Should a Doctor Help You Die? MAiD (Medical Assistance in Dying)

I can’t believe I am writing about the moral and ethical dilemmas of physician assisted death. I thought Dr. Jack Kevorkian (Dr. Death), and his boastful stories of the 130 people he assisted to die, was a thing trapped in the early 1990s. He passed away in 2011 and his stories are searchable on the internet. He publicly championed a terminal patient’s right to die with the assistance of a physician. But, in 1999 Dr. Kevorkian was found guilty of 2^nd degree murder in Michigan for brazenly administering a lethal injection into Thomas Youk. This is exactly what Dr. Kevorkian wanted. He allowed the airing of the procedure during an episode of 60 Minutes. He was very proud of the work he was doing. Dr. Kevorkian was a pathologist. He was not an oncologist. He was not a neurologist. He was not a psychiatrist. Dr. Kevorkian was a man who played God and used the most vulnerable to advance his own selfish agenda. After so many taunts, Dr. Kevorkian finally cemented his legacy by becoming a “martyr for his agenda.” He said and did the one thing out loud. His language and actions broke the taboo placed on assisted suicide. He was quoted as saying “Dying is not a crime.” I totally agree with that statement. In the United States, approximately 8990 people die every day and over 49,000 die each year by suicide. My question to answer his statement is “do people need doctors to help them do it?”

In 1997 US Supreme Court landmark Washington v. Glucksburg, it was unanimously held the right to assisted suicide in the United States was not protected by the Due Process Clause of the 14^th Amendment. So, for 28 years there has not been a federal right for a physician to administer a death drug. But as early as 1994 and again in 1997, both general election ballot issues, Oregon voted to pass a Death with Dignity Act for their state. This state legislation became the blueprint for Canada and several other states in the US. Following suit is California, Colorado, Delaware, Hawaii, Maine, Montana, New Jersey, New Mexico, Vermont, Washington, and DC. Oregon and Vermont have taken things a step further and removed residency requirements to die. Ironic both Oregon and Vermont have no residency requirements to end life, and both have no gestational age limits to receive an abortion. To my knowledge there is no current legislation in Kentucky to protect its residence from this purge.

MAiD law states (medical assistance in dying) have no oversight state program for assisted dying. There is no application. All you need to do is find a doctor willing to distort “do no harm” oath, tell him you want to die, answer a few questions and wait for your prescription of poison. The term Compassionate Choice is used frequently. The wording is so clever. To be so compassionate that your desire to alleviate another’s distress is expressed by helping them die. Really? I care so much about you I am going to assist you take your own life. There are no follow-ups or ways to monitor the severity of the dying process. Just like ordering and taking RU 486 to end an unwanted pregnancy, the doctor absolves themselves by turning their heads and walking away. Remember, that patient wanted to die. I gave them what they asked for.

MAiD laws are not compatible with a physician’s role as a healer. MAiD laws are difficult to control or track and once passed they pose a risk to society. The patient takes the poison outside of the doctor’s presence. Out of sight, out of mind. Recently in Canada, it was reported a life ending drug was prescribed and it took the patient 137 hours to expire. Imagine the suffering, mental angst, and emotional conflict the individual experienced waiting to die. It sounds so romantic and humane. To assist someone in taking their own life. How noble! There is a federal lawsuit in Colorado on behalf of an anorexia patient challenging the constitutionality of their assisted suicide laws. You read that right, ANOREXIA! The plaintiffs are asking for a permanent block of the enforcement of the assisted suicide law stating the law could be a violation of the 14^th Amendment due process, equal protection, violation of ADA, and section 504 of the Rehabilitation Act. This law protects no one. I would contend the statute singles out individuals with disabilities, elderly or the terminal placing them at risk of premature death rather than ensuring access to care, support, and suicide prevention. As Matt Valliere stated, “assisted suicide laws create separate and unequal systems in which the disabled are offered death instead of support.” Do we want this type of disparity for Kentuckians? Should we even allow this injustice to start for the citizens of our Commonwealth?

In Colorado, only 3% of physicians participate in a patient’s choice to die. Although for now that is a relatively low number, what does that say about the remaining 97% that do and say nothing? Are doctors not to continue care, provide effective communication, emotional support, provide comfort care, and pain control? Do they not hold a level of accountability to at least refer families to agencies that offer grief counseling or consult or schedule patients for second opinions? Is this a society we want to live in that will allow a physician who may be tempted by governmental overreach, pharmaceutical company incentives, or insurance claim denials to stand as a conduit of death? I never thought I would live in an environment where a doctor can write you a prescription, hand you a script, and send you on your way to a “soft landing.” That concept is so far removed from compassionate. The thought process is wrong on so many levels. I heard a teen from Tennessee deliver this line from her speech while attending the National Right to Life Conference in Kansas City this past summer. “Imagine if the doctor’s tools of death were replaced with a gun, knife, or rope. Would we feel the same way about the topic as we do?”

In January 2024, I watched my mother-in-law as she navigated through the dying process. She had been diagnosed 11 years earlier with non-alcoholic cirrhosis of the liver. There was not a whole lot the medical community could do for her prognosis. She continued to seek treatment, even having more good days than bad. She got to travel. She got enjoy her family. She got to immerse herself in quilting, mastering the craft. Her last few months were riddled with swelling, pain, and many trips to the ER. Everyone knew the end was near, but no one prepared us for the end. It is hard to give them up, but medical teams could have done a much better job. As the end of her life drew closer, no healthcare provider stepped up and offered the family support, information, or referrals. Hospice was offered, but there were no details about services for the family, what to expect, when to call, nothing. Palliative Care was not suggested. There was no “soft landing” for any of us. Some days, bloated, in pain, and uncomfortable, my mother-in-law was depressed and defeated, uttering the desire to just die on multiple occasions. Then relief would come, even the day before she passed, and she expressed her desire to live. What if dying with dignity laws existed in Kentucky? My mother-in-law may have chosen to end her life now 12 years ago, never seeing 3 of her grandchildren born or the other 3 grow up. The laws may end the suffering for one, but it causes so much pain for those that remain.

We live in a country where personal autonomy is valued, and in some cases protected. But laws are passed, and executive orders are signed to protect the interests of the collective whole. An individual’s wants cannot interfere with the collective greater good of society. So, I pose this question. Should the individual’s request to “die with dignity” supersede the whole’s greater interest of advocacy, mental health counseling, hospice, or palliative care? Are we creating a world where it is easier to medically die than it is to adopt a pet? Is this really the best we can do? Facilitate a death to maintain dignity? We cannot avoid dying as the scripture tells us “It was appointed unto man to die, and then the judgement.” But we can avoid allowing our medical community to facilitate and speed up God’s divine plan for His posterity.

If you would like to keep MAiD laws out of Kentucky, please contact your state representative or senator and let them know.

Damon Sexton, president, Right to Life of Central Kentucky