The greatest challenge we face comes not from pain and suffering, but from fear and ignorance. Physicians' ignorance of pain management techniques, and fear of using what they do know, leaves many patients to die in pain. Current medical practice, not medical capability, is failing patients. Patients' ignorance about their rights, and their fear, lead many to believe that they are destined to a painful death or an existence ravaged by the overuse of medical technology.

Painful and undignified deaths happen every day. Tragically, such deaths are essentially unnecessary. Our response to the ignorance, fear, and desperation associated with illness should be EDUCATION, HOPE, and LIFE AFFIRMING SUPPORT. We fail if our solution to suffering is to kill those who suffer.

Perhaps most disconcerting about the arguments made by euthanasia proponents is the glossing over of important social implications of such a policy. Bias in medical treatment against disabled, elderly, and indigent persons is well documented. Race and gender have also been shown to be factors in medical prejudice. If, as proponents suggest, an intolerable "quality of life" can justify a desire to die, illnesses which may evoke a desire to die will only be exacerbated by factors such as disability, age, economic disadvantage, and social isolation. Persons in our society already most vulnerable to discrimination and exploitation will have a new threat added to their lives. Legalized euthanasia would create a sentiment that their continued existence, with its ostensively "low quality," would have to be justified. In short, there will be a compulsion for some to commit suicide, to escape a life that has been made intolerable more by social conditions rather than by physical conditions.

Euthanasia proponents also cannot provide clinically-based research which shows that suicidal desires on the part of terminally ill or chronically suffering persons can be considered rational. There is a presumption, indeed a prejudice, that persons facing chronic or terminal illness could "rationally" desire suicide. But no clinical evidence supports this presumption. On the contrary, terminally ill persons are at no greater risk for suicide than the general population. In addition, the weight of clinically-based evidence indicates that nearly all instances of suicidal desire can be traced to diagnosable psychiatric morbidity.

Beyond the ignorance, fear, and prejudice that euthanasia adovcates perpetuate, they cannot offer a logically consistent rationale for their proposals to legalize assisted suicide and euthanasia. The subjective nature of the criteria for determining who would be eligible for assistance makes legislating this area impossible. Arbitrary and contradictory standards for permitting death assistance have been offered in no less than three pieces of legislation previously introduced in the Michigan Legislature. For example, one bill [sponsored by Sen. Berryman] would allow only self-administered lethal drugs only for "terminally ill" patients (within six months of death). A second bill [sponsored by Rep. Wallace] would allow assistance, including direct lethal injection, for the terminally ill and those suffering from intractable pain. A third bill [sponsored by Rep. Martinez] would allow all forms of death assistance, with no requirements as to the patient's condition, so long as the patient and two physicians agree that the patient is better off dead. It is obvious that no objective standards have, or ever could be established, for when a patient's suffering has become sufficiently "intolerable," and thereby justifying death assistance.

The slippery slope toward involuntary euthanasia is a real and ominous concern. Logic, law, and history refute the argument that allowing assisted suicide will not lead to involuntary euthanasia. Legal arguments presented in defense of a right to assisted death depend on court decisions addressing the "right to die" for incompetent patients. Yet no defense is offered to explain how those same court precedents allowing withdrawal of medical treatment for incompetent patients would not be applied to authorizing euthanasia. Neither can we ignore the Dutch experience. The Dutch now allow "involuntary euthanasia" ("murder," in this country) for incompetent patients and are drawing up guidelines for euthanizing handicapped newborns. The slippery slope is not a fictional threat. It is a reality.

Allowing assisted suicide would subvert the traditional role of the physician as healer and create a conflict for physicians in their practices. Both the national associations of allopathic (M.D.) and osteopathic (D.O.) physicians have rejected assisted suicide as acceptable medical practice. The American Medical Association in December 1993 adopted a report which held that permitting assisted suicide "would involve physicians in making inappropriate value judgments about quality of life."

Finally, the foundational arguments made for a "right" to suicide assistance are based on flawed reasoning. The first flaw in asserting a right to assisted suicide is the idea of providing a right based on one's physical condition. Such a prerequisite is unprecedented in our theory of rights. Second, assisted suicide is a right without guarantee. Individuals may request assistance, but no physician is required to provide that assistance. The right and power granted would lie with the physician, not the patient. Legalizing assisted suicide would only transfer power from vulnerable patients to physicians.