In the past few months, Physician Assisted Suicide (“PAS”) or Medical Aid in Dying (“MAiD”) has been a frequently discussed or considered issue both domestically and internationally.

Canada delayed until 2027, implementation of PAS for people whose primary diagnosis is a mental illness.

Colorado is seeking to expand its existing MAiD law to allow anyone in the United States to benefit (?) from its proposed, expanded MAiD law wherein life-ending medication can be prescribed by an “Advanced Practice Registered Nurse” and a “consulting provider” only needs to be qualified by specialty or experience to make a professional diagnosis and prognosis regarding a terminally ill individual’s illness.

According to the Death with Dignity organization, there are 19 states either considering, or opposing implementation of PAS or MAiD legislation. These states and bills can be found here:

Bills We are Tracking

“Fer it … or Agin’ it.” That seems to be our current society. Our world has devolved into black or white. Right or wrong. Coke or Pepsi. Republican or Democrat. Far Right Religious Loon or Far Left, Extremist Socialist Loon. Your choice has been made easy. Press this button or that button.

So too, with PAS/MAiD. You must either support those bills. Or you must oppose those bills. After all, topics as simple as our very existence, whether we have a soul, what constitutes a sentient being can readily be pigeon-holed into one of two choices.

“Fer it … or Agin’ it.”

In general, people who oppose PAS/MAiD bills show up during subcommittee hearings, present arguments opposing the proposed bill and seek to have the entire bill defeated. The politician’s aide then contacts the money people behind the politician and asks them how they want the politician to vote. The money people make their views known and the politician dances to that tune.

But what if there was another way?

Instead of supporting or opposing PAS/MAiD legislation, what if a specific carve out excluding eating disorders from these bills were proposed as a rider. Therefore, the position would be regardless of whether that legislative bill passes or expires, eating disorders must be excluded. And that is because we simply do not have enough medical and mental health information and knowledge about this illness.

When does Anorexia Nervosa become terminal? Does the medical community even have a remotely accurate understanding of the way eating disorders impact the brain? And if so, why haven’t effective, biologically based treatments been researched, studied and implemented?

We also know there are no generally accepted standards of care. The “experts” in the community cannot even agree about the most effective medical and mental health interventions to treat this deadly mental health illness. For that matter, should anorexia even be classified primarily as a mental health illness?

We know there is no effective collaboration with any other medical or mental health community.

Private equity companies dictate residential “standards of care” and the way this mental health illness is treated. Emphasizing profits over patient safety. Running treatment guidelines through their finance department. Even a former CEO of a residential treatment center is now admitting to this reality.

There are no pharmaceutical drugs which have been specifically researched, trialed and then approved to treat eating disorders. The drugs being used today were all designed to be used for other mental health and medical issues.

What criteria and protocol would be utilized to establish that which constitutes the highest level of treatment care before patients can utilize PAS/MAiD?  

How many years would a patient have to be afflicted with Severe and Enduring Anorexia before a death protocol is appropriate for them? For that matter, can any mental health or medical doctor, within all reasonable medical probability, opine that death will come within six months?

How often has this legion of information been presented to politicians when PAS/MAiD legislation is being considered?

Envision testifying before a legislative subcommittee and instead of making “Coke or Pepsi” arguments before the politicians (arguments they have heard numerous times), an advocate presents the above information and statistics plus much more. Advocates present compelling information, facts, reasons and logic why eating disorders must be excluded from the legislation.

And the law of unintended consequences may result in, while the discussion of PAS/MAiD is going on, we educate those politicians and society about the dangers of eating disorders. The high mortality rate. The dysfunctionalities and lack of understanding of this illness.

We must start to aim for the specific target before us instead of the zip code sized area of discussion and dispute on this topic which is currently raging.

Harvey Penick, the late, great golf coach and instructor had a famous saying, “Take Dead Aim.” This saying is more about a technique for focusing than a philosophy on how to play. By narrowing down to a very specific target you end up focusing in better on what needs to be done.

With regard to PAS/MAiD, we need to “Take Dead Aim.”