Thank you for this detailed and useful information. Don't patients with a terminal diagnosis have access to opioids as standard? Are barbiturates more humane than opioids for this purpose? The elephant in the room for the assisted suicide debate is the number of people who die through suicide every day, and don't have to go to Oregon or Switzerland to do it, with overdose or poisoning being a very common method- and that's just with drugs you can pick up from your local chemist's not the sort of drugs that someone in the advanced stages of a terminal illness has access to. Barring people who are severely mobility impaired, if someone wants to do it, they can do it and I doubt the relatively sudden death of someone with a terminal diagnosis is going to prompt close investigation, and even if it did it would be impossible to prove that their surviving relatives knew what they were going to do.
This is part of the reason I'm suspicious of the narrative and social imperative behind licit assisted suicide. I'm not convinced that having a normalised structure around assisted suicide is socially safer for disabled and seriously ill people, particularly with the "heroism" narrative around these cases alongside the denigration and stigma around disability and dependency.
You are absolutely correct that pretty much any terminally ill person that really wanted to, and was physically able, could construct a "medicalized" suicide. Final Exit, the book put out by Hemlock Society decades ago (and now in the 3rd edition) gives detailed instructions on several ways to do this. (I won't repeat the suggestions here.) Someone could also jump off a bridge, or run their car into a brick wall, shoot or hang themselves, or any number of other violent methods to end their life.
I'm not sure I agree with your impressions about the stigma of disability and dependency, though. And I'm not so sure I agree that the death with dignity laws are a social imperative, or even a slippery slope. I don't forsee a "Soylent Green" or "Logan's Run" scenario developing.
I do see that there are "religious imperatives" about a lot of things related to life, birth and death, and I believe that these are potentially far more damaging to society as a whole, than allowing personal choice, or engaging in compassionate and "unflinching tolerance."
There are 4 main life stages common to every society that has ever existed on earth: birth, death, coming of age, and pair bonding. Each society has developed rituals, rules, and ceremonies regulating what is considered "normal" behavior for these 4 stages. And these rituals and rules vary widely all over the planet, as well as through the centuries. It is only "normal" that we should continue to discuss, refine, and re-define what is "normal" behavior in our time, and in our societies, IMO.
We already have normalized the process of selecting the day one decides to give birth. We have normalized "maternal request" (no medical indication) cesarean sections in huge numbers. We are doing uterus transplants, and controlling fertilization, and creating embryos in laboratories. We can create life outside of the human body. Why, then, not give the same choices to those at the end of life? To face the inevitable, and choose the day one decides to leave?
I don't think anyone has suggested that we coerce terminally ill people into ending their lives-- just that for those that have clearly thought through all of the issues, they now have options in several states to do this legally. These are terminally ill people. One could argue that allowing them choice (when they have so bitterly few options) is far more compassionate than forcing them to submit to the pain, indignity, and emotional upset of their own wretched and certain deterioration.