Mary Kills People is a new Lifetime TV series about a fictional physician who leads two lives: By day she is an emergency room doctor, but while away from the hospital, she helps terminally ill people end their lives.
While I only have seen the first of six episodes, which aired last night, as a longtime family physician who treated patients from the cradle to the grave, I hope that it will provoke viewers to discuss their end-of-life care wishes. I also hope that it will not confuse viewers about the significant differences between the terms “assisted suicide,” “euthanasia” and “medical aid in dying.”
Euthanasia, also known as “mercy killing,” is illegal throughout the United States. In euthanasia, someone other than the dying patient administers a lethal drug to an individual.
Assisted suicide also is illegal throughout the United States. In fact, by definition, a suicidal person is mentally ill, suffering from severe depression and usually acting alone and often in a tragically violent manner.
In contrast, medical aid in dying is an option only for mentally capable, terminally ill adults with six months or less to live to peacefully end unbearable suffering. It is now authorized in the District of Columbia and six states that collectively comprise 18 percent of our nation’s population. In addition, bills authorizing this end-of-life care option have been introduced in 25 states since January.
Medical aid in dying has strict eligibility criteria as well as guidelines that meet the highest standard of care. Although each state’s law differs slightly, they all contain core safeguards, such as the attending physician must inform terminally ill adults requesting medical aid in dying about other end-of-life options. They include comfort care, hospice care and pain control. In addition, the terminally ill adult must be able to ingest the medication themselves. The currently authorized states also require patients seek a second physician’s medical opinion to confirm their terminal diagnosis, prognosis, and their mental capability to make this decision without coercion. If either physician is unable to determine whether the individual is capable of making this decision, they must refer the person to a mental health specialist for further evaluation. Mary does not follow any of these protocols in the show.
In Oregon, where I practiced family medicine for 35 years, medical aid in dying has been an end-of-life care option for nearly 20 years without any documented case of abuse or misuse. The Oregon Health Authority’s annual reports show most state residents who request it are enrolled in hospice care programs.
Mary Kills People clearly is not how medical aid in dying is practiced in authorized jurisdictions here in the United States. It is fictional, and it is entertainment. People should not confuse Mary’s illegal “services” in this fictional place with authorized, regulated end-of-life care options in the United States.
The reality is the show portrays an empathetic doctor who exceeds her medical practice boundaries, and fails to abide by medical ethical codes and laws. Compassion & Choices does not support euthanasia and assisted suicide. But we do advocate for expanding and improving authorized end-of-life care options for terminally ill adults to relieve their suffering.
Dr. Grube is national medical director for Compassion & Choices and a former chair of the Oregon Medical Board.