The controversial aid-in-dying legislation is facing opposition from an alliance of groups that oppose the bill for both moral and pragmatic reasons, arguing that the legislation would put elderly and disabled people at risk of being abused.
The bill, titled the “Patient Self-Determination Act” (S.5814-a/A.5261-c) would allow people with terminal illnesses to take medication to end their lives. J.J. Hanson, president of the Patients’ Rights Action Fund, who prefers to call the proposed legislation “physician-assisted suicide,” knows firsthand that not all diagnoses are accurate.
In May 2014, Hanson was diagnosed with stage-4 glioblastoma, a deadly form of brain cancer. His doctor told him he had less than four months to live. Miraculously, Hanson was able to fight the disease and two years later his cancer is in remission.
“I was told on three separate occasions that I would not beat it,” Hanson said during an Albany press conference this week. “If I had listened, I wouldn’t be here right now.”
His story speaks to the opposition coalitions’ major issues with the bill. They argue that patients should fight terminal diseases instead of giving in, and that legalizing physician-assisted death would discourage patients from doing so. “This is not about choice, this is about taking away choice from those who need it most,” Hanson said. The opposition to the aid-in-dying bill says legalizing physician-assisted death pressures patients into considering it even if they do not want to.
“The economic drivers behind this policy are dangerous and need to be looked at,” said David Kim, CEO of the Beacon Christian Community Health Center on Staten Island. “It would cost the health care system less to allow aid-in-dying rather than keep terminally-ill patients alive.”
On a nationwide average, it’s estimated that Medicare pays around $153 per patient every day for hospice care. Most lethal drugs, including high doses of opioids, cost less than $100.
The proposed law states that the patient must be in good mental health, will die within six months whether or not treatment is provided and must request lethal medication themselves. The patient needs the signature of two witnesses who cannot benefit from their death to testify that the patient is acting voluntarily.
Still, those in opposition of the bill say it doesn’t properly safeguard against potential abuse. Their first issue is the diagnosis itself. Hanson note that about 15 percent of patients are misdiagnosed every year.
Adam Prizio, manager of government affairs at the Center for Disability Rights, said the bill would allow for disabled people to be taken advantage of. He argued that aid-in-dying laws only work in a perfect world where nobody is corrupt and doctors always make the right decision. “Doctors are not infallible, they often think disabled people are worse off than they actually are,” Prizio said. “We should be aiding them in living, not dying.”
Beth Mahar, director of member services, Hospice & Palliative Care Association of New York State, says more resources should be devoted to expanding and improving end-of-life care, not encouraging patients to end their lives.
According to Mahar, only 28 percent of Medicare enrollees in New York die in hospice care, as compared to 44 percent nationally.
“We should ensure access to palliative care as a top health care priority,” Mahar said. “Instead of legalizing physician assisted suicide we should focus on quality of life for those confronted with a terminal illness.”
Mahar said hospice care not only provides physical relief, but psycho-social and spiritual support for patients. She said it aims to help patients with issues of loneliness and being a burden to loved ones. Corinne Carey, New York State campaign director for Compassion & Choices, an organization in favor of the proposed legislation, agreed that hospice and palliative care needs to improve and said legalizing aid-in-dying would serve to make the care more effective.
“Aid-in-dying laws create conversations between doctors and patients about the full-range of end-of-life care options, including hospice and other support,” Carey said.
Carey said “even the gold standard” of palliative care doesn’t always work, that people should always have as many choices as possible. Carey cites Oregon’s “Death with Dignity Act” — passed in 1997 — as a model for the New York law, whereas groups in opposition say the Oregon law has been unsuccessful.
Since the law was passed, 1,545 patients have had prescriptions written under the law and 991 people have died from ingesting the medications, according to a report from the Oregon Public Health Division. The report states that 90.5 percent of patients who took lethal drugs were enrolled in hospice care. The most common reasons cited were being less able to engage in activities that make life enjoyable (89.7 percent), loss of autonomy (91.6 percent) and loss of dignity (78.7 percent).
Although supporters of aid-in-dying legislation cite overwhelming pain as a justification, only 25.2 percent of patients listed it as a reason for taking lethal drugs. The opposition claims that financial problems are a major factor, but only 3.1 percent of patients listed financial implications of treatment as a reason.
The legislation will be sure to be a contentious issue this session, one that Hanson said “transcends partisan politics and beliefs.” The Senate bill is sponsored by John Bonacic, R-Mount Hope. Both versions are in their respective health committees.