STATE-BY-STATE CONSIDERATION IS HOW IT’S SUPPOSED TO WORK: A psychiatry professor’s WSJ oped, “The Assisted Suicide Movement Goes on Life Support,” explains why voters in liberal/progressive states such as Massachusetts have refused, and California is presently hesitating, to follow in the footsteps of existing right-to-die states such as Oregon and Washington.
Californians are realizing that assisted suicide represents the slipperiest of slopes. This can be especially true for those who rely on emergency rooms for primary care, lack health-care access, or who predominantly come from minority or immigrant communities with documented health-care disparities where many remain uninsured. They would have every reason to mistrust a health-care system under considerable pressure to drive down costs.
Furthermore, what message are we sending to teens and young adults if California legislators promote suicide as an appropriate response to difficult life circumstances? Suicide in the U.S. is a public-health crisis. Studies have repeatedly demonstrated a “social contagion” aspect to suicide, which leads to copycat suicides. . . .
The suicide rates in Oregon rose dramatically in the years following the legalization of assisted suicide there in 1997. After declining in the 1990s, rates rose between 2000 and 2010, surpassing the rate of increase nationally. As of 2010, suicide rates were 35% higher in Oregon than the national average.
As a psychiatrist, I have evaluated thousands of individuals who tell me they want to die. If they are helped through these crises—given the medical, psychological and social support they need—they are later grateful for that intervention.
A large body of psychiatric research has demonstrated that 80% to 90% of suicides are associated with depression or other treatable mental disorders. Yet only 5% of the individuals who have died by assisted suicide under Oregon’s permissive law were referred for psychiatric consultation before their death. This lack of basic psychological evaluation and treatment constitutes medical negligence.
I’m not so sure that California will reject the measure as did Massachusetts. Earlier this week, the California Medical Association became the first medical association to withdraw formal opposition of physician-assisted suicide, in exchange for language in the ballot measure that would allow health care professionals to “opt out” of the practice, if enacted.
Allowing States to experiment with new social policies is the appropriate way to handle issues about which there is tremendous disagreement– whether assisted suicide, gay marriage, abortion, polygamy or anything else. In a federal system such as ours, the national government has only limited and enumerated powers, and the residuum remains with the States. The Constitution does not mention any of these things, of course, and constitutionalizing them upsets the federalism architecture, imposing a one-size-fits-all decision when it would be much better to simply allow the people to decide, state-by-state, via the democratic process.