Buckley’s firing line debate between Patient Rights Action Fund’s Matt Vallière and Penn State’s Megan Wright (LAW ’16) wrestled with the need for and danger of assisted suicide in America.
Fiona Bultonsheen
Staff Writer, The Buckley Beacon
This past Wednesday, dozens of Yale students gathered in William L. Harkness Hall for an intimate firing line debate on the topic of physician-assisted suicide, formally known as medical aid in dying, or MAID.
The debate speakers were Matt Vallière and Megan Wright (LAW ’16), taking the negative and affirmative stance on the question, respectively. Vallière is the Executive Director of the Patients Rights Action Fund and an emergency medical services first responder dedicated to protecting individuals whose lives he feels are unfairly hastened to an end through physician-assisted suicide. Wright, current Professor of Law, Medicine, Sociology, and Bioethics at Penn State University, is a staunch advocate for patient autonomy in a private, medical life-ending decision in consultation with a doctor.
In her opening remarks, Wright highlighted that MAID allows for decision-making for a private medical life-ending decision in consultation with a doctor. She emphasized a legally competent waiting period wherein, upon two doctors’ approval, the patient can take home a self-administered lethal dose of a drug as prescribed by the physician. Access to this end-of-life care, she says, can bring about a peaceful and dignified end for someone with an incurable illness and terminal illness, for example. Wright made it clear that only 53 percent of Americans believe medical aid in dying to be morally acceptable. However, her argument was not one of morality, but of practicality in ensuring a dignified death for those nearest to the ends of their lives.
Vallière began by urging the audience to consider the misuse of assisted suicide in the states where it is legal. Not only is MAID difficult to control, but he claimed it is a veiled attempt to do away with the less fortunate, an erosion of the Hippocratic oath to do no harm. Mistakes in prognosis mean that one could “lose years to a best guess.” Vallière also pointed out that the process of obtaining legal eligibility with two doctors’ affirmations can be circumvented by shopping for a doctor until one more says yes. “If you really want to protect the vulnerable, why are we doing things that are circumventable?” he asked the room.
Wright rebutted that, in the states where physician-assisted suicide is legal, cases of mistaken prognosis make up to only 1 percent of deaths. In California, for example, death by physician-assisted suicide makes up 0.3 percent of deaths, and the most common demographic undergoing MAID is typically white, well-educated individuals with terminal illnesses.
Wright continued by affirming the requirement of self-medication, and how the practice can also be diverted to palliative care should the doctor-patient consultation come to that conclusion. By regulating this end-of-life option, Wright believes there is more safety through the oversight of the state.
Vallière argued that the oversight is a farce and “fast and loose public policy.” There is no way to ensure that once that drug is taken home by the patient, undue outside influence will not be involved. The coercion behind closed doors, combined with the lack of protections, like a third-party witness requirement or patient attestation, leads to a rash, deadly decision that disproportionately impacts those in the most vulnerable positions.
Wright concluded by saying, “People are not forced to die […] There are safeguards with 30 years of access with no evidence people are forced to die.”
During audience Q&A, a student asked whether the modern healthcare system sets up perverse incentives to administer healthcare for economic gain. Both speakers agreed that the healthcare system is broken. Vallière said the “net effect driven by brutal utilitarianism” makes it such that the results of the Canadian system are not far off for America if the country continues to accept MAID as a legal practice. He cited that 5 percent of all deaths in Canada are hastened through physician-assisted suicide.
While Wright agreed that the healthcare system needs reform, she said it is not an “either/or for affordable healthcare and medical aid in dying.”
When asked about religious and cultural differences in support for the legalization of medical aid in dying, Wright pointed out that populations that are less religious, more educated, more left-leaning, and in the American West are more likely to support the legalization of physician-assisted suicide. She also called out notable regional differences in perceptions, with the Southeast of the U.S. being more staunchly against medical aid in dying, while the West is largely more supportive of it.
Vallière concluded the period by saying that through the legalization of physician-assisted suicide, there emerges a wider and wider class of individuals with whom “suicide prevention standards do not apply.” Rather, MAID is a discriminatory measure to take out the weakest among us so that the harder thing, long-term palliative care (which Vallière argues is getting better and better each year), is not given as much careful consideration.
Looking to the future, Vallière pointed out that physical pain is not among the top reasons cited for Americans choosing a self-administered lethal prescription, where a lack of dignity, autonomy, bodily control, and inability to do what one found pleasurable in the past rank higher. This is a product of a growing underlying belief that life with a disability is not worth living, and raises concerns for American equality.