experience in the four American states where PAS is currently legal British academics David Albert Jones and David Paton show that "the introduction of PAS seemingly induces more self-inflicted deaths than it inhibits".

The suggestion that legalisation reduces the total number of suicides and postpones those that do occur is a popular argument on the right-to-die side. It was first mooted by libertarian economist and jurist Richard Posner and has subsequently been adopted by assisted suicide advocates around the world. It allows advocates of assisted suicide to claim, paradoxically, that they are against suicide. But there is precious little data to support it.

Now the study by Jones and Paton shows that Posner's argument is plainly wrong. In fact, PAS could actually increase an inclination to suicide in others.

As psychiatrist Aaron Kheriarty points out in an commentary in the same journal: "Several well-studied phenomena in the social sciences and suicide literature suggest that Posner's hypothesis was dubious, even before empirical testing. You do not discourage suicide by assisting suicide." He goes on to write:

"Many PAS advocates claim that this decision is a purely private exercise of personal autonomy, but … research suggests that behaviors like suicide, whether assisted or non-assisted, influence the behaviors of not only one's friends but also of one's friends' friends' friends. No man is an island."

One of the best-studied phenomena of suicide is the Werther effect, named after a disappointed lover who takes his own life in Goethe's 18th century novel, The Sorrows of Young Werther . The book was phenomenally popular and sparked a rash of copycat suicides throughout Prussia. The dangers of glorifying suicide are so obvious that the Centers for Disease Control and Prevention in partnership with the National Institute for Mental Health, the World Health Organization, and the Surgeon General recommend the utmost discretion in reporting suicides, lest vulnerable people succumb to the siren call of suicide.

California's new law shows that the copycat effect is alive and well. Jerry Brown and California have followed Brittany Marnard over the edge.