Federal lawmakers urge HHS Secretary to monitor assisted suicide

A bipartisan, bicameral letter has been sent to Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. urging HHS and the Centers for Medicare & Medicaid Services (CMS) to establish reporting requirements to better ensure that physician-assisted suicide laws are not discriminating against vulnerable people.

Key Takeaways:

• Senators James Lankford (R) and Tim Kaine (D) and Reps. Greg Murphy (R) and Luis Correa (D) have sent a letter to HHS Secretary Robert F. Kennedy Jr. calling for more reporting requirements where physician-assisted suicide is legal.

• The letter points to numerous problems with assisted suicide, including discrimination against vulnerable populations, chance of elder abuse, lack of drug oversight, negative impact on suicide rates, and lack of informed consent.

• Numerous disability groups have been actively fighting assisted suicide legislation for years, pointing to many of the concerns indicated in the lawmakers' letter.

The Details:

In their letter dated July 9, Sens. James Lankford (R-Okla.) and Tim Kaine (D-Va.), along with Reps. Greg Murphy (R-N.C.) and Luis Correa (D-Calif.) point to the various abuses that can occur with legalized assisted suicide, asking for federal oversight into a matter that has thus far been left to individual states to determine.

The letter states:

Physician-assisted suicide raises significant informed consent issues as well as concerns about disability and age discrimination. The vast majority of patients receiving physician-assisted suicide are enrolled in hospice—90% in Washington.

This poses challenges for HHS and CMS’ regulation of patient health and safety within the hospice program. We urge HHS and CMS to implement reporting requirements in the hospice program to monitor physician-assisted suicide for discriminatory practices against vulnerable populations...

The letter notes that in many cases, legalized assisted death sends a message to disabled people that their lives are less valuable.

In other cases, loose laws coupled with elder abuse and age discrimination often enable anyone — even someone who could profit from a patient's will or a disinterested caretaker — to act as a witness to the lethal drug request.

"These circumstances," the lawmakers say, "enable the possibility of financial exploitation."

The letter writers take issue with the fact that assisted suicide drugs are not approved by the Food and Drug Administration for the taking of human life. Further, they note that "physician-assisted suicide undermines America’s national posture of suicide prevention."

"Peer-reviewed data shows that where physician-assisted suicide is legalized, rates of suicide increase," they point out, noting the danger this poses as America faces an "epidemic of suicide."

"Physician-assisted suicide undermines suicide prevention services, normalizes premature death for vulnerable populations, and pushes society away from robust care, support, and the protection of life," they state.

Zoom In:

The letter makes several specific requests, asking Kennedy to monitor physician-assisted suicide practices for the following:

• Discrimination against individuals with disabilities, older adults, and other vulnerable populations;

• Proper disposal of unused medication and prevention of drug diversion;

• Insurance denials of life-sustaining medical care that offer to cover physician-assisted suicide drugs instead; 

• Drug complications;

• Consistency of drugs prescribed “off-label” for use in physician-assisted suicide;

• Compliance with federal restrictions on using funds, directly or indirectly, for health care items or services for physician-assisted suicide.

The Big Picture:

Currently, 13 states and the District of Columbia have legalized physician-assisted suicide. Though there are often "guardrails" or laws designed to ensure that a person seeking assisted death meets certain qualifications, as the letter writers noted, often too little is done to ensure that proper informed consent is taking place. They say:

There are grave informed consent issues within physician-assisted suicide. Patients spend little time with the physician providing physician-assisted suicide relative to the course of their disease.

Only 0.5% of patients received mental health referrals, even though many physician-assisted suicide patients show signs of depression, which can impair the decision-making process.

On top of this, “it is common for medical prognoses of a short life expectancy to be wrong,” and under the definition of terminal illness in physician-assisted suicide laws, “[t]here is no requirement that the doctors consider the likely impact of medical treatment, counseling, and other supports on survival.”

Numerous disability groups have been actively fighting assisted suicide legislation for years, pointing to many of the concerns indicated in the lawmakers' letter.

The Bottom Line:

"Every person has inherent worth and dignity, including those facing their final days,” Lankford said in a statement. “Hospice should be a place of compassion, comfort, and care, where the suffering are surrounded by loved ones and quality health care, not a place where they feel quietly pressured to end their lives through assisted suicide.”