WATCH
YOUR LANGUAGE!
discussing the terms we use
in the right-to-die debate
"medication"—"life-ending
chemicals"
OUTLINE:
A.
"MEDICATION" WAS ORIGINALLY A EUPHEMISM
B.
USING THE WORD "MEDICATION"
MAKES SUCH LAWS VULNERABLE TO ATTACK
USING DRUG-CONTROL LEGISLATION
C. GIVING DOCTORS EXCLUSIVE POWER
A.
"MEDICATION" WAS ORIGINALLY A EUPHEMISM
Beginning with the Oregon Death with Dignity Act in 1994,
laws
permitting physicians to prescribe drugs
for the purpose of
achieving a voluntary death
have described these drugs as
"medication".
This is a misleading use of the word
"medication".
And it could lead to some unintended
consequences.
When doctors prescribe
pharmaceuticals for a patient,
it has always been for the purpose
of
curing
or treating
some disease or condition,
to enhance or preserve the life
and health
of the patient.
But now the laws of some jurisdictions
permit physicians to write prescriptions for chemicals
with
the intent of causing the patient to die.
Most people will not be misled
by having the means of
death described as a "medication",
but there might be a
few
people who will be confused
by this way of speaking and/or
writing.
For example, what happens
when the
doctor, nurse, or family members says:
"It's time to take
your medication."?
Might the patient think: They are trying
to kill me!
Have they decided it is time to bring my life to an
end?
When the same word "medication"
is used for
chemicals
that can cure
and chemicals
that can kill,
what
is the sometimes-confused patient to think?
Similar expressions to be avoided for the same
reasons
include "medicine", "prescription",
and other expressions
drawn from the use of chemicals in
the healing arts.
Even tho the same
drugs in smaller amounts
might be prescribed to help a patient to
sleep,
the
only purpose for these chemicals in right-to-die laws
is to
produce a peaceful and painless death.
Therefore the chemicals should be correctly described:
They are
chosen because they will induce death
within a few hours at the
most.
Therefore they are lethal
drugs,
life-ending
chemicals,
a lethal
prescription,
or gentle
poison.
No
dictionary contains this use for the word "medication".
B.
USING THE WORD "MEDICATION"
MAKES SUCH LAWS VULNERABLE
TO ATTACK
USING DRUG-CONTROL LEGISLATION
Some opponents tried to overturn Oregon's Death with Dignity
Act,
complaining that death is not a legitimate use of
prescription medications.
This case went all the way to the U.S.
Supreme Court.
The Court ruled that the federal drug-control law
was not intended to apply to drugs prescribed by physicians.
If
it had been legitimate for the federal drug-control legislation
to
apply to prescription medications,
then every
prescription
written by a doctor anywhere in the USA
could be
reviewed by the Attorney General of the United States.
This would
have intolerably extended the powers of that office.
To overturn this ruling by the Supreme Court,
federal and state
legislation has been introduced
to
prevent using prescription drugs to induce death.
Opponents
of the right-to-die claim that
using prescription drugs to
produce death
is never a legitimate use of pharmaceuticals.
If
any such prohibitive legislation were to pass,
or if any
government agencies succeed
in controlling such use of
'medications',
then any laws that depend on physician-prescribed
drugs
might be overturned in that jurisdiction.
It seem unlikely that any such attempts will succeed
in taking away the power of doctors to prescribe life-ending
chemicals.
But the tide of political power can always shift.
And
if we have a high-profile case
involving the misuse of
prescription drugs,
public opinion might shift against laws
permitting lethal prescriptions.
Whenever
such right-to-die laws are created anywhere in the world,
the
legislators who oppose the practice
will attempt to tighten
regulations concerning prescription drugs
so that controlled
substances cannot be used to cause death.
In a few countries, this
is likely to succeed.
And if chemicals prescribed by a
physician
is the only method of managing dying included in such a law,
the
law becomes completely useless, null, & void.
A completely different kind of right-to-die law
outlaws
causing premature death
and permits
deaths that are not premature.
Because
this new approach to controlling life-ending decisions
does not
depend on physician prescriptions at all,
it is not
vulnerable to drug-control legislation.
D.
REPLACING THE WORD "MEDICATION"
Let's
examine some possible alternatives to "medication":
1. "life-ending drugs"
2.
"life-ending chemicals"
3.
"deadly drugs"
4. "gentle
poison"
5. "peaceful pill"
6. "death pill"
7.
"peaceful-death chemicals"
8.
"poison"
1. "LIFE-ENDING DRUGS"
Instead of using the word "medication",
we could substitute "life-ending drugs".
This would
make the discussion more honest and forthright.
We should not use
euphemisms
when we are discussing something as serious as
death.
Patients for whom English is not the primary language
could
possibly be led into serious mistakes
if the chemicals are
described as "medication"
and translated into the
patient's native language
as something that is intended to
cure.
An even more honest expression would
be:
"lethal drugs" or "deadly drugs".
Oregon
physicians are now permitted to prescribe lethal
drugs
with
the explicit intention of helping their patients to die.
If
"lethal drugs" seems too stark, "life-ending drugs"
is more gentle,
but it does say exactly the same thing:
These
substances are intended to bring death.
Our
laws should always say exactly what they mean.
Other terms besides "lethal drugs" might make such state
laws
less vulnerable to attack using the drug-laws
and/or
drug-enforcement agencies.
What
if
doctors could prescribe some special chemicals
that are NEVER used
for any other purpose than to induce death?
Then opponents would
not be able
to use the laws intended to control narcotics
as
means of preventing people from claiming the right-to-die.
In
other words, the chemicals used to produce death
would never be
listed in any laws
intended to control the recreational use of
drugs.
And if the chemicals were not
prescription drugs,
they
would not fall under the laws controlling prescriptions.
But opponents of the right-to-die might still attempt
to use the
government power to license physicians
as a way to prevent
physicians from prescribing
chemicals intended only to cause death.
Laws
like Oregon's Death with Dignity Act
grant a special power to
licensed physicians
—the
exclusive power to write a prescription
for death.
The
basic reason for giving doctors this power
is that we want doctors
to review the life-ending decision
from the perspective of someone
who deals professionally
with life-and-death questions.
The
doctor makes a professional recommendation for death
based on the
knowledge that medical training provides.
The doctor's
participation is a safeguard
to prevent premature death.
If we were able to devise some other combination of
safeguards,
perhaps we would not have to depend
on this
exclusive power of physicians to prescribe controlled
substances.
Or perhaps only a certain
sub-set of licensed physicians
would also be authorized to
provide chemicals intended to cause death.
If we worry about physicians abusing their power to write
prescriptions,
several safeguards are linked from the following
discussion:
Will
My Doctor Prescribe an Overdose of Drugs?
2. "LIFE-ENDING CHEMICALS"
An
alternative to "life-ending drugs" would be "life-ending
chemicals".
This might be preferred because even the word
"drugs"
could be misunderstood, especially in
translation.
Drugs are generally prescribed to cure
the patient, not to kill
him or her.
If the word "drugs" is used for both
purposes,
some confusion might easily arise.
But the word "chemicals" does not usually point to
curing.
Chemicals are used for thousands of purposes.
And these
chemicals would be described as "life-ending".
The
expression "life-ending chemicals" might be a little long,
but are there any problems of understanding?
Consider the
following sentence:
"We are now considering whether to use
life-ending chemicals."
3.
"DEADLY DRUGS"
The
expression "deadly drug" has a very long history in
medicine.
The Oath of Hippocrates has the new physician
vowing
never to give a "deadly drug" even if asked.
Thus for
thousands of years, physicians have known
what substances will
produce death.
This doctors' oath will have
to be changed, of course,
but the ancient vows have already been
changed in a number of ways.
Putting these
two words together—"deadly" and "drugs"—
should
make clear what
the chemicals are intended to do.
But
an even clearer expression would leave out the word "drugs",
because
that word has other very important meanings.
"Gentle
poison" is chosen for a chapter of this book:
Gentle
Poison: The Demand for Quick Death.
5. "PEACEFUL PILL"
The metaphor "peaceful pill"
points in the same direction.
There is actually no such pill in
existence.
But the concept
encapsulates our dream of a peaceful and painless end.
We wish for a
simple way to make today the last day of our lives.
Of course, if there were a "peaceful pill",
there would
be danger of people using for irrational suicide.
Perhaps
if each human body had a suicide
button,
almost
everyone would use it sooner or later.
If it were too
easy to kill ourselves,
we
would do it capriciously and when in despair.
We need safeguards
for life-ending decisions
to protect us from ourselves in our
darker moments.
Because "peaceful
pill" is a figure of speech
rather than an actual capsule of
chemicals,
it is not likely to be used in any legislation
concerning the right-to-die.
But some longer and more accurate
expression might be invented
to describe the life-ending process
intended.
6.
"DEATH PILL"
The
concept of a "death pill" seems natural
when we
consider exactly what actions we are planning.
We are hoping that
we can simply take a pill at the end of our lives
in order to
ensure that we will have a peaceful and painless death.
There
probably will never be a single pill that would produce death.
But
the bottle or box of chemicals might be our "death
pill".
This concept shares with others
the problems associated
with using the word "pill" in
this context.
Pills are normally what
we take in order to improve our health
and
to save
ourselves from premature death.
So we need clear ways to say that these "death pills"
are
definitely NOT
like any of the other pills we have ever taken.
7.
"PEACEFUL-DEATH CHEMICALS"
Instead of "death
pill", we could say "peaceful-death chemicals".
This
expression does not use either the misleading word "pills"
or
the misleading expression "drugs".
"Peaceful-death chemicals" is a cumbersome expression,
but
it does seem to describe exactly what is happening:
We are putting
chemicals into our own bodies
or into the bodies of people we
love
for no other purpose than to
produce a peaceful death.
Also, this expression, does not suggest
that the chemicals need
to be taken by mouth.
"Peaceful-death chemicals" could
also be administered in other ways,
such as injecting
them into the body of the patient to achieve death.
8.
"POISON"
If a right-to-die law were to
use the word "poison",
the debate would gain a new tone
of seriousness.
First, the particular
chemicals or other substances
would not fall under any
drug-control legislation
because people who take recreational
drugs are not planning to die.
Thus all laws that attempt to
control named chemicals
because they are harmful to the
recreational users
will not apply to other chemicals that might be
taken
by patients who have wisely chosen a shorter process of dying.
Life-ending poisons are specific chemicals
taken with the
explicit purpose of bringing peaceful and painless death.
And
doctors are not the gatekeepers for all poisons.
Perhaps some laws
permitting chosen death
will say that the patient may use a poison
that was obtained in some other way
than being
prescribed by a doctor and bought from a pharmacist.
Or the law
could leave it to the dying patient
to decide exactly what poison
he or she wants to use.
Opponents of the
right-to-die
might suggest new laws to control poisons.
But
whenever they prevent one substance from being sold,
other poisons
will be suggested.
The whole chemical industry would be overrun by
government agents
trying to prevent people from using specific
chemicals to cause death.
Such poison-control methods
of
attempting to prevent people from claiming the right-to-die
would
create such chaos in the chemical industry
that such efforts
would be quickly abandoned.
Replacing the
word "medication" with the word "poison"
takes
the process out of the hands of physicians.
Physicians are
licensed to prescribe and/or dispense medicines,
which
were always invented to cure diseases
or control physical
problems patients do not want.
We know that when taken in large
amounts,
most medicines will have toxic effects.
This is
one reason that doctors are given the power to decide
how much
medicine to prescribe at any given time.
But poisons have never been associated with doctors.
And doctors
do not control access to all poisons.
When we have rationally
decided to draw our lives to a close
(probably based on medical
information provided by our doctors),
we do not need to ask our
physicians to provide the methods
by which we choose to end
our lives.
The same psychological
objections to using "gentle poison"
also apply to the
shorter expression—"poison".
We will probably not
use this expression because it is so negative.
We do not want to
end our own lives using poison.
And we do not want to
poison the people we love.
E.
THE BEST ALTERNATIVE EXPRESSIONS
WILL
BE DECIDED BY
LEGISLATORS WHO WRITE NEW LAWS
Other suggestions besides the eight above are welcome.
When new
laws allow chemicals to be used to cause death,
the legislators
will be in charge of the exact wording.
And if any new law gives
doctors the power to control the chemicals,
they will probably not
be called either "poison" or "gentle poison".
A
less-dramatic but accurate expression might be "life-ending
drugs".
But the fact that we have
seriously considered
"deadly drugs", "poison",
& "gentle poison"
has caused us all to consider exactly what we are proposing.
We are discussing the
intentional termination of a human life.
Let our laws say
exactly what they mean.
Choosing death for ourselves or for the
people we love
has nothing to do with taking "medication".
Created
March 16, 2007; revised 3-22-2007; 3-29-2007; 3-30-2007; 4-4-2007;
4-10-2007;
6-3-2007; 9-4-2007; 10-2-2007; 1-18-2008;
1-18-2012; 1-19-2012; 2-22-2012; 3-29-2012; 7-18-2012; 9-12-2012;
10-17-2012;
5-4-2013; 6-24-2013; 7-18-2014; 11-16-2014; 5-1-2015; 7-7-2015;
3-26-2016; 4-1-2016; 3-28-2018;
Alternatives to "medication"
used in
various right-to-die laws and bills
California
End of Life Option Act (2015)
"aid-in-dying
drug"
http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520162AB15
Quebec Act Respecting the End of Life
"medical
aid in dying"
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/SG-QUEB2.html
Read
about "physician-assisted
suicide"—"physician aid in dying".
Read
about "hastened
death"—"timely
death".
Read about "euthanasia"—"gentle
death".
Go to Safeguards for Life-Ending Decisions
Go to Portal for the Right-to-Die