At the end of the day, every single person dies. The question is, what makes a “good” death, and how much control should people have over their deaths?
The Roger Mudd Center for Ethics explored these questions and more in a virtual panel on Feb. 11. The event brought three professors from across the country together to discuss the history and ethics of medical aid in dying as a part of the Mudd Center’s “How We Live and Die” series. Due to heavy snow, the lecture was moved from the Stackhouse Theater to Zoom.
Medical aid in dying (MAiD) is an option for terminally ill individuals to end their lives through prescribed medication.
“Many [terminally ill people] want to control the timing and manner of their death because, in the patient’s judgment, the burden of life outweighs the benefits,” said Thaddeus Pope, a professor at the Mitchell Hamline School of Law, in the panel.
While death seems far away for many in the Washington and Lee community, the reality is that every person will have an experience with death both directly and indirectly. The discussions surrounding medical aid in dying offers students and faculty members another perspective of how they or their loved ones may take control over their deaths in the future.
Pope said that 10 states and the District of Columbia have legalized MAiD. Patients must be over 18 years old, have a prognosis of six months or less to live, be mentally capable to make the decision and be able to administer the medication themselves to undergo MAiD, according to Compassion & Choices, a nonprofit organization working to improve patient autonomy.
Contrary to popular belief, MAiD is not the same as euthanasia or assisted suicide, Pope said. The difference between MAiD and euthanasia is who ultimately ends the life, he explained. Euthanaisa describes the process in which a healthcare provider administers life ending treatments to a patient, but MAiD requires patients to self-administer those treatments. According to Pope, euthanasia is not part of the current legislative conversation in any state.
Pope explained that it was important for the patient to have the final choice in MAiD in order to give them the most amount of control over their life and death. One-third of patients who get prescriptions to end their lives never take them, Pope said.
Despite MAiD not being legalized in Virginia, Pope said that terminally ill Virginians already take their lives into their hands by stopping life sustaining treatment, voluntarily stopping eating and drinking, and more.
“Virginia residents already choose the manner of their death every single day, and MAiD is just one more option,” Pope said.
In addition to explaining MAiD legislation, the panel explored individuals’ experiences with MAiD and the culture surrounding it. One of the panelists, Mara Buchbinder, a medical anthropologist, conducted a study of physicians, family members, friends and other related parties’ experience with MAiD in Vermont.
“One of the richest and most interesting parts of the study has been hearing about how people plan and even choreograph their deaths,” Buchbinder said.
Throughout the course of her study, Buchbinder documented stories about patients creating social events moments before their passing, from large ceremonies to small, intimate get-togethers. Buchbinder said it highlighted “the importance of social support and social connection in care for the dying.”
The panelists brought attention to the other side of the argument, too: MAiD can be used as a result of coercion or the fear of being a burden.
“The notion of being a burden at the end of life is inescapable. It’s not unique to MAiD, but I think that it has been erased from the public discourse on MAiD because it’s very dangerous to the advocacy arguments in favor of MAiD,” Buchbinder said.
While legislation around the country has many safeguards against coercing terminally ill patients to get MAiD, Pope argued that it has not done enough to protect patients from being coerced out of MAiD by family, friends and physicians.
Along with concerns around coercion, there are also racial disparities associated with MAiD. According to Pope, primarily college-educated White people use MAiD. Terri Laws, professor of African and African American Studies at the University of Michigan-Dearborn, said during the panel that African Americans are less likely to use or support MAiD because of their complicated history with the healthcare system.
“African-Americans are not looking for new or better ways to die, but rather looking for better ways to live: looking for better healthcare, not better death,” Laws said.
Laws said she’s concerned about the cultural impacts of MAiD.
“What are we doing when we’re legalizing [MAiD]?” Laws asked. “Are we in fact enculturating a particular type of death as the most courageous as the most preferred?”
