End of life care is more than an aid in dying

Gov. Kathy Hochul will allow medically assisted suicide in New York, a measure meant to ease the suffering of those who are terminally ill, if more safeguards are added to prevent exploitation.

New York will become the 13th state giving mentally competent individuals with a diagnosis of six months or less to live the right to end their lives by taking a prescripted cocktail of lethal drugs. The law protects those who assist in this process from any legal consequences.

Stripped to its essence, New York is elevating personal freedom over society's broader ethical and moral restraints about the taking of a life.

To prevent abuses, Hochul negotiated with determined advocates pressing this change for more than a decade. The new provisions that legislature leaders have signaled will be approve in early January include certification of the patient's mental capacity to make the decision, that the patient's initial evaluation be done in person, by a physician, and that the patient's request be made orally and recorded by video or audio. There is now a mandatory five-day waiting period and the mental health evaluation must be done by a psychiatrist or psychologist. Anyone with a financial interest is ineligible to be one of the two witnesses required. Unfortunately, the death certificate must list only the underlying medical condition with no record of the lethal dose of drugs. 

That such concessions took so long and only under intense pressure from the governor to make sure a dying person's right to live is protected raises a question of why these provisions were not in the original language of the bill. It's a question that encapsulates our concerns about the slippery slope of breaching social norms about controlling how you die.

Certainly society should treat the dying with compassion; better end of life care is greatly needed. Too many are alone and afraid. An aging population dies more often from chronic long-term diseases, which can cause prolonged and painful deaths. We have all prayed for someone's suffering to end.

But this door, once opened, cannot easily be closed. The legal ability to take your own life, in whatever narrow parameters at the start, can eventually devolve into hardly any restrictions on doing so. The American Medical Association opposes these laws as a contradiction of a physician's duty to provide care.

Canada is closing in on a decade of assisted suicide laws, each broader than the one before. First legalized in 2016 for Canadians whose death was "reasonably foreseeable" for a patient with a grievous and irreversible medical condition, it was expanded five years later to include those whose "death is not reasonably foreseeable." Now, 1 in 5 deaths there are of a person's own wishes. Another expansion to be implemented in 2027 would allow Canadians suffering solely from a mental illness to be eligible for assisted suicide.

New York, on the precipice of altering one of society's fundamental tenets to protect life, must be vigilant not to accelerate a culture shift that undermines that very value.