Free to Die and Free to Speak

BY JERRY DINCIN – When the state of Georgia arrested four Final Exit Network volunteers, it accused them and our group, which advocates for the right to die with dignity, of assisting in suicides. In doing so, it drew attention to a Georgia law that violates the First Amendment right to free speech — and now FEN has brought an action in U.S. District Court to defend its rights.

Georgia’s prosecution has revived a legal row likely to play out across the country in the months and years ahead.  “Assisted suicide,” as it is so often and unjustly called, has been a controversial subject since at least the 1990s, when Michigan doctor Jack Kevorkian was imprisoned for helping terminally ill patients die. Quite a few states have passed laws against actively providing “aid” or “assistance” in another’s death. Ironically, Georgia’s statute isn’t explicit on that point.

Rather, the state’s assisted suicide law (O.C.G.A. 16-5-5) says that anyone who “publicly advertises, offers, or holds himself or herself out as offering” to aid another in “suicide” is committing a felony. In other words, the law bans talking about aid in dying. That makes it unconstitutional under the First Amendment. A state has no more right to ban speaking about assistance in death than it does to outlaw political speech or controversial books.

The fact is, a small number of terminally ill patients, finding themselves incapacitated or in agony, choose to bring an end to their suffering. It is unfortunate that assistance in death is called “assisted suicide” no matter what the circumstances. The people who rationally decide to terminate irreversible suffering are not “suicidal” and do not wish to die any more than the next person. Their decision should not be likened to the tragedy of an untimely death by real suicide.

FEN’s volunteers are deeply sympathetic to the wishes of these patients, and believe that being able to choose whether to live or die should be a basic human right for those under extreme medical circumstances. However, no one in our organization has ever actively aided in another person’s death.  Aid in dying is now legal, but only for a physician, in Montana, Oregon and Washington. “Physician aid in dying” will not likely be legal in other U.S. states within the next few years. But it’s not what we do: we do not aid in dying and we are not, most of us, physicians.

Rather, our volunteers provide information, counseling, and moral support to terminally ill patients who are considering ending their lives. Usually they’re grappling with conditions like Alzheimer’s, with its slow, painful descent into advanced dementia; Lou Gehrig’s disease, in which bodily functions, from speaking to swallowing, fail one by one; or inoperable pancreatic cancer, with its crippling abdominal pain. Usually, those patients have already explored all known methods of treatment, in vain.

FEN provides two services. First, our volunteers give information on hastening death to those who feel that an incurable medical condition has made life intolerable. Second, we provide compassionate company in the final moments. Technically, since our volunteers share information on how to induce death with certainty and without suffering, Georgia authorities were following their state laws when they brought charges against four of our members in 2009. But that law shouldn’t exist in the first place. That’s why FEN recently brought an action against Georgia in U.S. District Court, to vindicate the free speech rights of our volunteers.

The U.S. population is aging. At the same time, advances in medical science are transforming the way we experience death. It used to be that dying was mostly natural, inevitable, and quick. Now, medicines and machines make it possible to keep a dying patient on life support for years. Real choice needs to become a part of the process. And when death becomes a matter of choice, individuals should have the freedom to make it for themselves.

Because of these demographic and scientific shifts, we expect to see the debate over the right to die intensify. Meanwhile, more and more people will seek out the counsel of organizations like FEN. As we undergo this change as a society, let’s keep our constitutional rights — and our freedoms — in sight.

Jerry Dincin, Ph.D., is the President of Final Exit Network and a retired psychologist with more than 30 years of clinical experience. The website for Final Exit Network is www.finalexitnetwork.org.

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