Should NYS adopt medical aid in dying? No

A vigorous and well-funded campaign is afoot in New York State to convince lawmakers to legalize physician-assisted suicide. Couched in warm euphemisms, this campaign distorts reality and hides the true facts that abound when doctors are allowed to prescribe lethal doses of narcotics and toxins whose only purpose is to end a person’s life.

New Yorkers and New York lawmakers should know the facts.

Evidence in 10 states, Canada, and several European countries demonstrates that legalization is a grave mistake.

Most health care professionals, including the American Medical Association, consider physician-assisted suicide unethical and contrary to the purpose of medicine.

Physician-assisted suicide undermines the trust essential to the doctor-patient relationship. Patients wonder: “Is my doctor providing me the best care, or simply unwilling or unable to give me the care and comfort I need? Is she merely stringing me along until I am eligible for physician-assisted suicide?”

The record shows that these laws initially limit the suicide option to persons with terminal illnesses but rapidly extend to the most vulnerable among us — the lonely, depressed and destitute, and those with mental illness or disabilities.

In 2022 alone, 2,264 Canadians terminated their lives for loneliness, 323 opted for suicide when they were unable to access palliative care, and 196 died unable to obtain disability support.

In March, a Calgary judge ruled that a 27-year-old woman with autism must be allowed to obtain a fatal dose from a doctor over her father’s objections.

It’s a classic “slippery slope” in which lawyers argue that it is unjust to restrict application only to some patients, and the guardrails fall away. Once a “right” to suicide is conceded to some, how can it be denied to others?

Indeed, the group pushing for this idea admits its goal is to expand laws as soon as they’re passed.

“Once medical aid in dying is authorized in new states, we work to ensure that the practice is truly accessible,” the euphemistically named “Compassion and Choices” group states in its federal tax filing.

More than 60,000 people have committed suicide under Canada’s so-called “Medical Aid in Dying” law since it was enacted in 2016, including 16,000 in 2023. Physician-assisted suicide deaths have increased by 30% annually, and at this rate, physician-assisted suicide will account for 5% of all deaths in Canada by 2025.

In some urban areas of the Netherlands, 12-14% of deaths occur by legalized suicide, and eligibility is open to children and persons with mental illnesses and eating disorders.

Published data increasingly cite examples of patients being offered physician-assisted suicide when access to palliative care, disability or social services is denied by insurance or limited government resources.

Those supporting physician-assisted suicide are motivated by sincere but misplaced compassion. They state that individuals require the freedom to determine when to end their lives. While every terminally ill and suffering patient should invoke compassion, state-sanctioned suicide is not the answer.

In fact, it’s the exact opposite of the right answer — particularly at a time in our history when youth suicides are such a huge concern. Physician-assisted suicide has been shown to result in increased rates of suicide in general.

While the Hippocratic oath has taken on several modern iterations, one provision remains the same: Primum non nocere. First, do no harm. Please let it be said that this remains our guiding principle.

Before New York State goes down this path, we must ask ourselves how we treat those at the end of their lives. Indeed, we must do better in end-of-life care, including palliative care. State-sanctioned suicide is not the answer.

This guest essay reflects the views of Dr. Eve E. Slater, assistant secretary of the U.S. Department of Health and Human Services from 2001 to 2003 and professor of clinical medicine at Columbia University’s Vagelos College of Physicians & Surgeons.