Gov Hochul Must Sign Medical Aid in Dying legislation
Legislation to allow medical aid in dying for terminally ill, mentally capable adults has passed New York's legislature and is awaiting a decision by Gov. Kathy Hochul. As a Board-Certified Fellow of the American Academy of Neurology, an advocate for people with disabilities, a cancer survivor, a person living with a disability, and a part-time New York resident, I support this measure.
First, the facts: Eligibility for medical aid in dying (MAID) laws in the U.S., including New York's proposed law, requires patients to be capable of making their own health decisions, diagnosed with a terminal illness and expected to live six months or less, to receive approval from two physicians, and to self-administer the medication.
The law is clear that having a disability or being elderly does not, in itself, make one eligible.
Some worry about “slippery slopes” and coercion, as noted in the August 5 Times-Union commentary by Max Rodriguez, who claims this legislation endangers people with disabilities. Such arguments are misleading. Concerns about MAID leading to abuse are unfounded; over 26 years of Oregon's Death with Dignity Act show no documented cases of coercion or misuse. In fact, about a decade after its implementation, The Journal of Medical Ethics found that the rates of assisted dying in Oregon “showed no evidence of heightened risk for the elderly, women, the uninsured ... people with low educational status, the poor, the physically disabled or chronically ill.”
The safeguards in the legislation are robust, ensuring individuals who are not eligible cannot access it. Prior pieces have argued that a psychiatric evaluation is at the discretion of the prescribing physician and is subject to vagueness. Doctors have an ethical and legal duty to do what is best for our patients; to us, this standard is neither vague nor subjective, and we err on the side of caution. Throughout my decades as a medical practitioner, we have always encouraged our patients to seek second or third opinions as they see fit; however, it is now referred to as “doctor shopping.”
Opponents of medical aid in dying seem to suggest that they represent the views of all people with disabilities. This is far from the truth. Recent national polling found that nearly 8 out of 10 U.S. residents (79%) who self-identify as having a disability agree that “medical aid in dying should be legal for terminally ill, mentally capable adults who choose to self-ingest medication to die peacefully.”
Those of us in favor of this bill are asking to have the option of medical aid in dying if needed. For those opposed, there will be no obligation to use it. In states where MAID is legal, it often helps terminally ill individuals continue fighting; about one-third of prescriptions in Oregon go unused, providing comfort that the option exists.
The idea that this law sends the message that needing help with daily living or losing independence makes life less worth living is not accurate. This law sends the message that autonomy means the right to make your own decisions about your own healthcare. If you have the cognitive ability to make decisions for yourself, you should have the right to make all decisions.
No law or idea is perfect. There is so much work to be done to ensure that people with disabilities have equitable access to quality health care, resources — and at the end of their lives — compassionate palliative care and hospice options on their terms.
We must not deny eligible, terminally ill, cognitively competent New Yorkers the option of ending their suffering. I urge Governor Hochul to sign the Medical Aid in Dying Act, allowing the dying to choose to end their suffering peacefully.
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Dr. Seth Morgan is a retired neurologist living with Multiple Sclerosis. Since leaving his practice, Dr. Morgan (who prefers to be called Seth) has become deeply involved in disability rights advocacy and is a strong supporter of medical aid in dying for terminally ill adults.