In preparing to present at an upcoming CLE on assisted suicide in Virginia, I’ve been looking at a bill that passed the Virginia Senate by vote of 21-19 (SB 280). This bill would have kept in place the general prohibition against assisted suicide while creating an exception for certain kinds of assisted suicide given a new name. Among the features that stand out in this bill, one that has caught my attention is a provision that requires the person filling it out to mislabel the cause of death:

§ 54.1-2999.1. Medical aid in dying; request; process; duties of attending health care provider.

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G. Medical aid in dying; request; process; duties of attending health care provider. The cause of death listed on a medical certification of death completed for a patient who received medical aid in dying shall be listed as the patient’s underlying terminal condition. No medical certification of death completed for a patient who received medical aid in dying in accordance with this article shall identify suicide or homicide as the cause of death for such person solely because the person was provided medical aid in dying pursuant to this article.

This is unethical. There’s a sense for all of us in which the human condition itself is the “cause of death.” But it seems odd to have a “medical certification of death” with a field for “cause of death” in which something other than a proximate efficient cause of the person’s dying is to be listed.

The premise of the “medical aid in dying” euphemism for medically assisted suicide is that the assistance is needed to accomplish the intended goal of the patient’s death. When the intended goal is accomplished, it is a false attribution to attribute the cause of death to the underlying condition that authorized the medical intervention that actually caused the death.