Yesterday, a doctor asked me about “do or refer” provisions in some of the newer bills seeking to legalize assisted suicide in the United States. For this reason, I now address the subject in the context of a 2018 Wisconsin bill, which did not pass.
The bill, AB 216, required the patient’s attending physician to “fulfill the request for medication or refer,” i.e. to write a lethal prescription for the purpose of killing the patient, or to make an effective referral to another physician, who would do it.
The bill also said that the attending physician’s failure to comply would be “unprofessional conduct” such that the physician would be subject to discipline. The bill states:
[F]ailure of an attending physician to fulfill a request for medication [the lethal dose] constitutes unprofessional conduct if the attending physician refuses or fails to make a good faith attempt to transfer the requester’s care and treatment to another physician who will act as attending physician under this chapter and fulfill the request for medication. (Emphasis added).[1]
The significance of do or refer is that it’s anti-patient, by not allowing doctors to use their best judgment in individual cases.
Consider Oregonian Jeanette Hall. In 2000, she made a settled decision to use Oregon’s assisted suicide law in lieu of being treated for cancer. Her doctor, Kenneth Stevens, who opposed assisted suicide, thought that her chances with treatment were good. Over several weeks, he stalled her request for assisted suicide and finally convinced her to be treated for cancer.
Yes, Dr Stevens was against assisted suicide generally, but he also thought that Jeanette was a good candidate for treatment and indeed she was. She has been cancer free for 19 years. In a recent article, Jeanette states:
I wanted to do our law and I wanted Dr. Stevens to help me. Instead, he encouraged me to not give up and ultimately I decided to fight the cancer. I had both chemotherapy and radiation. I am so happy to be alive!
If “do or refer,” as proposed in the Wisconsin bill, had been in effect in Oregon, Dr. Stevens would have been risking a finding of unprofessional conduct, and therefore his license, to help Jeanette understand what her true options were.
Is this what we want for our doctors, to have them be afraid of giving us their best judgment, for fear of sanction or having their licenses restricted or even revoked?
With proposed mandatory “do or refer,” assisted suicide proponents show us their true nature. They don’t want to enhance our choices, they want to limit our access to information to railroad us to death.
Notes
[1] AB 216 states:
156.21 Duties and immunities. (1) No health care facility or health care provider may be charged with a crime, held civilly liable, or charged with unprofessional conduct for any of the following:
(a) Failing to fulfill a request for medication, except that failure of an attending physician to fulfill a request for medication constitutes unprofessional conduct if the attending physician refuses or fails to make a good faith attempt to transfer the requester’s care and treatment to another physician who will act as attending physician under this chapter and fulfill the request for medication. (Emphasis added).
Margaret Dore is an attorney in Washington State where assisted suicide is legal. She is also president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia worldwide.