Assisted Suicide and Conscience Protection

This is an article I wrote that was published in the Catholic Free Press on December 31, 2021.

Yesterday was the legislative reporting deadline. Last year the bill was sent to Health Care Financing and its reporting deadline extended until the end of the year. We will know Monday what came of it. With our state house being the only one in the nation that has yet to reopen from COVID, and this being given as a reason for extensions, we are expecting the same to happen.

While the public hearing is over, the assisted suicide bill known as An Act Relative to End of Life Options (End of Life Options Act) is still awaiting action by the Joint Committee on Public Health. Continuing to meet with legislators to inform them of our opposition is crucial to preventing this bill from becoming law. Unless extended, the deadline for the committee to report out is February 4, 2022. Particularly troubling about this bill is that it contains something other assisted suicide laws do not: the wiping away of conscience protection for Catholic clinicians, hospitals, and anyone else opposed to it.

Medicine was once centered on the knowledge, skill, and ethics of clinicians to provide compassionate patient care. As medicine progresses into a system centered on providing services, patient volume and satisfaction become the goods sought by the corporations and regulators running it. In this brave new world, declining a patient request for a legal service because of a clinical judgement based on conscience is grounds for termination. Advocates claim this is necessary to prevent discrimination, but, in fact, it aims to end Catholic healthcare.

Catholic clinicians never refuse to care for a patient. We sometimes refuse to offer or refer for treatments that we view as harmful, such as assisted suicide, even if it is legal and others disagree. And we always offer alternatives that, for some things, may simply be our presence and support. Discrimination is not involved. It is a false claim by those who replace human dignity with human desire and do not tolerate those who think differently. While patient satisfaction is important, when government payments and clinician salaries depend on it then conscience objections must go, and any bioethical constraints go as well.

The End of Life Options Act is designed to protect doctors willing to hasten the death of their patients. It forces all others to either get used to it, refer to someone who will do it, or get out of medicine. None of those are acceptable to those of us who never view someone as better off dead. Even now, this language already exists in recently palliative care laws. These laws mandate that all facilities and clinicians supply information to patients about palliative care and other “end of life options.” It also states that, “Nothing in this section shall be construed to permit a healthcare professional to offer to provide information about assisted suicide or the prescribing of medication to end life.” People can opt out but must refer to someone willing to discuss all the “end of life options.”

Why would anti-conscience language be placed in a palliative care law when no one objects to informing patients about it? Keep in mind that the End of Life Options Act, which states that “aid in dying” shall not be considered assisted suicide. If the End of Life Options Act passes, everyone will be required to inform patients that “aid in dying” is an “end of life option.” Additionally, every doctor will be mandated to offer the “service” or refer to someone who will. That will be the end of Catholic medicine in Massachusetts.

Assisted suicide should never be legalized, and it should never be linked to palliative care. A small number of suicide activists are using palliative care to attack people of faith. Not only must we tell legislators to reject the assisted suicide bill, but also to amend the existing palliative care laws. And we must keep a close eye on other related bills.

An effective referral is when a clinician is directly involved in obtaining a service that he or she will not offer from someone who will. If I am unwilling to be involved with hastening the death of a patient, I will give them the name of someone who will. I am being made into the means by which the patient obtains hastened death. In ethical language, this is immediate material cooperation with evil. Since I do not approve of assisted suicide, my cooperation is material, not formal; since I am a necessary part of the patient obtaining a hastened death, my cooperation is immediate, not mediate. Handing over a patient to someone I know will carry out what I will not does not absolve me of any guilt; look at the effect it had on Judas.

This language of an effective referral has become “boiler plate” language in palliative care bills and laws. By “boiler plate” I mean that the language has been well crafted by lawyers for this purpose and it is being replicated like a virus in our laws. For example, here is the effective referral language in current palliative care law:

If the attending health care practitioner fails to provide the patient with information and counseling under this section in a timely manner, the attending health care practitioner shall promptly arrange for another physician, physician assistant, nurse practitioner, advance practice nurse or registered nurse licensed to do so or shall promptly refer or transfer the patient to another physician, physician assistant, nurse practitioner, advance practice nurse or registered nurse licensed to do so.

And with it is the assurance that this is not tied to assisted suicide – because, well, hastening death is aid in dying, not assisted suicide. It is all in the language…

Nothing in this section shall be construed to permit any attending health care practitioner, as defined in this section , or any other medical professional to offer physician assisted suicide or prescribe medication with the intent to end life.

This exact (boiler plate) effective referral language is also in bill HD.4482 “An Act Relative to Palliative Care Compassionate Support” sponsored by Representative Silvia, a strong opponent of assisted suicide. From where , then, is this boiler plate language coming?

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