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Is “Death with Dignity” Really Suicide?

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As the Maryland General Assembly prepares to again debate whether to legalize physician-assisted suicide, there is a behind the scenes argument about how to refer to this practice – “Death with Dignity”? “Physician-Assisted Suicide”? “Aid in Dying”? “Doctor prescribed suicide”? What may seem trivial is actually remarkably important to truly understanding the impact of legalizing this practice in Maryland.

It’s clear that supporters of this issue refuse to use the word “suicide” and often argue that the practice does not resemble suicide at all. Yet, when we remove the politicization surrounding this issue and read carefully, suicide is a very accurate term after all.

When California was debating whether to legalize physician-assisted suicide in 2015, palliative care physician and noted progressive Ira Byock wrote an op-ed in the Los Angeles Times arguing against the bill. In a striking section, Dr. Byock notes that language around the issue is full of debate, but ultimately PAS supporters’ “euphemisms” are inaccurate and misleading. He writes:

“’Suicide’ is distasteful, so they [PAS supporters] promote “physician aid-in-dying,” “death with dignity” and the “right to die.” And yet all of these mean taking action to end one’s own life. The news media have largely adopted the assisted suicide movement’s terminology, so these euphemisms are worth unpacking here.

 “Physician aid-in-dying” makes it sound like giving someone a lethal drug is an extension of hospice and palliative care. It is not. As a palliative care physician I aid people in dying by treating their symptoms and supporting them through the difficult practical and emotional tasks of completing their lives. In more than 35 years of practice I have never once had to kill a patient to alleviate the person’s suffering.

 “Death with dignity” implies that frail or physically dependent people aren’t already dignified. But they are. People who are disabled or facing life’s end can be cared for in ways that allow them to feel respected, worthy and valued.”

But what really caught our eye and convinced us that suicide is definitely the right term for this practice was a letter to the editor written in response to Byock’s article. The author wrote:

“Suicide is rarely the result of a single issue. It is almost always driven by an underlying illness such as untreated depression.

A person who commits suicide reaches a point of hopelessness. They see no way out. They believe their families and the world will be better off without them. Survivors of a suicide attempt have said that it presents itself as a logical solution and a relief of suffering. In those ways they are choosing a “death with dignity.””
 
If that sounds familiar, it’s because it is the same context offered by PAS proponents about why the practice sound be legal. They are talking about suicide.

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