The Humanist Case Against New York’s Proposed Medical Aid In Dying Law

Wayne Miller of Malone testified April 23 before the New York State Assembly Standing Committee on Health on proposed legislation that would permit medical aid in dying. His remarks are below:

“Chairman Gottfried and Honorable Members of the Assembly Health Committee, thank you for the invitation to present my testimony today. I am Wayne Miller, a writer, historian, retired librarian and active Democratic Party Committee member in Franklin County.

I am here to share with you the liberal and humanist case against legalization of assisted suicide, which is that this proposed legislation, intended to increase an individual’s control over their own life, does the opposite by injecting two bureaucracies (governmental and medical) into the decision-making process. I’ll also address some related historical and moral aspects of the legislation

A young man I knew was tall, dark, handsome and smart, with a winning smile. I met ‘Ryan’ while working as the library media specialist in the high school where he was on the basketball team. I later learned that Ryan suffered bouts of depression. A decade later in a time of great need, he reached out for help from our county’s primary mental health provider. Given an ‘emergency’ appointment for 60 days later, Ryan ended his life much sooner.

The Medical Aid in Dying bill outlines a screening process involving evaluations by health care professionals. The North Country is only one part of our state where there is a chronic lack of timely access to professional care. If the proposed legislation becomes law, will A.I.D. applicants go to the end of the queue and wait, perhaps months, for their competency to be assessed? Or will they displace those who are seeking care to stay alive? Experience in other states suggests doctors will just not bother with a referral.

This is just one problematic facet of the bureaucratic process this legislation would create to govern one of life’s most intimate events. The questions it raises lead to the existential humanist question: Will this course of action benefit humankind or not benefit humankind?

Proponents hold that this legislation will give each of us greater autonomy. And lack of autonomy is consistently the No. 1 reason cited by those who apply for assisted suicide in Oregon. Since suicide is already legal, would not this legislation objectively reduce individual autonomy by transferring significant responsibility for the decision-making to others? Doesn’t it replace self-determination with a heavily mediated process employing a series of decidedly non-private actions conducted by government ordained professionals using legislatively specified subjective criteria?

This legislation seems intended to accomplish two things: professionalization and transparency. Professionalization, or the involvement of medical and other professionals in the process, opens some of life’s most intimate moments to involvement by the otherwise noninvolved. Transparency, or the requirement to observe and record data, is the opposite of privacy. Medical Aid in Dying is antithetical to autonomy, privacy, and intimacy during one of the most human events.

We should also consider if death via medically assisted suicide is the moral equivalent of taking one’s own life. As one looks at this seldom discussed topic, three perspectives emerge. Some people think it makes no difference, as ending one’s life by any means is a totally acceptable and reasonable action. This is the situation in Switzerland, where one merely must give any reason save one to qualify for being prescribed a lethal dose. A second view is that suicide, aided or not, is wrong. The ethical constructs or religious beliefs of such people preclude the intentional termination of a life.

A humanistic view of suicide follows a middle path where in some cases it might be called a morally acceptable course of action. Such is the case of Capt. Lawrence Oates, who threw himself onto a live grenade to save the lives of many under his command. Or the self-immolation of Quang Duc, the Buddhist monk who committed suicide on a busy Saigon street to hasten the end of the Vietnam War and thereby save the lives of other innocents. Those of us who were alive in the ’70s undoubtedly still recall that burning memory.

The moral implications are confusing and diffusing for physician-assisted suicide. The individual who wishes to end their life transfers moral responsibility for the decision and the act in some substantial part to a process proscribed by legislation and conducted by other humans. These other humans and the process under which they operate dispassionately accept some part of the moral responsibility for prematurely ending a person’s life. Will not the real effect of this legislation be to dissipate a person’s moral responsibility for the premature ending of their own life?

Proponents offer various reasons to justify this action and its blurring of morality.

Some argue that its purpose is to relieve pain and suffering. But the data from Oregon demonstrates that in practice, this is almost a nonissue. So how does this legislation benefit humanity?

One answer is economic. Former Colorado Gov. Richard Lamm has spoken of the ‘duty to die,’ pointing out that the elderly must make way for younger people. We live in an age when health insurance providers, not physicians, increasingly determine the medical care we are authorized to receive. I’m sure each of us knows of cases where a sick person has had to fight with their insurer to get the care they need. Please carefully consider the implications of legalizing a ‘treatment option’ that discounts to $30 the total cost of a person’s end-of-life care and compare that to the cost of months or years of life-supporting care. And keep in mind that right now each person has the right to refuse treatment at any time. If you do enact this law, please understand that it will equate to a reduction of the value we place on an important portion of each person’s life.

The Justification appended to the summary of this bill notes the names of some organizations that support medical aid in dying. Organizations that oppose such legislation include the one that most broadly represents those that will be charged with carrying out its dictates, namely the Medical Society of the State of New York. That society addressed end-of-life economics last month at MSSNY’s annual House of Delegates, where the following resolution was approved:

“RESOLVED, that MSSNY support efforts to increase funding in New York State for the availability of end of life care, mental health services, activities of daily living support services, hospice and palliative care programs which improve each person’s quality of life as it nears its natural end.”

‘Its natural end’ is decidedly NOT a $30 doctor-prescribed lethal dose.

Lastly, let’s examine the language used in the arguments for this legislation. The terms used seem well considered to gentrify and obfuscate what objectively is voluntary euthanasia. The organizations promoting such legislation have undergone several rounds of rebranding over the last five decades to sell a concept that was repeatedly rejected until given its current softer labeling.

A-02382 would codify this doublespeak. It stipulates that: action taken in accordance with the article shall not be construed for any purpose to constitute suicide, assisted suicide, attempted suicide, promoting a suicide attempt, mercy killing, or homicide under the law, including as an accomplice or accessory or otherwise.

It further stipulates, “2899-p provides that if otherwise authorized by law, the attending physician may sign the qualified individual’s death certificate. The cause of death listed on a qualified individual’s death certificate who dies after self-administering medication under the article will be the underlying terminal illness.”

Calling the voluntary ingestion of a known lethal dose not suicide clearly incorporates an assumption of moral and ethical authority on the part of the Legislature. Instructing physicians to lie by listing the cause of death as something other than the administration or ingestion of poison further undermines ethical behavior and the public trust.

This bill’s justification cites the case of Brittany Maynard. While this California resident makes a wonderful poster child, the truth is that she had the legal right to commit suicide, as did New York resident JJ Hansen, who had exactly the same condition and prognosis as Ms. Maynard. JJ retained responsibility for his own life and death. It turned out that he did not have fewer than six months to live, as medical experts estimated. He had years. In earlier testimony, his widow described the value of those years to JJ and their young son, as well as the gift of their infant born just a few months before JJ’s death.

In summary, the language in this bill attempts to transfer moral responsibility and obscure the objective truth. And it goes beyond that when it instructs physicians to swear that the cause of death is something other than the ingestion of poison. This means the legislation encompasses moral and ethical dictates, and imposes upon physicians compromised ethical standards. At best it is intended to blur the lines between truth and fiction, something we have all too much of in public life today. As Gandhi said, “Morality is the basis of things and truth is the substance of all morality.”

Source, “The case against New York’s proposed Medical Aid in Dying law”, The Malone Telegram

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