Should NYS adopt medical aid in dying? Yes

A few months ago, the New York State Bar Association produced a report in favor of legalizing medical aid in dying in the state. Despite this and many other efforts over the years to get legislation recognizing the right of competent terminally ill people to request lethal medication to speed their dying, the Medical Aid in Dying Act continues to languish in Albany.

It should be passed and quickly by the State Senate and Assembly, and then signed into law by Gov. Kathy Hochul.

All New Yorkers ought to have the opportunity to choose how best to control the manner of their dying in accordance with their personal values when terminally ill.

Some say to pass this bill is to put the poor and the disabled at grave risk — that they will be hustled off to unwanted, coerced deaths due to the costs or burdens they may pose to others. Some maintain that hospice exists as an option, making medical aid in dying unnecessary. Neither of these arguments against passage holds any water.

What about risk to the vulnerable of abuse? I contracted paralytic polio as a child in 1957 and now find myself severely disabled by both post-polio syndrome and nerve damage to my spinal cord. If abuse were likely, I would be first in line to object to legalization.

I first heard about efforts to legalize medical aid in dying in 1996. I was an early critic and vocal opponent of Oregon’s effort in 1996-1997 to permit doctors to assist competent, terminally ill persons to manage their deaths. Why? My fear of the potential harm in rushing the poor, minorities, and the disabled to unwanted deaths. Nearly 25 years later, those same worries concern some who oppose allowing the same option in New York State.

On Oct. 27, 1997, Oregon enacted the Death with Dignity Act which allows terminally ill individuals who are competent to choose to end their lives after a waiting period through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose.

This is what New York is now considering.

Oregon required the Oregon Health Authority to collect information about the patients and physicians who participate in the Act, and use that information to publish an annual statistical report.

In decades of reporting, the state has seen no abuses. Media investigations have produced no evidence of abuse of the vulnerable. There are no protests from families of the poor or disabled after the fact. The law has worked. And there has been no effort to retract medical aid in dying in Washington, Colorado, Vermont, New Jersey, California or any of the nine states that subsequently followed Oregon’s lead.

Has the law been used too frequently in Oregon or other states? It has not. Indeed, of those who request lethal medicine as they are dying, studies show as many as a third of them do not swallow the deadly medication. These patients say knowing they have a “parachute at the bedside” lets them face their impending death with less fear and anxiety. They decide to live longer.

Is hospice an adequate road for dying? For many it is. But, some facing death don’t want to go heavily sedated or emaciated. Others want to control when they die, who is present, and go with a ceremony or celebration of their lives. Why should New York deny them what so many other states have permitted without seeing problems?

It is time to create an option in New York for those who want to choose the manner of their dying when terminally ill. Ethics demands protection against abuse. Happily, how to do that is known. Ethics also demands honoring the wishes of those who ought to be able to face terminal illness according to their values and choices, whether rich or poor, disabled or not.

This guest essay reflects the views of Arthur Caplan, head of the Division of Medical Ethics at NYU Grossman School of Medicine.