Illinois Catholic civic and health advocates are bracing for an expected attempt to make physician-assisted suicide legal in the state sometime in the next two years. “It’s imminent,” said Patrick Cacchione, executive director of the Illinois Catholic Health Association. The national medical director of Compassion & Choices, an advocacy group for what it calls “medical aid in dying,” spoke on the Springfield campus of Southern Illinois University’s medical school Oct. 17, and lawmakers have said they expect to consider a bill legalizing the practice in the next year or two. The practice has been legalized either by referendum, vote of the state legislature or court decision in nine states and the District of Columbia. The first was Oregon, where voters narrowly passed the “Death With Dignity Act” in 1994, but it didn’t take effect until 1997, when the U.S. Supreme Court ruled that it did not violate the U.S. Constitution. The next state to approve physician-assisted suicide was Washington, more than 10 years later in 2009. Most of the states that have approved it are on the East or West Coast, said Robert Gilligan, executive director of the Catholic Conference of Illinois. “That seems to be their strategy,” he said. Gilligan and Cacchione said Catholic public policy groups are working now to build coalitions with others that oppose physician-assisted suicide, especially those that advocate for people with disabilities. They also will work to figure out what kinds of messages work best. “We’re really in the infancy of our campaign,” Cacchione said. “It’s going to be an uphill, difficult fight. They’re going to make it an issue of choice, like the abortion issue. My body, my choice. My death, my choice.” Dr. Daniel Sulmasy, acting director of the Kennedy Institute of Ethics at Georgetown University and a professor of biomedical ethics, said that patient autonomy is one of the main arguments advocates for physician-assisted suicide rely on. He spoke to members of the Catholic Health Association in an Oct. 24 webinar. Patient autonomy is not the only thing that matters, he said. Doctors must also weigh whether any kind of intervention is good for the individual patient and good for society. Advocates also say physician-assisted suicide is necessary to address unendurable pain in terminally ill patients, but Sulmasy said that just isn’t true. Doctors can give medication to control pain for those who are terminally ill, even if that medication will shorten the patient’s life. “The difference is, are you doing this to control symptoms? Or are you doing this to kill the patient?” he said. In reality, what research exists on physician-assisted suicide shows that more patients request a fatal prescription because they fear a loss of control or being a burden to their loved ones more than pain. That raises its own issues, he said. If people are seen as justified in killing themselves to avoid becoming dependent on others, what does that say to people with disabilities who are dependent on others for their whole lives? “It means there’s a judgment being made that their life is not worth living,” Sulmasy said. At the same time, it sends a message to people who are not terminally ill and want to commit suicide. While the suicide rate is rising all over the United States, especially among young people, it is rising faster in states that have allowed physician-assistant suicide, he said. During the webinar, Sulmasy gave doctors possible responses to such arguments. He also encouraged them to join medical professional groups so that they can help stop people from changing their stance toward the practice away from saying it should be forbidden. “At surface, it seems reasonable to say people disagree about this so we should be neutral,” Sulmasy said. “But in this case, neutrality is not a neutral position.” That’s because if organizations such as the American Medical Association do not oppose the practice, they are tacitly endorsing the idea that it should be permitted, he said. That goes even in a time when more states are allowing the practice, Sulmasy said. “We need to take a stand on something as critical as this,” he said. “As soon as an organization becomes neutral, it’s in the newspapers the next day as ‘dropping opposition,’ and that’s about right.” The bottom line, he said, is that “it’s bad medicine. You can stop all suffering if you make the patient dead, but that’s not a wise thing to do. You are ending the sufferer rather than the suffering.”