Is Euthanasia a Valid Route When Faced with Severe and Chronic Pain with No Feasible Medical Solutions?

Question: I have been having a tremendous amount of pain over the past year or so. I’ve seen multiple physicians seeking a solution, but it has so far resulted in very little relief. The constant pain has greatly impacted my quality of life. I live in Oregon and have recently started looking into euthanasia laws. Is severe, chronic pain a legitimate reason to pursue this if a medical solution remains out of reach?

Response from Rhoda Olkin, PhD: I am so sorry you are living with pain that is making life seem unbearable. Of course it has impacted your quality of life, how could it not? I’m not going to make suggestions about pain management, as I suspect you have tried many things and heard a lot of suggestions. Instead, I want to address your idea of physician-assisted suicide (PAS). Yes, it is legal in Oregon (and now in California, Colorado, Hawaii, Maine and Montana). I cannot answer whether you would qualify under Oregon law.

Now I want to address my concerns about PAS that may apply to you. First, people who choose PAS often have several things in common. They are more likely to be living alone, and isolation is a factor in their wish to die. Second, they tend to be female, White and in at least middle- or upper-middle-income brackets (it seems poor people struggle to survive, not die). They are usually (but not always) older. And depression compounds the problem of making the decision.

Informed consent means that the person is truly informed about all options, and about what the process would be like. Consent means that you are freely giving permission to proceed. This means you are not concerned with finances (e.g., your care is taking money away from family or kids’ inheritance), or with being a burden to others. It also means not making the decision through thinking that is clouded by depression.

Those who determine eligibility for PAS are two medical professionals. As a psychologist, I may be biased (probably am!), but I think that mental health professionals are better equipped to help you think through your reasons for wanting to die, as well as reasons for wanting to live. They can assess any depression and work on ways to improve your quality of life. They cannot eliminate pain, but they may help you figure out how to live with it, even when it seems like you cannot.

Family members need to be considered. Are there any minor children left behind? How do other family members feel about PAS? Are there any religious considerations, i.e., does anyone believe that PAS is a sin? Would they like to be informed beforehand? Would they want to be there?

In a country that does not have guaranteed health care for all, it seems ironic to me that we now allow PAS for all (in certain states). As someone who also lives with pain, and empathizes with how exhausting it can be, I nonetheless would suggest exploring all options for living better. Actively seek all things that give you even a modicum of pleasure.

Usually, the wish to die is transient, lasting about 24 to 48 hours, then it passes. It might return. But this irreversible decision should not be made when feeling suicidal. Some people feel better just knowing they have the medications to use PAS. They are there but do not have to be used. Every day can be another choice point. I hope you will choose each day to see it through.

Post-Polio Health (Vol. 40, No. 4, Fall 2024)