Latest news with #PaulaRitchie
New York Times
6 days ago
- Health
- New York Times
Why the Euthanasia Slope Is Slippery
This week the Legislature of New York State passed a bill, now sitting on Gov. Kathy Hochul's desk, allowing assisted suicide for people facing a diagnosis that gives them six months or less to live. A few days before the vote, my colleague Katie Engelhart published a report on the expansive laws allowing 'medical assistance in dying' in Canada, which were widened in 2021 to allow assisted suicide for people without a terminal illness, detailing how they worked in the specific case of Paula Ritchie, a chronically ill Canadian euthanized at her own request. Many people who support assisted suicide in terminal cases have qualms about the Canadian system. So it's worth thinking about what makes a terminal-illness-only approach to euthanasia unstable, and why the logic of what New York is doing points in a Canadian direction even if the journey may not be immediate or direct. In a debate about euthanasia I was once asked, by the husband of a woman who sought assisted suicide unsuccessfully before her painful death, what I would have had the doctors offer her in place of the quietus she sought. His implication was that doctors always need to offer something: In most situations, that means care and treatment, but at the exceptional point when nothing further can be given, it's legitimate to expect them to deliver something else. This is the logic that undergirds laws that offer assisted suicide only to the terminally ill. It assumes that the dying have entered a unique zone where the normal promises of medicine can no longer be kept, a state of exception where it makes sense to license doctors to deliver death as a cure. The problem is that a situation where the doctor tells you that there's nothing more to be done for you is not really exceptional at all. Every day, all kinds of people are told that their suffering has no medical solution: people with crippling injuries, people with congenital conditions and people — like Ms. Ritchie — with an array of health problems whose etiology science does not even understand. Want all of The Times? Subscribe.
National Post
07-06-2025
- Health
- National Post
Colby Cosh: There's no point to gatekeeping MAiD if doctors never say 'no'
Article content On Sunday the New York Times Magazine published a feature about Canada's legal regime for assisted suicide, wrapping large volumes of reporting on law, ethics and medicine around the individual story of Paula Ritchie, an Ontario woman who sought and received 'MAiD' after an unhappy life full of pain and misery. Article content Katie Engelhart's story plays pretty fair with an explosive social issue that is of increasing global concern. She knows the NYT 's world audience is aware of Canada's avant-garde experiment with the facilitation of medical suicide for patients who don't have terminal illnesses, and she doesn't stack the deck either way. Article content Article content She's not under any fanciful illusions about the quality of Canadian medicine or Canadian welfare, specifically describing how mere administrative mistakes can lead to intolerable suffering for which the Canadian state now provides a fatal exit. She acknowledges that there was nothing demonstrably wrong with Ritchie apart from mental illness and ill-specified 'functional disorders'; there is some accounting of times she refused potentially helpful treatments out of sheer despair. Article content Article content At the end of the story, as Ritchie is put to death like a sick pet with friends and family around her, one can't help thinking she might be better off — and one can't help wondering whether we are playing with fire. That very uncertainty is the whole problem with MAiD, of course. Because it is an experiment, we're left trying to extrapolate the second-order social effects of a legal regime over which nobody has complete political control. (MAiD is, to say the least, not the only social problem of this nature.) Article content Canadian law doesn't yet theoretically allow for MAiD for mental illness alone without some accompanying physical diagnosis. But a diagnosis is a label, and there is a myriad of labels available for those 'functional disorders' and chronic-pain syndromes whether or not there is any observable biological signature. If you want desperately to die with a doctor's help, as Ritchie did, you can probably find one who has an extreme ideological commitment to total patient autonomy, as Ritchie did, and get him to sign off, as Ritchie did. Article content Article content I don't know of any case where a doctor gave MAiD to anybody who didn't have a clear, emphatically expressed desire to die. And, as Engelhart points out, there is not yet any apparent epidemic of 'Track 2' assisted suicides not involving terminal or irresolvable physical illness. But her story hints uneasily that Canada may simply be turning euthanasia into just another medical specialty, or indeed turning some doctors into vending machines for lethal poisons. They're being asked, in Track 2 cases, to approve and facilitate suicide, or to refuse to do so, after assessing a patient's purely subjective suffering. One uneasy physician interviewee asks: 'If you want to allow people to end their lives when they want to, then put suicide kits in hardware stores, right?'
New York Times
02-06-2025
- General
- New York Times
A Merciful Death
I grew up in the '80s and '90s and remember being fascinated by the controversy around Jack Kevorkian. He was a Michigan doctor who argued that sick people should be allowed to die on their own terms rather than suffer through a grueling illness. Was he a traitor to his oath to 'do no harm'? Or was he an angel of mercy, letting victims of disease exercise one last bit of agency over their failing bodies? Kevorkian, who went to prison for helping dozens of people with 'physician-assisted suicides,' seemed so radical at the time. Now his ideas are commonplace. Ten states and lots of Western nations have assisted-dying laws. But they're mostly built for people with a life-ending diagnosis. Canada is trying something more. There, a patient can have a state-sanctioned death if she is suffering — but not necessarily dying — from an illness. For the cover story of yesterday's New York Times Magazine, Katie Engelhart followed one woman's journey to die. It's a nuanced portrait of a person racked with pain and a tour of some controversial bioethics. I spoke with Katie about the difficulty in knowing what's right and what's wrong when people suffer. Your story has so much intimate detail about the struggles of the main character, Paula Ritchie. How did you get her to confide in you? Paula was, in her own words, 'an open book.' The first time I called her, we talked for nearly three hours. She had applied for medical assistance in dying, or MAID, after suffering a concussion, which led to dizziness and insomnia and pain that never went away. I knew that Paula would be an interesting case study, in large part because of the complexity — the messiness, really — of her life. She was the kind of patient whom opponents of MAID worry about. Paula had a mix of physical and psychiatric conditions: chronic pain, chronic fatigue, bipolar disorder, depression. She had a history of childhood trauma. She lived below the poverty line. She was very lonely. You watched Paula die. I was moved, reading about her last moments. What was it like to see that? I was trying to be as small a presence as possible in the room. I sat in a folding chair at the foot of her bed. As a reporter, the experience was doubly intense: I was there to do a job — to gather information — but I was also experiencing the moment as a human being, sitting in a room full of suffering. I said very little to Paula and she said very little to me, although she did briefly reach for my hand as she was getting ready for her injections. Want all of The Times? Subscribe.
New York Times
01-06-2025
- General
- New York Times
Do Patients Without a Terminal Illness Have the Right to Die?
One of the doctors wanted to know why, despite everything, Paula Ritchie was still alive. 'I'm just curious,' she said. 'What has kept you from attempting suicide since August of 2023?' 'I'm not very good at it,' Paula said. 'Obviously.' Then she started to cry. She said that everything was getting worse. She said she didn't want to suffer anymore. 'This is a more dignified way to go than suicide.' Paula was lying in the big bed that she had pulled into the center of the living room, facing an old TV and a window that looked out on a row of garbage bins. The room's brown linoleum floors were stained, and its walls were mostly unadorned. On a bookshelf, there was a small figurine of an angel, her arm raised in offering. At 52, Paula had a pale, unblemished face and a tangle of dark hair that fell around her waist. The day before the appointment, in January this year, she washed her hair for the first time in weeks, but then she was not able to lift herself out of the bathtub. When, after hours, she managed to get out, her pain and dizziness was so bad that she had to crawl across the floor. Dr. Matt Wonnacott sat in a folding chair at the foot of the bed. He was there as Paula's 'primary assessor': one of two independent physicians, along with Dr. Elspeth MacEwan, a psychiatrist, who drove through the snow to Smiths Falls, Ontario, to evaluate Paula's eligibility for Canada's Medical Assistance in Dying (MAID) program — what critics call physician-assisted suicide. 'You're a difficult case,' Wonnacott admitted. Another clinician had already assessed Paula and determined that she was ineligible — but there was no limit to how many assessments a patient could undergo, and Paula had called the region's MAID coordination service every day, sometimes every hour, demanding to be assessed again, until the nurse on the other line had practically begged Wonnacott and his colleagues to take Paula off her roster. Want all of The Times? Subscribe.
