Assisted suicide is bad medicine for all NYers

Disney World. Four more birthdays. Teaching your son how to ride a tricycle.
3 years, 7 months and 18 days.

These are some of the priceless things J.J. Hanson got to experience with his wife, Kristen, and two sons, James and Lucas, and that was how long he lived after being diagnosed with terminal brain cancer before succumbing to the brutal disease on Dec. 30, 2017.
“James knows who his daddy is,” said Kristen Hanson.

But there is another reality in which James might not have had the chance to get to know his daddy. A scenario in which J.J. Hanson, when dealing with the natural depression that comes from learning you may have months to live, starts to think, “Should I give up? Am I too much of a burden to my family?”

Hanson recalled her husband telling her, “If I had those pills on the nightstand, I don’t know if I would have done that.”
“You can’t undo that,” she said.

J.J. Hanson didn’t have those pills, overcame his depression and became a fierce advocate.

But the second scenario could play out in other lives in the very near future if New York’s Medical Aid in Dying Act, which was reintroduced this year, is enacted. It would allow doctors to legally prescribe a lethal dose of pills to a terminally ill patient who requests them.

While proponents call it “death with dignity” because they view it as allowing a person freedom of choice on how and when they want their life to end, opponents call it “assisted suicide,” because it ends a life unnaturally and raises red flags with regard to vulnerable populations.

The New York State Medical Society, which polled its members on the issue last year, has maintained its position of opposition to the legislation. The Catholic Church and groups that advocate for the disabled and elderly are also strongly opposed to the legislation.

Some form of assisted suicide has been legal in Oregon since 2004 with Washington, California, Colorado, District of Columbia, Hawaii, Montana and Vermont following suit.

“Legislation that removes equal protection from any human life devalues all human lives. Despite sanitized language, it sanctions murder by another name for some utilitarian purpose, typically political or economic,” Bishop Edward B. Scharfenberger said. “As we are seeing after the Reproductive Health Act, so also with proposed ‘assisted suicide,’ will more lives be deemed useless, inconvenient or dispensable. It is the Christian way — and the way of any humane society — to accompany the sick, disabled and most vulnerable, not to eliminate them.”

THE BILL

The Medical Aid in Dying Act has languished in New York over the last few legislative sessions. Assembly Member Amy Paulin (D-Scarsdale) re-introduced it (A2694) for this year on Jan. 25. The Senate sponsor, Diane Savino (D-Staten Island), is expected to follow suit soon. The difference this year is that now the state Senate, like the Assembly, is controlled by the Democrats.

The legislation is far from a slam dunk in New York, however. Unlike abortion, this issue does not break down along party lines and legislators are often influenced by their personal experiences. There are Republicans who are sympathetic and Democrats who oppose, according to the New York State Catholic Conference.

“For people who are proponents of the legislation, their whole argument is freedom of choice,” says Kathleen Gallagher, the New York State Catholic Conference Director of Pro-Life Activities. “…But when you break it down, there really isn’t free choice when you look at all the pressures on the person making the choice.

“You’ve got insurance companies and health-care rationing that is determining some choice; you’ve got family members who are feeling overburdened and the patient who doesn’t want to make their family overburdened; and you’ve got physicians themselves who subtly make decisions about whose lives are worth living. I would argue there is no freedom of choice,” Gallagher said.

The problem with this type of legislation, which is also under active consideration in New Jersey and elsewhere, is that it can open up a Pandora’s Box full of potential problems. Oregon is already looking to expand the definition of terminal illness from six months to a year. And a study in that state in 2017 showed troubling results: Since the law was enacted, there was a 12 percent increase every year in lethal prescriptions — with a 30 percent increase in 2015 — and 25 percent of people said they were in too much pain. The study included data from 1998-2015.

Dr. Charles Blanke, the lead author of the study, told oregonlive.com that that figure shows physicians are not doing enough to manage the pain of patients. And just 5 percent had a psychological evaluation during the process. It’s generally accepted that 3-in-4 patients will face depression, sometimes severe, when faced with a terminal illness. This often leads to thoughts of suicide, which instead of treatment for depression could lead to a lethal dose of pills.

“New York State spends hundreds of millions of dollars every year on suicide-prevention efforts in schools, in prisons,” Gallagher said. “When they build new bridges, they post signs in an effort to stop suicides and remind people that life is worth living; that is what the signs says. Except for this population; this bill says just the opposite.”

Even more staggering in the study: 3 percent of patients used the law because they could not afford chemotherapy. Opponents also worry that palliative care and experimental treatments will be scrapped, because it’s less costly to take a handful of pills.

“Proponents are trying to pick off all groups that oppose this,” said Michael Burgess, former director for the New York State Office of the Aging. “They are really making these efforts and putting their resources behind this, but I think we have enough people, if we exercise our muscle, to stop this.”
The pro-assisted suicide movement is directed and funded by the national organization Compassion and Choices (formerly known as the Hemlock Society).

THE CHURCH

Catholic teaching rejects assisted suicide because it recognizes that all life is sacred, and euthanasia and assisted suicide “(are) an action … which causes death in order to eliminate suffering. It is therefore a rejection of God’s Gift of Life,” according to the website www.catholicendoflife.org, a national resource for Catholic end-of-life teaching created by the New York State Catholic Conference with a grant from Our Sunday Visitor Institute.
“I don’t agree with it in any sense,” Sister M. Peter Lillian Di Maria, O.Carm, Carmelite Sisters for the Aged and Infirm, said of the legislation. “It’s not permissible according to our Judeo-Christian tradition to take life. You can call it whatever you like — it’s still taking a human life.”
The Catholic Church has long supported palliative care, even if that care may hasten death. The Church has never taught that you must use all available means to sustain life when life is clearly near its end.

When it comes to management of pain, the Church says patients should be as “free of pain as possible, so that they may die comfortably. This is part of our Christian obligation to be charitable and to love our neighbor. Even pain medications that may indirectly shorten a person’s life are morally permissible, as long as the intent is to alleviate pain and not to hasten death,” the NYSCC states on it end-of-life resource page.

THE ADVOCATE

Kristen Hanson has taken up her husband’s cause against assisted suicide as community relations advocate with Patients Rights Action Fund (PRAF), a national secular organization fighting the legalization of assisted suicide.

 “We filled this need within the community of opposition,” Hanson said of PRAF, which J.J. served as president. “He knew these laws could never be properly regulated and that the laws could be abused. What happens when now you legitimize suicide as a medical treatment is that it opens the door wide-open for insurance companies to offer this as a medical treatment.”

“The very real danger here is that this is being sold as only for people who are terribly suffering at the end of life and it won’t affect anyone else. We cannot trust that health insurance companies will do the right thing,” said Hanson. “These laws are inherently discriminatory. They are carving out a piece of society and say you are no longer going to get suicide prevention, you are going to get suicide assistance.”

Hanson’s concern played out in the case of Barbara Wagner, who was suffering from lung cancer and instead of her insurance company in Oregon paying for the very expensive drug that would continue to keep her alive, offered her assisted-suicide pills that cost $50.

”I got a letter in the mail that basically said if you want to take the pills, we will help you get that from the doctor and we will stand there and watch you die. But we won’t give you the medication to live,” Wagner told ABCNews.com at the time.

THE DISABLED

Discrimination and the lack of ability to empathize with someone who is disabled is particularly troubling to Katy Carroll, a lawyer for the Policy Analyst Center for Disability rights.

“It’s problematic because as disabled people, we face a tremendous amount of ableism in society. People see living with a disability as terrible and pitiable,” said Carroll, who is legally blind due to albinism. “People say I can’t imagine living like that; a general sense that a disabled life is not a quality life. So, when presented with this assisted suicide option, our experience is that rather than refer us to mental health services, it is more likely that it’s reasonable that you would want to kill yourself because of your situation,” Carroll explained.

 When you can’t put yourself in another person’s shoes and feel what their life is like without pity, the potential for abuse is obvious.
 “People with disabilities are more likely to be abused or coerced and there are these so-called safeguards built into the law, but at the end of day they are not going to prevent these things,” Carroll said, adding that, according to the proposed legislation, no witness is required at time of death, and there is no guarantee that the person is self-administering the drugs. Someone, for whatever motive, could administer the lethal dose without consent.

THE DOCTOR

This legislation essentially would turn doctors into killers. And that’s something that Dr. Matt Lynch says is just plain wrong.

 “It is bad for the patient; it’s contrary to the doctor’s purpose to promote health,” said Lynch, a neurologist who has also given informational talks at area churches. “And this is diametrically opposed to that because you are essentially killing the person. It legitimizes the perception that people that are dependent aren’t worth anything.”

 If this legislation passes, physicians, as part of discussing end-of-life options with a patient, would be required to tell them about assisted suicide. And when it comes to end-of-life issues, people are worried about dependency, depression and being in pain. These words come up again and again when talking with experts, whether they are religious or not.

“I had one guy say once, ‘When it gets worse, just put me in the corner,’” said Lynch, who deals with ALS and dementia as a neurologist. “I had another person say, ‘I don’t want to live,’ She is also depressed and that colors her view. People have this sense that they are being a burden to someone, and when you offer them the chance to take their own life, it legitimizes it.”

People naturally go through depression when they are facing the end of their lives, and having pills on hand that could end their lives could cause someone to make a decision that could be markedly different a week or a month later.

 “Depression can be a difficult diagnosis to make,” Lynch said. “It’s difficult to differentiate the effects of depression and natural grief and the effects of the medication.”

 Lynch is a big proponent of palliative and hospice care, adding 90 percent of a patient’s pain can be controlled in those environments.
 “The reason you hear so many stories about suffering, is that people don’t have access to (care),” Lynch said. “Our position is not that end-of-life care should be ignored, but we want to promote access to hospice and palliative care. Yes, there are some people who are suffering but the reason is they don’t have access to the services they need.”

THE ELDERLY

Palliative care, by definition, is specialized care for people with a serious illness; it doesn’t have to be a terminal illness. The goal is to bring comfort in all areas of suffering not only for the resident, but also for the family. The Church stands firmly behind administering palliative and end-of-life care. Palliative care continues through end-of-life care.

Since 1929, it has been the mission of the Carmelite Sisters for the Aged and Infirm to care for elders by serving in, sponsoring, or cosponsoring long-term care facilities in the United States and Ireland. 

A key value of the Carmelite Sisters’ philosophy of elder care is keeping the dignity of the person intact. Essential to realizing this is understanding each person’s story, where he or she has come from and recognizing his or her suffering in terms of mind, body and spirit.  This includes reaching out to family and loved ones who experience their own struggles and are attempting to make sense of the pain they too are experiencing.

“The dignity of the human person should always be respected first, and (assisted suicide) takes the dignity away,” Sister Peter said. “Being compassionate to people means we are called to ‘be’ with and accompany them, always affirming their human dignity no matter how incapacitated they may (or have) become.”  

 Helping people through this time without their needing to turn to a lethal dose of pills involves the support of the sisters, staff, and family.

 “When we are privileged to sit by the bedside of those who are critically ill and in the dying process, we begin to understand the sacredness of this time for families and friends as they share in conversations and in silence,” she said. “We witness the true meaning of the word ‘compassion,’ which literally means ‘to suffer with’ and it allows us to honor their shared experience as they accompany their loved one on this journey to God. Pro-assisted suicide organizations such as Compassion and Choices have robbed the meaning from our understanding of ‘compassion.’ We need to take its meaning back.”

 Sister Peter adds that it really comes down to putting yourself in God’s hands.

 “We trust God’s plan,” she said. “Would you rather be trusting God’s plan for each person or allow legislation to determine a plan? You decide.”