Against LD 1313

An Act to Enact the Maine Death with DignityAct

Commentary

Senator Gratwick and Representative Hymanson and and members of the Joint Standing Committee on Health and Human Services. My name is Michael Clark and I am a family physician in private practice in Newcastle. I oppose LD1313. Thank you for the opportunity to address the Committee.

As stated, I am a practicing family doctor and provide care for patients of all ages—including those with serious illness and suffering at the end of life.

I have grave concerns about the unintended consequences of LD1313 for patients, for their families and for the healthcare profession.

I don’t have to remind everyone present about the current devastating opioid crisis that is destroying lives and families and overwhelming our healthcare system. This crisis was in part created by well-intentioned physicians trying to relieve the suffering of our patients, without a clear understating of the full impact and the unintended consequences our prescribing practices would produce on the community at large.

I appeal to this committee, as you deliberate the implications of LD 1313, to consider not only the painful testimonies of individual suffering, but also the overall impact of this legislation and its unintended victims:

Consider the aging mother with a new diagnosis of metastatic breast cancer whose desire to not be a “burden” to her adult children who live out of state, compels her to obtain a lethal prescription without their knowledge or opportunity to care for her in her time of need.

Consider the elderly couple with fixed income and few resources facing the new reality that the long-term care costs of the husband’s diagnosis of a degenerative neurologic condition will leave the wife impoverished, so he chooses death to protect her.

Consider the veteran whose physical scars only hint at the deeper emotional wounds that leave him isolated and keep him from getting the help he needs– and who concludes that physician assisted suicide is just a reasonable “treatment option”.

The final unintended victim I would ask you to consider is the integrity of my profession.

The doctor-patient relationship is fundamentally one that is based on trust, anchored by the central commitment of the doctor to, first, do no harm, and to always pursue the patient’s best interests.  Allowing doctors to give lethal prescriptions to their terminally ill patients destroys that central commitment and is ultimately just too dangerous.

Physicians are fallible human beings who are grappling with unprecedented levels of burnout and increasing levels of stress and cost pressures. To be frank, it is easy to write a lethal prescription. In contrast, it takes time, skill and great effort to provide good end-of-life care to our patients. It requires all of the physician’s faculties and skill poured out on behalf of their patient.

Physicians do not possess the prognostic power that LD1313 assumes. Research shows that even experienced specialists struggle to predict a terminal patient’s 6-month life expectancy or the clinical course of a particular patient’s illness. Physicians cannot provide the kind of informed consent that would otherwise be the standard of care for any other medical treatment.

Society has given physicians tremendous responsibility – precisely because of the sacred oath we all made to never harm those who entrust themselves to our care.

It is at great peril that we alter that fundamental commitment.

In conclusion, I leave you with the heartfelt observation of my 11-year-old, who, when asked about this legislation simply stated:

“Dad, doctors are supposed to relieve their patient’s suffering…not end it”.