Reaction mixed on allowing lethal medication for terminally ill

Times Herald-Record (Middletown, NY)

June 04-- Jun. 4--NEW PALTZ -- Anne Smith doesn't know if the degenerative disease that is robbing her strength and mobility, and will eventually silence her, would someday entitle her to take a lethal pill, if New York grants terminally ill patients that option.

But she does know the difference that choice made in the deaths of her sister and a friend of theirs, who lived just five miles apart but in separate states, a few years ago.

Her sister Joan, who was suffering from intense pain and could barely swallow as a result of her respiratory disease, lived in New Hampshire and had no access to life-ending medicine. She resisted food and drink to end her life. Their friend Al in Vermont took a doctor's pill about a year later and died peacefully, surrounded by loved ones.

"That is something I think someone should have: the option to choose," Anne said. "Not forced, but choose -- that's important."

Pending in Albany in the final weeks of this year's legislative session is the Medical Aid in Dying Act, a bill that would allow doctors to prescribe lethal medication for patients who request it and are determined to have less than six months to live. Eight states and Washington, D.C., have legalized the practice, which opponents call "physician-assisted suicide." (Supporters reject that label, arguing that a dying patient with months to live isn't committing suicide by hastening that end.)

New Jersey Gov. Phil Murphy signed aid-in-dying legislation less than two months ago. New York Gov. Andrew Cuomo said in April he would sign his state's bill, although its prospects in the Legislature are uncertain. Lawmakers in Maryland and Connecticut recently tabled or narrowly rejected similar proposals.

Supporters like Smith and her husband, Ray, argue that many patients in states that allow the practice never take the lethal pills they were prescribed, yet take comfort in knowing they have that option.

Smith, who is 86 and recently moved from Gardiner to a senior community called Woodland Pond at New Paltz, was diagnosed about a year and a half ago with corticobasal degeneration, a rare and untreatable neurological disorder. She has since become an advocate for aid-in-dying legislation, which she sees as a matter of choice for terminally ill New Yorkers.

"Why oppose it if it's an option only?" Smith asked. "I'm for individual choices."

Prognoses can be wrong

Among those speaking out against the bill is Kristen Hanson, a Sullivan County mother of two whose late husband, J.J., died from brain cancer at age 36 in 2017. J.J. Hanson, who previously had been Ulster County's budget director, lived more than three years beyond the four months his doctors expected him to survive and became an opponent of aid-in-dying laws and president of a group that fights such legislation.

Kristen Hanson, now community relations advocate for the Patients Rights Action Fund, says her husband's outliving his prognosis taught them that doctors are fallible and that patients who request a lethal pill also might have more time to live than expected. She and her husband had their second son while his cancer was in remission.

She also argues that terminally ill patients may suffer depression that clouds their judgment, and that insurance companies may try to coax patients to request a lethal pill rather than continue expensive medical care. What dying patients truly need, she says, is better palliative care.

"That's what people deserve at the end of life," Hanson said, recalling her own difficulty in finding hospice care in Sullivan County. "It shouldn't be a choice between being in a hospital and assisted suicide."

Polls and priests are split

A majority of New York voters surveyed by Siena College in February supported the aid-in-dying bill, with 58 percent in favor of allowing terminally ill patients with "demonstrated decision-making capacity" to take a lethal pill and 34 percent against. Support was at 61 percent in the suburbs and 65 percent upstate.

Opponents include the New York State Catholic Conference, which told lawmakers in a memo in April that authorizing doctors to prescribe lethal pills would "blur longstanding medical, moral and legal distinctions between withdrawing extraordinary medical assistance and taking active steps to destroy life." The practice also would "undermine the physician's role as healer" and lead to pressure on "vulnerable persons to end their lives," the memo argued.

The Medical Society of the State of New York recently voiced concerns about the bill's potential impact on "vulnerable populations." The society's president, Dr. Arthur Fougner, said in a statement on May 14 that the medical society opposes "physician-assisted suicide," but will continue studying the issue and work to "improve access and quality of palliative care for all of our patients, particularly in their last days."

But doctors are split on the issue. Testifying in support of the bill in hearings last year was Dr. Maggie Carpenter, a New Paltz doctor who makes home visits and is the medical director for Hudson Valley Hospice. She argues the legislation has enough safeguards to prevent abuse and poses no risk to patients with disabilities, noting that a patient must have a terminal illness -- not a disability -- and the concurrence of two doctors to get a prescription.

"This is not suicide," said Carpenter, who is one of Anne Smith's doctors. "People are dying, no matter what I do, and I am just helping them decide how they die."

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