The Impact of Brittany Maynard’s Video

The video and Brittany’s death galvanized support for the assisted-dying movement in California and around the country. Backers once again introduced the aid-in-dying bill in the California state legislature. This time, the bill passed and was signed into law by Governor Jerry Brown. For Steve Heilig, ethicist with the San Francisco Medical Society, the new law was unexpected. Heilig had been on the front lines for the last twenty years, lobbying for aid-in-dying legislation. “I think it was the next day...I just started sobbing,” he said, “And I was shocked by myself. But I realized it was all about all this work and all these people through the years and somehow this had paid off after so much time and so much frustration.”

For years, opponents successfully blocked efforts to legalize assisted dying. They’ve raised concerns over the potential for abuse. The elderly could be coerced to end their lives by greedy relatives. Disabled and poor people might hasten their deaths because they can’t afford good health care. Author Wesley Smith, a leading critic of the right-to-die movement, argues that the medical system has a great financial incentive for hastening the death of patients. He said, “When you consider our health care system with managed care, HMOs, profits being made from cutting costs, what could be cheaper than having an assisted suicide for a cancer patient, rather than treating them to the end of their lives?”

To address these concerns, safeguards were written into the new law. Patients must be terminally ill and mentally competent to qualify. They must make two verbal requests for aid-in-dying at least fifteen days apart, as well as a request in writing. Patients must consult two physicians to confirm their terminal diagnosis. Finally, the patients must self-administer the lethal medication. Heilig says the safeguards in the new law will provide vulnerable patients with adequate protection. “These are the most scrutinized of all deaths,” he said, “So it would be much easier not using this, if you really wanted to bump somebody off.”

Access to Aid-in-Dying

Before physician-assisted dying became legal, many people at the end of their lives were quietly hastening their deaths behind closed doors. Lonny Shavelson witnessed the deaths of people ending their lives in secret during the AIDS epidemic. He called these deaths “dark bedroom suicides.” “About twenty years ago, what I saw was horrible,” said Shavelson, “Patients were taking the wrong medication at the wrong times and having bad outcomes.” He said patients often did not have the benefit of medical guidance to assist them. “Bad outcomes included things like partial overdoses, where people would fall asleep for two days from an overdose of morphine that did not result in death, but resulted in brain damage,” said Shavelson, “And they’d wake up two days later, sicker than they started and with even more suffering.”

When physician-assisted dying became legal, Shavelson opened his new practice, Bay Area End of Life Options.4 His is the only medical practice in California focused solely on the new law and assisting qualified patients. “There was almost a call that I felt, which is, ‘you’ve been thinking about this and advocating this for such a long time,’ ” said Shavelson, “It’s almost like ‘put up or shut up.’ Make it work. Be careful. It has complicated implications.”

Like abortion, assisted dying is unpopular among right-to-life and some religious groups. Shavelson’s new medical practice could potentially be a lightning rod for controversy. “I get hate mail quite regularly and I get called Dr. Death quite frequently,” he said.

Within days after his new business opened, Shavelson received multiple requests for help around the state. “Many, many patients, and I mean hundreds of patients, are interested in having an aid-in-dying medication as one option as their death approaches and cannot find any physician who will cooperate with them or participate with them,” he said.

All Catholic hospitals have opted out of participating for religious reasons. Many hospitals in the rural areas and the Central Valley are also opting out. But Shavelson is hopeful that as they become more familiar with the new law, more doctors, hospices, and hospitals will assist patients with their aid-in-dying requests. “This is opening the conversation—the ability to ask for medication to end your life is saying to a doctor ‘if you don’t take better care of me and provide a better death, I’m gonna kill myself,’ ” said Shavelson. He says it is his hope and expectation that more doctors will become better informed and actively involved with end-of-life care. “This is what we saw in Oregon for eighteen years, that there were increased conversations about good end-of-life care and not that many medications written for aid-in-dying.” said Shavelson, “I expect that’s going to happen in California.”

‹ Page 1  Page 3 ›