This September, Harvard Medical School professor David S. Jones ’92 introduced students to assisted suicide, one of the most publicized ethical dilemmas of modern medicine, in the second lecture for his popular new Gen Ed course Ethical Reasoning 33: “Medical Ethics and History.”
In the course’s syllabus, Jones compared physician assisted suicide to the hot-button topic of abortion, writing that “no issues in medical ethics arouse greater passions.” For Jones’s course, the question of whether doctors can provide life-ending medication to terminally ill patients introduced Harvard undergraduates to basic tools of moral reasoning.
But for Massachusetts voters this year, the question is more than academic.
This Tuesday, voters will weigh in on Massachusetts Ballot Question 2, Prescribing Medication to End Life, a law proposed by initiative petition that is often referred to by its supporters as the “Death with Dignity Act.”
The proposed law would allow Mass. licensed physicians to prescribe medication to terminally ill patients meeting certain conditions that they could self-administer to end their life.
Harvard affiliates have been powerful voices in this year’s debate over physician-assisted suicide—an unsurprising reality, given the effect the initiative could have on those at the Medical School, the School of Public Health, the 17 affiliated hospitals and research institutes, and even professors in the Law School or government department.
Among Harvard professors and students, as with voters across Massachusetts, opinion remains split on both the philosophy and practice of Question 2.
THE 0.2 PERCENT
If passed, Massachusetts would become the fourth state, after Oregon, Washington, and Montana, to legalize some form of physician-assisted suicide in the last two decades.
According to Lachlan Forrow, an associate professor of medicine at Harvard Medical school, Question 2’s presence on the ballot is representative of the changing ways that Americans are relating to their health and health care.
“The fundamental important message is that Americans are deeply dissatisfied and worried about the care that they will receive at the end of life,” Forrow said.
The Massachusetts initiative would apply specifically to terminally ill patients who have been demed mentally competent and have less than six months to live.
Although he has not openly taken a position on the Massachusetts initiative, Forrow—who serves as the director of ethics and palliative care programs at the Harvard-affiliated Beth Israel Deconess Medical Center—has in past weeks written and spoken publicly about the history and real-world implications of assisted-suicide policies. He emphasized that the experiences of Oregon, the first state to legalize the practice in 1994, demonstrate the rarity of assisted-suicide requests.
“In Oregon, out of 1,000 people who die, two request and get a prescription for a lethal dosage of medication,” Forrow said. “That means 99.8 percent of people’s needs of care for end of life have nothing to do with [those who choose that option]. Even if this passes, at best, this would be a 0.2 percent solution for the challenges of caring at the end of life.”
AN ETHICAL DILEMMA