But “the right to die” remains one of the most controversial topics in medicine and health care, and many lawmakers in conservative states like Tennessee have generally opposed the legalization of physician-assisted death.
To wade through the ethical and moral questions involved in the debate, East Tennessee State University’s Public College of Health hosted the seminar “Legalized Physician-Assisted Death: Is it Right for Tennessee?” At the forum, speakers on both sides of the debate discussed the issue from medical, ethical and moral perspectives.
Facilitator Erin Mauck, an ETSU community and behavioral health doctoral candidate and health professor, said the event’s purpose was to cover all of the angles of arguments for and against physician-assisted death — pros and cons, legal barriers to passing the legislation and religion’s impact on opinion. She said her interest in the topic comes from years of advocacy and academic research into the matter.
“I personally have been an advocate for legalized assisted dying for over six years, and received a research grant from ETSU in 2015 to travel to Oregon to do a case study on their Death with Dignity Act,” Mauck said ahead of the event, adding that she’s currently doing field placement at the Veterans Affairs Medical Center at Mountain Home in hospice and palliative care for her dissertation on “end-of-life health care.”
The forum’s speakers included former physician and U.S. Rep. Phil Roe, R-1st, state Sen. Jon Lundberg, R-Bristol, VA hospice care psychologist Christine Adler, Ballad Health Chaplain Heather Holland, ETSU philosophy professor Paul Tudico and Veterans Affairs hospice coordinator Kathleen Neal.
While only 39 percent of those surveyed in a 2015 Vanderbilt poll opposed physician-assisted death, Lundberg immediately made his opposition clear. He also disagreed with the American Academy of Family Physicians’ rejection of the use of the phrase “assisted suicide.”
“If suicide is taking one’s own life, that’s what we’re talking about,” he said, adding that he believes the law would be a “slippery slope.”
“The advances in medical technology are happening at such a fast rate that what is incurable today will be curable,” he said.
Roe was also more than apprehensive to voice support for physician-assisted death for this reason, in particular.
“What would have been terminal 40 or 45 years ago, now it’s not,” he said. “Diseases like hepatitis C — when I graduated from medical school — we didn’t even have an alphabet for it. We just knew it was some virus out there. Now it can be cured in 12 weeks, so you’ve got to keep an open mind about what is terminal.”
Adler, Holland and Tudico all pointed out that physician-assisted death gives terminally ill patients more autonomy and agency in their health care decisions. For terminally ill patients, Adler said she’s learned it’s not a question of whether or not some patients are choosing to die — it’s a matter of when.
“We talk to them about what their underlying concern is — is it depression, pain or are they simply tired of the fact that they know they’re dying and wish to have a greater say in when the process will end?” she said, adding that since many of the patients do not actually want to die, the term physician-assisted “suicide” is inappropriate.
“We (in the health care industry) tend to rob them of their ability to have agency,” Holland chimed in.
Tudico said the debate often circles back around to autonomy, which he said conservative lawmakers like Roe and Lundberg should be willing to understand.
“At the end of the day, that’s a decision about their well-being,” he said. “If we really value their choices and less government interference in people’s lives, it would seem to me that this is something we should advocate for.”
So far, some of the states which have legalized physician-assisted death have done so through a referendum, but Tennessee does not have voter initiatives. Since 2015, state legislators from both major parties have put forward two House bills and two Senate bills supporting physician-assisted death before they ultimately failed or stayed on file.