California’s End of Life Option Act does not require a psychological evaluation prior to receiving a prescription for aid-in-dying drugs. This lack of basic psychological evaluation and treatment constitutes medical negligence.
The Act puts vulnerable individuals at risk. We can’t ignore the economic factors at work in medicine. For example, patients in Oregon have been refused life-extending chemotherapy by their insurance companies, who instead opt to pay for aid-in-dying drugs. There are forces at work that will pressure individuals and narrow their options, rather than expand their range of options.
The Act communicates the message that under especially difficult circumstances, some lives are not worth living. This message will be heard by not only those with a terminal illness but also any person struggling with the temptation to end his or her life.
The Act abandons vulnerable patients to lethal drugs. To abandon suicidal individuals in the midst of a crisis under the guise of respecting their autonomy is socially irresponsible. It undermines sound medical ethics and erodes social solidarity.
The Act will undermine the ability of patients to get adequate medical care. Patients with a terminal illness are exquisitely vulnerable to any suggestion from their physicians, their health care team, and their insurers that they are becoming too expensive to care for, or too burdensome.