Little evidence that poor, uninsured will seek assisted suicide

California Gov. Jerry Brown has signed into law a bill that will allow terminally ill patients to legally end their lives with doctor-prescribed drugs, despite objections from some religious groups and rights advocates who worry that the poor or disabled might be offered a right-to-die option as a cheap alternative to costlier life-saving treatments.

"There is a deadly mix when you combine our broken health care system with assisted suicide, which immediately becomes the cheapest treatment," Marilyn Golden, a senior policy analyst at the Disability Rights Education & Defense Fund in Berkeley, California, told Reuters on Monday. "The so-called protections written into the bill really amount to very little."

But the available data from two of the four other U.S. state that have similar legislation — Oregon, Washington, Vermont and Montana — show that these fears may be unfounded. The legislation in Oregon and Washington, the two states for which Al Jazeera was able to obtain data, has been used rarely, and almost exclusively by the terminally ill and insured.

“I had colleagues saying they were really concerned about the effect on vulnerable populations — people without insurance, people who were poor,” said John Dombrink, a professor of criminology, law and society at the University of California, Irvine and co-author of the book “Dying Right: The Death With Dignity Movement.”

But when looking at the numbers from Oregon and Washington, Dombrick said, “I don’t think the data bear that out … 100 deaths is such a small part of the people who die in Oregon.”

In Oregon, where terminally ill Brittany Maynard moved from California to end her life in a highly publicized case that reignited the debate in her home state, 105 people died in 2014 as a result of the state’s Death with Dignity Act (DWDA), according to Oregon’s Public Health Division. State records show a total of 34,160 Oregon residents died that year, 781 of them by suicide.

Two-thirds of the patients who elected to die that year had cancer, and 16 percent had amyotrophic lateral sclerosis (ALS), often known as Lou Gehrig's disease. All of them had some form of health insurance and nearly half were well-educated, with 47.6 percent earning at least a bachelor’s degree.

The new California law is modeled after Oregon’s 1997 legislation. It requires confirmation from two doctors that a patient has six months to live and is mentally competent, before a doctor can prescribe life-ending drugs. A previous version of the bill failed to advance in the State Assembly in July, and a similar bill was shot down in 2007. The new legislation was passed on Sept. 11 but went unsigned for weeks while Brown, a former Jesuit seminarian, grappled over whether or not to sign it, reportedly consulting with multiple doctors and a Roman Catholic bishop.

In the state of Washington, the numbers are similar. In 2014, 126 people died after taking prescribed medication through the state’s own DWDA, according to the Washington Department of Public Health (PDF). Seventy-three percent of them had terminal cancer, 13 percent had a neurodegenerative disease such as ALS and 14 percent had other illnesses including heart and respiratory diseases. About 93 percent of them had some form of health insurance, and 76 percent had at least some college education.

At least two dozen states introduced physician-assisted suicide legislation this year, and the New Mexico Supreme Court will hear arguments on Oct. 26 on an aid-in-dying case that was struck down by the Court of Appeals, according to local media.

There is growing support among American adults for assisted suicide, with 68 percent in favor of doctor-assisted suicide for terminally ill patients living with severe pain, according to a May 2015 Gallup poll — a 17 percent increase from 2013.