State approves ‘right to die’

Press, 15 October 1976, Page 12

State approves ‘right to die’

From the “Economist,” London

Governor Br- i of California has signed the country’s first “right to die” bill for terminally ill patients. His decision is said to have cost him much agony of mind, but tbe bill is really quite modest. It only makes it explicit that patients may refuse extraordinary treatment given simply to postpone the momr-t of death. Sick adults (or far-seeing well ones) would be allowed to affirm in writing that once all hope is gone they do not want to be kept technically alive, perhaps in discomfort, perhaps in pain, by all the complicated para-

phernalia of modern medicine.

The document must be witnessed by two people who will not benefit from the death and by a doctor who is not’ attending the patient. When the moment comes for a decision, two doctors must certify that the patient is really dying. The law, which goes into effect on January 1, will free doctors of any risk of malpractice suits in such cases (fear of being held responsible causes some unnecessary treatment). It will also prevent insurance companies from refusing to pay benefits, on the ground that the death amounted to suicide.

Support for the measure came from the California Medical Association, patients’ rights organisations and old people’s groups; even the state’s Catholic Conference did not oppose it. So-called pro-life groups objected; they fear the legislation may open the door a crack to euthanasia for the old and ill.

Demand for the step was spurred by the publicity surrounding the case of Miss Karen Quinlan, whose doctors insisted on keeping her on a respirator for over a year although she remained in a coma and seemed certain never to attain more than a vegetative state; her parents wanted her to be allowed to die. Ironically, if New Jersey had had a “right to die” measure, it would

have made no difference to Miss Quinlan, since she was taken ill too suddenly to express any views about her treatment.

There are few aspects of the case, however, that are relevant. Doctors do sometimes make mistakes. Those who attended Miss Quinlan were sure that she could not live if she were taken off the respirator. In fact, she is still alive although the respirator was disconnected by court order in May. There are questions, too, about what constitutes extraordinary medical measures. Should the patient be denied antibiotics? Feeding by tube? Such questions used to be decided by doctors on their own; now they may become matters for legislation in many states.