By David C. Leven
Earlier this month, California enacted the End of Life Option Act to allow aid in dying, the process by which a terminally ill, mentally competent patient with less than six months to live may request a prescription for medicines that the patient may take to end intolerable suffering and achieve a peaceful death. In doing so, it became the fifth state to affirmatively legalize aid in dying. New York, which has both legislation and a lawsuit pending to achieve aid in dying, should be next.
When suffering becomes intolerable, terminally ill patients should have this option available along with other options that also result in death, such as the withdrawal of a ventilator, stopping dialysis, voluntarily stopping eating and drinking and palliative sedation.
What we have learned about aid in dying, which has been extensively studied for almost two decades, is that it is a safe practice and rarely used. Only about three of 1,000 patients end their lives by taking the prescribed medicines, and about one-third of those patients who get the prescriptions never take the medicines. But thousands of others are greatly comforted knowing that this option is available.
A 2007 study in the Journal of Medical Ethics found that there is no disproportionate impact on or reason to be concerned about abuse of vulnerable populations. Moreover, 80 percent of patients who take the medicines are in hospice (compared to only 50 percent nationwide), receiving excellent end-of-life care. But even that care is not enough to sufficiently control the suffering of a small number of patients.
It is no wonder that aid in dying now enjoys the support of some 81 percent of New Yorkers, according to a September poll. The support cuts across political and religious affiliations. And doctors themselves support aid in dying by a margin of 54 percent to 31 percent.
Currently, however, doctors and loving family members in most states are at risk of imprisonment when they help patients die with life-ending medicines. And they face a terribly unfair dilemma when a dying patient asks for needed help.
Yet the practice does go on underground, but illegally and unregulated. It must be made legal and appropriately regulated.
When Gov. Jerry Brown signed the California bill into law he reasonably and compassionately said, “I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.”
Aid in dying must be a right available to terminally ill, mentally competent patients; and the government should not interfere with this most personal and intimate decision. It is time to legalize aid in dying in New York.
David C. Leven is the executive director of End of Life Choices New York.