Should terminally ill patients be able to ask their doctors to help them end their lives? Voters in Massachusetts will address that controversial question on Nov. 6. If passed, the "Death with Dignity" initiative — also known as Question 2 — would allow a patient with less than six months to live to request medication that would end his life.

 

Similar physician-assisted suicide laws are on the books in Oregon and Washington, as well as in some other countries, such as Switzerland. Backers of Question 2 include the American Civil Liberties Union and the Massachusetts Death with Dignity Coalition.

 

The Massachusetts measure (pdf) would make the process entirely voluntary. Patients must be suffering from a terminal condition that has been confirmed by at least two doctors. The patient must also possess the mental capacity to make a request to the doctor. Patients would be required to make their requests at least three times: twice verbally and once in writing, with witnesses. If the life-ending medication were prescribed, it would be self-administered by the patient.

 

The bill's supporters say it will ease the pressure on families. "It is not a choice between life and death. It's a choice of the exact timing and the manner of death because these patients are dying," Dr. Marcia Angell, former editor of the New England Journal of Medicine, told NPR.

 

Others opposed the bill for a variety of reasons. "No civil right to commit suicide exists in any social compact," said Ira Byock, director of palliative care at Dartmouth-Hitchcock Medical Center. Writing for The Atlantic, he says it is easier for patients in Oregon to get approval for doctor-assisted suicide than it is for them to get approval for hospice care.

 

The Massachusetts Medical Society has also come out against the bill, saying it is unnecessary. According to a statement on the society's website, "Assisted suicide is not necessary to improve the quality of life at the end of life. Current law gives every patient the right to refuse lifesaving treatment, and to have adequate pain relief, including hospice and palliative sedation." The society also says life expectancies for people with terminal illnesses are hard to estimate and witnesses could be biased if they would financially benefit from a patient's death.

 

Opponents of the bill have raised more than $1.6 million to fight it, compared with less than $500,000 raised by supporters, according to the Associated Press. Although opponents have raised more money, at least one poll suggests that more than 60 percent of Massachusetts voters support the bill.

 

Massachusetts is not alone facing the question of physician-assisted suicide. According to a report in The Economist, bills regarding assisted suicide are pending in England, Scotland, New Zealand, Quebec, and New South Wales in Australia. The magazine writes that this "reflects a big shift towards secular thinking and individual autonomy as well as growing worries about the medicalized, miserable and costly way of death that awaits many people in rich countries."

 

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