Every day my Google Alerts send me interesting articles about death and dying.  Some I read, some I pass by, but this one caught my eye. A medical student wrote a piece about the medical practice of “physician-assisted suicide” as a collaborative process.  While he said some interesting and powerful things, I was deeply compelled to provide information to him, and to his readers on kevinmd.com that the term “physician-assisted suicide” is incorrect. 

The following is my response to his article:

“I applaud Mr. La, an aspiring medical professional, for shining a light on medical aid in dying (MAID) in his recent article “Physician Assisted Suicide is a Collaborative Process”.  As he points out, MAID is becoming more available as states are increasingly legalizing the process. It is, in fact, a growing movement in our country that offers a humane and dignified death to those people in permissive states who are terminally ill, suffering, and wish to have a say in how they die. However, having attended many deaths as a volunteer with End of Life Choices California, and as a retired physician, I can attest that these individuals are clearly not suicidal, which we know to be a mental health issue where someone is choosing to die who could otherwise live. These brave people who choose medical aid in dying would give anything to keep living, but a debilitating, painful and terminal disease is taking their lives. They are simply choosing to end that life in a quiet and peaceful way, usually at home, surrounded by loved ones.  

Mr. La’s unfortunate use of “physician-assisted suicide” is outdated verbiage that is primarily used by people who are opposed to MAID.  However, I do not believe that he is taking a stance in opposition to MAID in his article nor condoning the practice as suicide. The laws that have been passed in each state are all very clear on this very issue.

For example, in my home state of California, the End of Life Option Act, Assembly Bill 15, is very clear that medical aid in dying is NOT suicide, euthanasia or any other term that blames the patient.  Medical aid in dying is a determined and seriously considered choice, with significant steps and oversight which must be applied to keep the law from being abused. The bill states that “nothing in its provisions is to be construed to authorize ending a patient’s life by lethal injection, mercy killing, or active euthanasia, and would provide that, action taken in accordance with the act shall not constitute, among other things, suicide or homicide.”

Another critical point to note is that pursuant to Section 443.18 of the bill, “death resulting from the self-administration of an aid-in-dying drug is not suicide, and therefore health and insurance coverage shall not be exempted on that basis.” Section 443.18 goes on to say “Nothing in this part may be construed to authorize a physician or any other person to end an individual’s life by lethal injection, mercy killing, or active euthanasia. Actions taken in accordance with this part shall not, for any purposes, constitute suicide, assisted suicide, homicide, or elder abuse under the law.”

If interested, one can read the specifics of the law here.

While we at End of Life Choices California will always defend the terminology of medical aid in dying in this way, another larger, national advocacy organization committed to improving care at the end of life, Compassion & Choices, is also very clear on the point of suicide vs. medical aid in dying.  Their accurate opinion can be read here: https://compassionandchoices.org/about-us/medical-aid-dying-not-assisted-suicide/

It is our hope, as a California nonprofit committed to providing information and personal support to people seeking answers at the end of their lives, that physicians will continue to educate themselves and become more willing to provide this important medical service to their patients at one of the most significant times of their lives. I believe it is the ultimate in patient abandonment not to do so.  If you are a physician wishing to learn more about MAID, please contact us at info@endoflifechoicesca.org and we will put you in contact with physicians who do prescribe MAID and would be happy to share their experience. 

Dr. Judy Neall Epstein
Founding Director, President
End of Life Choices California

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End of Life Choices California offers information and non-judgemental personal support to anyone seeking help managing end-of-life care planning or decision-making in California.  Please visit www.endoflifechoicesca.org.  To speak with one of our volunteers, please call 760-636-8009 or email us at info@endoflifechoicesca.org.  All our services are free of charge.