The assisted dying movement is gaining momentum. These opponents are pushing back
What does it mean to die well, with dignity? The question is at the heart of the contentious debate over whether legalizing physician-assisted death for terminally ill patients is an act of compassion, upholding an individual's dignity, or a troubling step toward devaluing human life.
The debate has recently returned to the spotlight in New York, where the state Assembly passed a bill in April that would allow terminally ill patients with a prognosis of six months or less to live to request life-ending medication.
It also came up in May, when 'Dilbert' cartoonist Scott Adams revealed that he only has a few months to live and indicated that he might take advantage of California's End of Life Option Act.
New York's proposal requires confirmation from two doctors, who must verify the diagnosis and ensure the patient is mentally sound. The measure passed narrowly — 81 to 67 — after more than four hours of debate. Its fate now rests with the state Senate, where it needs 32 votes to pass and currently has 26 co-sponsors.
Currently, 12 jurisdictions — including Oregon, Colorado and the District of Columbia — permit what's commonly known as 'medical assistance in dying' (MAiD) or 'assisted suicide.' On May 20, Delaware became the latest state to legalize medical assistance in dying, and at least 19 other states are considering similar laws.
Canada, Switzerland, Belgium and the Netherlands have adopted MAiD laws, some extending eligibility to people without terminal illnesses. The United Kingdom is also reviewing a similar bill, with a vote expected later in June.
'Passing this bill is about love, compassion, and reducing needless suffering. No one should have to endure agony when there is a better, humane choice available. This is not a political issue — it's a human issue, and we owe it to New Yorkers to pass the Medical Aid in Dying Act,' said the bill's sponsor, Assemblymember Amy Paulin, D-Westchester, in a press release. Supporters argue that allowing patients to choose death in the face of unbearable suffering respects their dignity and autonomy.
For those speaking out against the bill, legalizing physician-assisted suicide devalues life and puts vulnerable populations at risk, including people with disabilities, poor people and people with mental illness. Dr. Lydia Dugdale, a physician and ethicist at Columbia University, wrote in a recent New York Times op-ed that the debate isn't about dying well.
'It is about relieving society — government, medical systems, even families — of the responsibility to care for those who need the most help: the mentally ill, the poor, the physically disabled,' she wrote.
Opponents worry about a 'slippery slope,' arguing that vague eligibility requirements could lead to the kind of expansion seen in Canada, where assisted suicide has become available to people suffering not only from terminal illness, but also from conditions like loneliness, eating disorders and mental illness. 'I cannot get through a day ... It's physical torture,' said a Canadian woman with a series of nonterminal diagnoses, whose journey seeking, and receiving, MAiD is the focus of a recent New York Times story.
'Once we go down this road, there is no going back,' said Ed Mechmann, the director of public policy at the Archdiocese of New York, speaking at a recent event in New York hosted by Communion and Liberation, a Catholic lay movement, along with other opponents of physician-assisted suicide. 'It will change the nature of health care, of living and dying forever,' Mechmann said.
The terms 'physician-assisted death' or 'assisted suicide' typically refer to a medical practice in which a terminally ill person is provided a lethal dose of medication they can take to end their life. The term 'medical assistance in dying' is commonly used in U.S. and Canada policy discussions and often refers to both assisted suicide and euthanasia.
Euthanasia, by contrast, involves a medical professional administering a life-ending medication, typically by injection, at the patient's request. Euthanasia is not legal in the states that have legalized MAiD, whereas countries like Canada and the Netherlands allow both.
Although the proponents of MAiD often frame assisted suicide as a matter of personal autonomy, those who oppose it believe that in reality, it would accomplish the opposite and endanger vulnerable patients who struggle to access care and support. 'As a practicing physician, I will tell you this does not become a matter of choice for most people,' said Dugdale, author of the 2020 book 'The Lost Art of Dying,' speaking at the New York event. 'The concern is that once you have a choice legalized for the privileged few, it will then threaten life for many others who find it difficult to maintain life for a variety of reasons.'
Weak safeguards of the laws and ambiguous definitions would likely contribute to eventually including a wide range of chronic conditions, including diabetes, heart disease, cancer and even mental health disorders like anorexia, Mechmann noted. In such cases, choosing death may not reflect true autonomy but rather systemic neglect, he said.
In Colorado, for instance, patients with anorexia have already qualified for assisted death on the grounds that the condition can be fatal if untreated. In 2024, Quebec, a province in Canada, established the right for a person with a serious and incurable illness to choose a medically assisted death in advance. Also in Canada, patients with a mental illness as an underlying medical condition will be eligible for MAiD in 2027.
But even with long-term patients, it can be difficult to determine whether a desire to die stems from informed decision-making or untreated depression, Dugdale said. 'The people who tend to seek to end their lives through lethal prescription, who want assisted suicide, are at high risk for depression demographically,' Dugdale said. Among those groups are older adults with advanced cancer, especially white men.
Depression is often overlooked or misdiagnosed, despite being treatable. In Oregon, where MAiD has been legal the longest, less than 1% of patients requesting lethal prescriptions are referred for psychological evaluation. 'This is a major oversight that fails to protect depressed people from making flawed decisions,' Dugdale wrote in her op-ed.
Opponents also challenge the popular narrative of MAiD as a carefully considered choice made by an informed patient with a long-trusted physician. 'Very few patients have a doctor they call their own anymore, or a doctor who knows them,' said Dr. Eve Slater, a physician and Columbia University professor at an online event hosted by Plough, a Christian magazine, on June 2. Slater, who previously served as assistant secretary for Health and Human Services, said that for many today, especially in New York, care is fragmented, which makes it more challenging to make intimate and ethically sound decisions. She added that legalizing physician-assisted death could further erode the foundational trust between doctor and patient.
Physicians also often misjudge how long terminally ill patients will live, according to Slater. 'I've been thankfully proved wrong on many occasions,' Slater said. ' I think there is a fallacy in the premise that you qualify if you have less than six months to live, because any doctor who declares that is assuming a crystal ball that they don't have.'
In reality, legalizing assisted death risks creating a new social norm — one that pressures vulnerable individuals, especially those who are alone, seriously ill or unsupported, into feeling like death is their best or only option.
In 2019, Kate Connolly, a communications professional in New York City, received a call that her mother had been rushed to the hospital with a brain aneurysm, she recalled while speaking alongside Dugdale and Mechmann. For the next four and a half years, her mother remained confined to her bed and wheelchair, on a feeding tube, unable to do much without assistance.
Yet, even in a severely disabled state, her mother's presence was cherished by her family before she died, Connolly said. 'Her family's role, which was also a great sacrifice, was to be steward, not dictators, but respectful stewards of a precious gift,' Connolly said.
Around the same time, Connolly learned her unborn son had developed a cystic hygroma — a condition often considered incompatible with life.
Both with her mother and her son, Connolly described pressure from medical professionals to end their life prematurely — through abortion or withdrawal of care, which were presented as practical and compassionate choices. She chose to continue her pregnancy, giving birth to a son and holding him after he died.
Although hastening death may sometimes seem like a more compassionate and pragmatic decision, this mindset fosters a view of suffering lives as disposable, Connolly said. 'The truth is, from what I've seen, dying is not a problem to be solved,' she said. 'It is an experience to be lived and even embraced. It is a sacred time, truly set apart from any experience.'
End-of-life decisions must involve thoughtful, peaceful conversations between patients, families and doctors, Connolly noted. 'What is the right course of action? What is reasonable or what is needlessly extending pain and suffering?' she said. 'You cannot ask these questions thoughtfully or with any real meaning when you're being pushed to just do the expedient thing and end the life in front of you.'
According to studies from Canada, the top reasons that patients say they seek a lethal prescription are more social rather than physical. In Canada, the 2022 annual report revealed that the most commonly cited reasons for requesting MAiD were loss of ability to engage in meaningful activities (86%) and loss of ability to perform daily activities (81%). While supporters of MAiD often argue that alleviating pain is one of the main reasons for hastening the death of a patient, about 59% are concerned about 'controlling pain.'
According to Oregon data, nearly 30% of MAiD-seeking patients cite current and future concerns about pain. 'So it's much more an issue of control,' Dugdale said, adding that the U.S. has robust pain control. 'Dying in pain is not an issue. It should not be an issue.' Instead, loss of independence and fear of being a burden often are.
These fears should be met with care, not a prescription, Mechmann said. 'It's incumbent on us to make sure people don't feel (like a burden).'
With her medical trainees, Dugdale observed a shift in attitudes toward physician-assisted dying. In recent conversations, she said, some trainees wondered, 'Why don't we just do away with our societal aversion to suicide altogether?' and embrace the view that if individuals wish to end their lives, they should be free to do so without interference. Once, she was asked whether assisted suicide can be a solution to the problem of loneliness.
With this mindset, end-of-life decisions would be made through a utilitarian and individualistic lens. Many physicians are uneasy about appearing 'paternalist,' Dugdale said. 'And so to mitigate that, we defer everything to the patient,' she said.
The core ethical principles of beneficence (doing good) and non-maleficence (avoiding harm) have, in practice, been overshadowed by an almost singular focus on autonomy, Dugdale said. For doctors, she continued, MAiD can offer a controlled intervention in the often unpredictable process of dying, providing a sense of agency amid uncertainty.
'There's already a growing pressure to sacrifice one's life for the so-called 'greater good' and to rid the world of expensive, hopeless cases,' she said. Normalizing the idea of choosing death, especially in a society already grappling with high health care costs and an aging population, may cause younger health care professionals to view seriously ill, expensive patients as burdens.
A study from Oxford University points to a correlation between legalized assisted suicide and euthanasia and increased rates of more common forms of suicide in both the U.S. and Europe. 'Once it becomes widely acceptable that I can end my life on my own terms, that feeds a culture of death,' Dugdale said.
In Canada, euthanasia is now the fifth most common cause of death.
'At some point, the vast majority of people in the state of New York are gonna be laying in a hospital bed. And when the doctor shows up, what are we gonna think? Is this my ally or is this my enemy?' Mechmann said.
So what, then, is the way forward?
Investing in meaningful relationships and community and maintaining deep personal connections through family, faith communities, clubs or friendships is a bulwark against loneliness and despair, experts agreed. It's human connection — not lethal prescriptions — that is the real antidote to suffering, participants in the event said.
'Suffering is inevitable,' Mechmann said. But the assisted suicide is a 'bad answer' to the problem of suffering. 'It's love, it's community, it's not despairing. It's being willing to embrace some of the suffering and to live with it and to walk with it.'
Editor's note: This story deals with the practice of assisted suicide. If you or someone you know is struggling with thoughts of self-harm, the 988 Suicide and Crisis Line is always available. You can text or call 988 any time or chat at 988lifeline.org. In Utah, you can also reach out to SafeUT, 833-372-3388, or download the SafeUT app.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Axios
an hour ago
- Axios
Abbott vetoes Texas THC ban
Gov. Greg Abbott on Sunday night vetoed the THC ban bill pushed by his fellow Republicans in the Texas Legislature. Why it matters: The move secures the future of the state's multibillion-dollar hemp industry and keeps those who rely on legal THC products with more options — for now. It also articulates a divide among Texas conservatives in how they view cannabis and how to address its rising popularity. Between the lines: Abbott waited to act less than an hour before the midnight deadline to veto bills. Driving the news: Senate Bill 3 sought to ban the possession, sale and manufacture of all THC products — including consumable delta-8 THC which Texas lawmakers legalized in 2019. Context: Delta-8 THC is a minor chemical variant of the main psychoactive ingredient in traditional cannabis and provides lesser psychoactive effects. It can be coupled with CBD, another hemp-derived compound used for pain relief and mental wellness. In 2019, Abbott signed the Texas farm bill, which partly legalized products containing small amounts of hemp-derived delta-8 THC, including edibles, beverages, vapes and traditional bud. Catch up quick: Last year, Lt. Gov. Dan Patrick vowed that Texas would once again criminalize all forms of THC after claiming products were being sold with "unlimited THC" and marketed to children with "life-threatening" consequences. The Senate passed SB 3 26-5 in March, and the House followed suit with an 87-54 vote in May. Flashback: Thousands of veterans, business owners and THC proponents sent Abbott letters urging him to veto the bill. The big picture: The move comes as Abbott this weekend expanded the state's medical marijuana program, opening it up for people with chronic pain, traumatic brain injury, Crohn's disease and in palliative care, and as more states have loosened cannabis restrictions in recent years.
Yahoo
an hour ago
- Yahoo
Senate Republicans cannot force US Postal Service to scrap EVs, parliamentarian says
By David Shepardson WASHINGTON (Reuters) - Senate Republicans cannot force the U.S. Postal Service to scrap thousands of electric vehicles and charging equipment in a massive tax and budget bill, the Senate parliamentarian said late on Sunday. The U.S. Postal Service currently has 7,200 electric vehicles, made up of Ford e-Transit vehicles and specially built Next Generation Delivery Vehicles built by Oshkosh Defense. USPS warned on June 13 that scrapping the electric vehicles would cost it $1.5 billion, including $1 billion to replace its current fleet of EVs and $500 million in EV infrastructure rendered useless and "seriously cripple our ability to replace an aging and obsolete delivery fleet." Senate parliamentarian Elizabeth MacDonough, whose role is to ensure lawmakers follow proper legislative procedure, said a provision to force the sale could not be approved via a simple majority vote in the Republican-controlled chamber and will instead need a 60-vote supermajority, according to Democrats on the Senate Budget Committee. She ruled last week that Republicans cannot use the bill to overturn landmark rules to drastically reduce vehicle emissions and boost EV sales. Senate Republicans have also sought to reclaim more than $1 billion out of $3 billion Congress gave USPS in 2023 as part of a $430 billion climate bill to buy EVs and charging infrastructure - including $1.2 billion for electric vehicles. USPS told Congress "summarily removing all electric vehicles and charging infrastructure would hobble our ability to deliver to the American people, it would directly harm our ability to serve your constituents, and it would waste crucial funds for no reasonable purpose." Replacing the current 7,200 electric vehicles would directly cost the Postal Service at least $450 million and USPS has also spent $540 million on electrical infrastructure upgrades "which is literally buried under parking lots, and there is no market for used charging equipment," the company added. USPS would also face significant costs from Oshkosh for halting EV purchases under its contract. USPS said in December that purchases in 2025 would be around "50-50" EVs and gas-powered. USPS plans to buy some 66,000 electric vehicles by 2028. Senate Republicans argued scrapping EVs would "focus USPS on delivering mail and not achieving the environmental aims pushed by the Biden administration." In March, the White House forced out Postmaster General Louis DeJoy, who led efforts to restructure the money-losing U.S. Postal Service for nearly five years. USPS has lost more than $100 billion since 2007. David Steiner, a FedEx board member and former CEO of Waste Management, has been named as incoming postmaster general. President Donald Trump said in February he was considering merging the Postal Service with the Commerce Department, a move Democrats said would violate federal law. Error while retrieving data Sign in to access your portfolio Error while retrieving data Error while retrieving data Error while retrieving data Error while retrieving data
Boston Globe
an hour ago
- Boston Globe
Democrats, and some Republicans, question Trump's unilateral attack
Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up 'The foreign minister of Israel said Friday night that its own bombing campaign had set the Iranian nuclear program back 'at least two or three years,'' Kaine noted on 'Face the Nation' on Sunday. 'There was no urgency that suggested, while diplomatic talks were underway, that the U.S. should take this unilateral action by President Trump's orders yesterday.' Advertisement He disagreed with the assertions of Vice President JD Vance and Secretary of State Marco Rubio, who stressed on Sunday shows that the U.S. is not at war with Iran. 'Would we think it was war if Iran bombed a U.S. nuclear facility? Of course we would,' Kaine said. Advertisement A few Republicans are also breaking with the president on the issue. Rep. Thomas Massie (R-Kentucky), who this month introduced a resolution alongside Rep. Ro Khanna (D-California) to require congressional approval before any strike, said Sunday that there had been 'no imminent threat' to the U.S. to justify Trump's unilateral actions against Iran. The U.S. House, Massie noted, was on recess last week. If the situation in Iran was as urgent as the Trump administration has made it seem, the White House should have called lawmakers back to Washington. 'Frankly, we should've debated this,' Massie told CBS's 'Face the Nation.' 'Instead of staying on vacation and doing fundraisers and saying, 'Oh, well, the president's got this under control, we're going to cede our constitutional authority.'' Rep. Warren Davidson (R-Ohio) on Saturday also questioned the legality of Trump's attacks, saying on social media, 'it's hard to conceive a rationale that's Constitutional.' As news of the strikes broke Saturday, Rep. Marjorie Taylor Greene (R-Georgia), who has also opposed U.S. intervention in Iran, posted on X that 'this is not our fight.' Senate Minority Leader Charles E. Schumer (D-New York) called on the Senate to enforce the War Powers Act - the measure that would reaffirm Congress's right to declare war. Schumer urged Senate Majority Leader John Thune (R-South Dakota) to bring the act to a vote on the floor 'immediately.' Schumer said Saturday that confronting Iran's 'ruthless campaign of terror' requires 'strategic clarity.' Trump, he said, must be held accountable by Congress. 'No president should be allowed to unilaterally march this nation into something as consequential as war with erratic threats and no strategy,' he said. Advertisement But Trump's defenders pointed to other authority in the Constitution, with Sen. Lindsey Graham (R-South Carolina) pointing to Article II, which allows the president some war powers. 'You can't have 535 commander in chiefs,' Graham said, referring to the number of lawmakers in the House and Senate. 'If you don't like what the president does in terms of war, you can cut off the funding.' Graham, in an interview on NBC's 'Meet the Press' on Sunday, argued that while Congress has declared war only a handful of times in U.S. history, and has not since World War II, other presidents have launched military operations without congressional authorization. In 2011, for example, President Barack Obama ordered a military intervention in Libya without lawmakers' approval. In other instances, Congress has given the president the power to order limited military attacks by passing an Authorization for the Use of Military Force, or AMUF. Some point out that the 2002 authorization, which gave the president the authority to use armed forces against 'the continuing threat posed by Iraq,' is still active, despite efforts by some lawmakers in recent years to rescind the authority. Defense Secretary Pete Hegseth said Sunday that congressional leaders were informed of the attack soon after the U.S. planes left Iranian airspace. Various lawmakers also argued that Trump should not have bombarded Iranian nuclear facilities because U.S. intelligence did not show that the country was at risk of an Iranian attack. 'You don't want to take an action like this without a strong basis - that is, that Iran was imminently pursuing a bomb, and we simply don't have the intelligence or, if we do, it hasn't been shared with the Congress,' Sen. Adam Schiff (D-California) said Sunday on CNN's 'State of the Union.' Advertisement The top two Republicans in Congress - House Speaker Mike Johnson (Louisiana) and Thune - were quick to praise what they said was Trump's decisiveness even though the president made the decision to attack Iran without Congress's input. Both Thune and Johnson were briefed ahead of the strike, according to two people familiar with the matter who spoke on the condition of anonymity to discuss a sensitive military operation. Johnson said Trump's attack should serve as a 'clear reminder to our adversaries and allies' that Trump 'means what he says.' 'President Trump has been consistent and clear that a nuclear-armed Iran will not be tolerated. That posture has now been enforced with strength, precision and clarity,' Johnson said. Other lawmakers warned about the strikes snowballing into a prolonged conflict, as Iran has asserted that it reserved 'all options' to act in self-defense. Sen. Ruben Gallego (D-Arizona), who served in the Marines, warned the nation should not be 'dragged into another endless war in the Middle East.' 'I would know. I saw close friends die next to me serving as a Marine in a high-combat unit in Iraq,' he said in a statement. 'Each of these deaths was needless.' A few House Democrats called for Trump's impeachment over the strikes. 'He has impulsively risked launching a war that may ensnare us for generations,' Rep. Alexandria Ocasio-Cortez (D-New York) wrote on X. 'It is absolutely and clearly grounds for impeachment.' But Schiff - who served as impeachment manager during Trump's first impeachment trial - told CNN that congressional Republicans have made it clear that they have a 'high bar' for impeachment processes against Trump. Advertisement 'The better remedy, frankly, is - if Republicans will show any backbone whatsoever - to pass a war powers resolution to prevent any further military action,' he said. At least one Senate Democrat, however, openly applauded Trump's actions on Saturday night. 'As I've long maintained, this was the correct move by [Trump],' Sen. John Fetterman (D-Pennsylvania) said. 'Iran is the world's leading sponsor of terrorism and cannot have nuclear capabilities. I'm grateful for and salute the finest military in the world.' Marianna Sotomayor, Amy B Wang and Niha Masih contributed to this report.
