Death, Dignity and Decision Making: Massachusetts Ballot Initiative No. 2

“It is hereby declared that the public welfare requires a defined and safeguarded process by which an adult Massachusetts resident who has the capacity to make health care decision and who been determined by his or her attending and consulting physicians to be suffering from a terminal disease that will cause death within six months may obtain medication that the patient may self-administer to end his or her life in a dignified manner.” So begins Section 1 of the “Death with Dignity” initiative petition, which will appear on the ballot in Massachusetts this November. The initiative, if passed, would make Massachusetts the third state in the country to enact a law concerning physician-assisted suicide. Laws were passed in Oregon in 1994 and Washington in 2008, and now Massachusetts residents will be asked a similar question.

Paula Span of the New York Times wrote in May, “November in Massachusetts would be plenty interesting this year even if the only electoral fireworks came from a high-profile Senate race and a presidential election pitting the candidate who carried the state four years ago against the candidate who was once its governor.” And the Massachusetts Senate race between Elizabeth Warren (D) and Scott Brown (R) has become one of national importance, as the majority in the Senate will be determined by a few key seats. Neither candidate has commented at length about their position on the issue.

The International Business Times (IBM) reported in late August that, “Just as is stipulated in the Oregon and Washington laws, under the Massachusetts initiative patients must meet a series of requirements before they can obtain a prescription. Qualified patients must have a terminal illness with a diagnosis of six months or less to live certified by a consulting physician, who must also certify the patient is mentally competent to make and communicate their health care decisions.” Some have questioned the meaning of the “self-administer” and “voluntary act” language, suggesting it is legally ambiguous and provides no safeguards for physicians abusing the law.

Margaret Dore, a Washington-based attorney, said that the law lacks clarity with respect to patient choice. According to the IBM, “While the law explicitly states that ‘such a process be entirely voluntary’ on the part of the patient, Dore argues that ‘self-administer’ can legally mean something as simple as being able to physically ingest the medication, not necessarily administer it in the proper sense of the word. “

“Ingestion does not require a ‘voluntary act,’” Dore said. “They say this is about your choice. But the way the law is written, choice is not assured.”

A few stories have appeared recently. The Atlantic Monthly published a piece, “How the Catholic Church Misunderstands Death with Dignity,” where Wendy Kaminer argued that, “This view of suicide as selfish, even when undertaken to avoid extreme pain and suffering, is central to the debate over it.” She also suggested in the piece that, contrary to Cardinal Sean O’Malley’s sermon against the measure, “The people must approve the Massachusetts Death with Dignity proposal at the ballot box. It will not be a directive laid down by ‘the government.’”

It is this issue that is perhaps the most pressing for Christians to consider as we near November 2nd: is this measure best decided by ballot box? What does it mean for our legal and political community to put a question of such serious moral import – with implications ranging from the sanctity of human life to the meaning of “voluntary” to our understanding of suffering – among a list of other initiatives on a November ballot?

As Boston Globe writer Lisa Wangness wrote in a Sept. 11 article, “Rarely does the political system confront matters of life and death so directly. With Election Day less than two months away, many religious leaders are intensifying their focus on the question.”

I want to suggest that, more important than the particular positions taken by denominations or faiths, more critical than the passing of the initiative (or not), is an examination of the arena in which we discuss these questions. Placing a question about physician-assisted suicide (or death with dignity) on a ballot eliminates the possibility for dialogue with the parties outside the immediate political realm. Churches, medical communities, and families all have serious stakes in the conversation. They all have deeply rooted beliefs about pain, suffering, and human freedom. These beliefs cannot be enacted by a simple “Yes” or “No” box on a paper in a booth at the local elementary school. Nor do I believe they should be. We are quick in this country to put things to a legal test – either in courts, through petitions, or through the people we elect. And certainly the government is responsible for properly administering justice and ensuring the protection of human health and welfare.

But the Massachusetts ballot initiative does not ask how the government can best ensure the protection of human health and welfare – as I would like it to – but instead asks us to decide with our vote the very meaning and definition of health and welfare.

As the initiative continues to make news heading into the final stretch of the election cycle, might I suggest that we ask ourselves not only what we might vote on a given initiative, but also whether that initiative truly belongs on a ballot? Is the election arena the best place to reach consensus about the meaning of human welfare? Is filling in a bubble on a form the best way to make decisions with such moral weight?

-Hilary Sherratt is a recent graduate from Gordon College, where she majored in Religion, Ethics and Politics. She is currently working as a grant writer at Gordon, and loves all kinds of writing. She hopes to eventually get her PhD in theology or history. She blogs about everyday life at and tweets at @hilarysherratt
Photo courtesy of Lee Cullivan