HMS Panel Considers "Death with Dignity" Ballot Question

Lachlan Forrow, the director of ethics and palliative care programs at Beth Israel Deaconess Medical Center, posed a philosophical question to his audience on prescribing medication to end life: “Who has the right to tell anybody how to die?”

At Thursday afternoon’s public forum at the Harvard Medical School, this question was more than abstract. A panel composed of two medical and two legal experts explained the issues surrounding Question 2 on this November’s general election ballot for Massachusetts, known as the “Death With Dignity” Initiative.

If passed, the initiative would make Massachusetts the third state, after Oregon and Washington, to grant doctors the legal right to prescribe barbiturates to end the life of a terminally-ill patient, a process often referred to as physician-assisted suicide. At the patient’s oral and written request, and with the agreement of at least two physicians, the patient will be given either a pill or a liquid syrup to ingest, putting them to sleep in minutes and granting an almost certain death in the next half hour.

All four panelists at the forum supported the initiative, a leaning mirrored in the composition of the audience, which included both medical students and local community members. A hand vote taken at the beginning of the event revealed that fewer than 10 of the more than 100 people gathered expressed their intention to vote against the measure.

The practice, according to Forrow, is a phenomenon that already happens to some extent in the medical field. Forrow, who has served as the chair of the Massachusetts Expert Panel on End of Life Care, said he believed that the “only thing this law will change is making it not illegal.”

Still, the panelists emphasized that the instances of patients actually taking prescribed medication to end life have been relatively rare.

In an introduction before the panel, event moderators Robert D. Truog and Christine Mitchell, who both teach medical ethics at the Medical School, presented the results of a study on the prevalence of physician-assisted suicide in Oregon since its legalization. Though nearly 200 of every 1,000 adults who died had considered the option, only 20 made formal requests, two received the prescriptions, and one actually took the medicine.

Panelists at the forum said the greatest advantage of the initiative would be the choices offered to terminally ill patients.

Panelist Marcia Angell, a lecturer at the Medical School who was one of the original petitioners for the Death With Dignity Act, added that it gives people the ability to control their environment in their last moments.

“One of the greatest attractions is they can die at home around their loved ones,” she said.

Audience member Gary S. Gray—who works at Harvard Catalyst, a group that seeks to bring cross-disciplinary health care solutions to the public—said that the event, though thought provoking, had not changed his vote on the issue.

“I came undecided,” he said. “I’m still in the middle.”