Saturday, December 15, 2018

Assembly member Amy Paulin at Mid-Westchester JCC. (Credit: Compassion&Caring.org)

Susan Rush introduces panelist physicians Grube (left) and Berman. (Credit: Marc J. Berger, MD)

On Thursday, November 8, the New York Chapter of Compassion and Choices held a forum at the Mid-Westchester JCC on the pending state legislation regarding physician-assisted suicide.

Assembly member Amy Paulin (D-Westchester), just re-elected two days earlier, is the sponsor of A.2383, New York’s Medical Aid in Dying Act. State Senator Diane Savino (D-Staten Island/Brooklyn), sponsored the companion S.3151 bill in her chamber. When the New York Legislature reconvenes in January 2019, this legislation will be reintroduced, authorizing “medical aid in dying for terminally ill adults with less than six months to live and found by two doctors to be mentally capable to make this medical decision.” The law would give eligible patients the option to request a prescription for medication they can take to shorten a difficult, painful dying process. The bill was first introduced on May 10, 2016, and passed by the Assembly Health Committee two weeks later, but a full vote by either chamber has not been held.

An Eagle Point Strategies Survey, conducted in September 2015, showed that 77 percent of New Yorkers agreed that “when a mentally competent adult is dying from a terminal illness that cannot be cured, the adult should be allowed the option to request a prescription for life-ending medication from a doctor, and decide whether and when to use that medication to end their suffering in their final stages of dying.”

Paulin opened the forum with a description of her sister’s eight-year battle with ovarian cancer. After a recurrence of this disease, her sister entered hospice care in Georgia and died two weeks later, without any of her close relatives nearby. This tragedy influenced her to sponsor legislation to allow “death with dignity” in New York State.

Prior to leading a panel discussion, Susan Rush, an activist for options for the terminally ill, shared her father’s fatal battle with stage IV lung cancer. He was a retired Marine and a devout Catholic who refused analgesia and died an uncomfortable death at home.

Next, two physicians on opposite sides of this debate shared the stage. Dr. David Grube practiced family medicine in Philomath, Oregon, for 35 years. He retired from practice in 2012, and serves as the national medical director for Compassion & Choices. He has lectured nationally on professionalism, medical ethics, end of life care and humor in medicine. Oregon was the first state to legalize physician-assisted suicide. Their “Death With Dignity Act” was passed by Oregon voters in November 1994. Since then, Dr. Grube treated many patients who made the difficult choice of ending their lives. His personal “call-to-arms” was finding his terminally ill neighbor/friend/patient with a fatal, self-inflicted shotgun wound. He reiterated that he felt he conducted himself throughout his career in full compliance of the honor and ethical expectations of medicine’s primary credo (first, do no harm).

Dan Berman, MD, a member of the Young Israel of New Rochelle, is an attending infectious disease specialist at Montefiore Medical Center and a frequent speaker on Jewish medical ethics, among other halachic topics. He clarified that he was appearing in opposition to the proposed law as a physician, and not as an observant Jew. As a fellow of the American College of Physicians, he emphasized that no American physicians’ organization supports these laws. They are joined in opposition by the British Medical Association and Australia’s AMA. 

Berman is also concerned that such legislation can “follow a slippery slope.” The New York law would require two medical witnesses and certification of the patient’s mental competence to make such a decision. Berman fears that the decision-making process could be extended to the proxies for the mentally unfit and young children.

An irony in the Oregon law raised by Berman is the mental health evaluation required of the terminally ill who refuse to consider suicide, while psychiatric evaluation is always requested of anyone else expressing the desire to commit suicide. Berman also discussed the nationwide suicide crisis, which includes a 30 percent rise over the last two decades. 

Dr. Grube pointed out that in the 20 years since Oregon’s law was enacted, 1179 patients made use of the law. Seventy-seven percent were diagnosed with terminal cancer and 8 percent suffered from advanced ALS. He emphasized that not one extra death occurred as a result of the law. Each patient was terminal and was likely to die within six months. He also said that in the first 10 years of his state’s law, 80 percent of assisted deaths were attended by physicians, but that dropped to 30 percent in the second decade.

Physician-assisted suicide is currently allowed in six states (Montana, California, Washington, Colorado, Vermont and Oregon) and the District of Columbia. Hawaii recently enacted a law to take effect on January 1, 2019, and 30 more states are considering it.

Attending the event, but not part of the program’s speaker panel, were members of “New York Against Assisted Suicide” who distributed a “psak halacha” signed by many rabbonim opposing physician-assisted suicide laws.

By Judy Berger

 

 

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