Columbia Biomedical Roundtable Statement Against Assisted Suicide

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To the Honorable Members of the New York State Legislature:

We are writing on behalf of the Columbia Biomedical Roundtable. Our members are doctors, nurses, medical and nursing assistants, medical residents, and medical students who work for either the Columbia Vagelos College of Physicians & Surgeons or New York Presbyterian Hospital. We oppose legislation (A995-C/S2445-B, “Medical Aid in Dying”) that would legalize Physician Assisted Suicide (PAS). Our membership includes those with religious faith and those without. We oppose this legislation because it would erode doctor-patient trust, harm the vulnerable, and cannot be controlled.

Consider that you are being asked to legalize suicide. Evidence shows that in jurisdictions wherein PAS has been legalized, contrary to expectations, rates of general suicide have increased. The epidemic of depression, loneliness, despair, hopelessness, and other negative ideation – particularly among our young people – makes this perhaps the worst possible time for lawmakers to legitimize suicide as a way out.

Consider that while most of us think in terms of an ongoing relationship with our primary doctor, most New Yorkers are not privileged to have their own primary doctor. Thus, a prescriber who hardly knows the patient may be asked to take responsibility for his/her death. This is why in the name of personal “autonomy,” those who will suffer the most from “letting the genie out of the bottle” are the most vulnerable among us.

Those at highest risk are those with disabilities or mental health or behavioral conditions, Black and Brown people, and those unable to access necessary medical care. In 2022 alone, 2,264 Canadians were allowed to terminate their lives for loneliness, 323 for inability to obtain palliative care, and 196 for lack of adequate disability services. Each of these numbers is a person’s life.

Consider that under the bill before you, the doctor has no obligation to find out what happened to the lethal dose just approved. That means fatal dosages of a dizzying combination of barbiturates, opioids, and benzodiazepines could be out there and may be left in medicine chests or on countertops where others, including children, might inadvertently access them.

When one reviews the supposedly “good” outcomes in Oregon, one patient took more than 10 hours to enter coma, and another took more than 100 hours to die. The bill also requires physicians to falsify the patient’s death certificate by listing the underlying illness as cause of death and not the lethal dose that he or she just prescribed. A deliberate false statement on a death certificate is a crime under the state’s Penal Law.

Consider that regardless of how many restrictions are put into the original laws, permission for physician-assisted suicide expands to non-terminal patients – as we have seen in the Netherlands, Belgium, and Canada — because once a “right” to suicide is conceded, how can such a right be denied to others?

Thinking that state-sanctioned suicide would remain limited to those covered by these initial rules is short-sighted and naive.  Indeed, a group pushing for this idea admits its goal is to expand laws as soon as they’re passed.

“Once medical aid in dying is authorized in new states, we work to ensure that the practice is truly accessible,” the euphemistically named “Compassion and Choices” group (formerly the Hemlock Society) states in its federal tax paperwork.

We’ve heard that some New York lawmakers say, “I can’t worry about Canada; I have to worry about New York.”

We don’t ask you to worry about Canada, but to at least know about Canada. And the lesson from Canada is that once doctors are permitted to prescribe death pills for one group, it’ll be hard to deny it to others – despite your best and most compassionate intentions. Moreover, we will never be able to assess its impact on New Yorkers because the means to collect accurate data won’t exist.

In Canada, more than 60,000 individuals have died by physician-assisted suicide since legalization in 2016 and 16,000 died by doctor’s prescription last year. In Canada, this law is on pace to account for five percent of all deaths by 2025. In some urban areas of the Netherlands where this law began in 2002, 12-14% of deaths occur by that means. Canada has legalized but not yet implemented access for mental illness. In March, a Calgary judge ruled that a 27-year-old woman with autism must be allowed to obtain a fatal dose from a doctor over her father’s objections. The “slippery slope” is real.

By whatever name you call it, this notion changes medicine forever by engaging doctors to extinguish human life, turning them from healers to active participants in killing a patient. This is diametrically opposed to the aspirations of the healing profession. It turns medicine on its head. Giving a patient a prescription for a lethal dose of drugs is the medical equivalent of handing the patient loaded pistol.

It’s no wonder the American Medical Association by vote this past November said, “Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.”

We understand that those supporting this idea are motivated by sincere compassion, but we believe it is misguided. While every terminally ill, suffering patient ought to invoke compassion, suicide is not the answer. Rather, we must strive to improve end-of-life care. Legislators and heath care professionals in New York State must work together to obtain the resources to relieve each individual person’s various forms of pain. But sanctioning suicide is not the answer.

Respectfully submitted,

Columbia Biomedical Roundtable, with membership of over 100 healthcare professionals at Columbia Vagelos College of Physicians & Surgeons and New York Presbyterian Hospital. See: www.columbiabmr.org

President, Dr. Eve Slater, MD, FACC, Professor of Clinical Medicine, Columbia Vagelos College of Physicians and Surgeons, and former Assistant Secretary for Health, U.S. Department of Health and Human Services (2001-03).

Board member, Dr. Jonathan M. Barasch, MD, PhD, Lambert Professor of Medicine, Urology, & Pathology at Columbia Medical School.

Board member, Dr. Maria De Miguel, MD, MS, Associate Professor of Medicine at Columbia University Irving Medical Center.

Board member, Dr. Chin Hur, MD, MPH, Irving Professor of Medicine and Epidemiology.

Member, Dr. Donald W. Landry, MD, PhD, Hamilton Southworth Professor of Medicine, Chair Emeritus of the Department of Medicine, and Director of the Center for Human Longevity at Columbia University.

Note: This organization and its website reflect individual views; it does not reflect the institutional views of Columbia Vagelos College of Physicians and Surgeons or New York Presbyterian Hospital.

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