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Valley Perspective

Suicide Is Not a Treatment for Anything

The 'right to die' plus managed care is a dangerous combination.

April 04, 1999|GEORGE RUNNER | Republican Assemblyman George Runner represents the cities of Lancaster, Palmdale and Santa Clarita

An earnest debate has begun in the state Legislature over physician-assisted suicide with the introduction of Assembly Bill 1592 by Dion Aroner (D-Berkeley).

Unfortunately, although this measure is born out of a sincere desire to help suffering people, it does so in the worst possible way. AB 1592 not only leads our society down the dangerous slippery slope of euthanasia but undermines California's accomplishments in addressing individuals suffering from pain. In addition, it weakens current efforts in the state Legislature to further deal with friends and family members who are in pain.

Significant strides have been made to address the very serious issue of under-treated pain, and the Legislature is committed to continue working on this important policy area. Nevertheless, advocates of AB 1592 argue for an Oregon-style "right-to-die" law based on untreated pain. What these advocates seem to miss is that suicide is not a "treatment" for pain or any other problem.

Physician-assisted suicide advocates argue that pain cannot be treated, therefore individuals suffering from pain need the option of physician-assisted suicide. However, even in extreme cases such as terminal cancer, pain can be treated with viable pain management therapy. For advocates of physician-assisted suicide to use individuals in pain as motivation for leading Californians down this dangerous road that every medical profession in our state opposes is foolhardy at best.

Essentially, if California enacted physician-assisted suicide, that would de facto create enormous pressures on the elderly, disabled and those suffering from terminal illnesses to ensure that they not "linger" too long. This is especially dangerous when combined with our current system of managed care.

Health Maintenance Organizations (HMOs) may attempt to reduce health care costs by refusing to pay for expensive or "unnecessary" procedures. What better way to cut costs than on those people who won't be here much longer anyway?

If this sounds farfetched, consider the following: While discussing the recently passed Oregon right-to-die law, a spokesperson for QualMed Oregon Health Plan confirmed that it would cover lethal medications "as a prescription" while its "value option" plan limits hospice care to $1,000.

Derek Humphrey, a leading proponent of euthanasia, has just released a book titled "Freedom to Die," in which he admits cost containment is an ultimate goal: "A rational argument can be made for allowing [assisted suicide] in order to offset the amount society and family spend on the ill, as long as it is the voluntary wish of the mentally competent terminally ill adult . . . . The hastened demise of people with only a short time left would free up resources for others. Hundreds of billions of dollars could benefit those patients who not only can be cured but who want to live."

Just think of all the money that could be saved by HMOs if they spared the expense of treating AIDS patients or the disabled, many of whom could easily be classified as terminally ill.

In 1997, the Pain Patient's Bill of Rights was passed by the Legislature and signed into law by the governor. This law gives patients with intractable pain the right to take opiate medication in whatever dosages and method of administration necessary to relieve pain, rather than subject themselves to surgeries or implants.

In 1998, two laws were enacted that enabled the terminally ill to have greater access to pain medications and reduced the inefficiency of the triplicate prescription process for these individuals. Those suffering from a terminal illness are no longer subject to long delays in approval of non-formulary medications. They are also exempt from requirements that their Schedule II prescriptions be made in triplicate and routed through the Department of Justice.

Finally, the California Medical Assn. amended the law relative to continuing education requirements for physicians to include courses on end-of-life issues. These can include courses addressing pain and symptom management, the psychosocial dynamics of death, dying and bereavement and hospice care.

Although voters in Oregon narrowly approved physician-assisted suicide, California has been making great strides to ensure that pain medications are readily accessible to patients in pain. It has also moved to ensure that doctors who lawfully prescribe appropriate dosages of medications do not have to fear the wrath of law enforcement officials intent on waging the war on drugs.

California must continue down the humanitarian path of treating pain in suffering individuals--not authorizing HMO administrators to end lives to bolster their bottom line.

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