State Lawmakers wrapped up their session without voting on the Medical Aid in Dying Act, which would allow terminally ill adults to ask their doctors for life-ending medication. It’s been floating around chambers for a couple of years. But with a new democratic majority in the senate, chances appeared better for passage. The legislation generated plenty of discussion surrounding end of life issues, and about the ethical dilemmas posed by this complicated and emotionally charged topic…
Dr. Kim Overby is a clinical ethicist and Professor of the Practice at Cornell University.
“A couple things are factoring in here. One, is that Americans tend to prioritize autonomy or the right to determination, and have control and independence.”
And the other, she says, is most Americans don’t like to think about death, talk about it, or plan for it.
“And, when they do, they often express fear about untreated symptoms, particularly pain, and this loss of control at the end of life. I think aid in dying laws are maybe falsely juxtaposed as a peaceful death to what is perceived as being a frightening experience of dying, attached to machines, having little say or control…”
Millar says the county and state medical societies have long been opposed to medical aid in dying. Dr. Overby at Cornell says it conflicts with the goals of medicine.
“The traditions of this profession are to emphasize care and comfort, and that physicians really should not participate in intentionally ending a person’s life. I think a lot of physicians and health care professionals feel this would fundamentally change the nature of the patient-clinician relationship, and ultimately undermine patient trust.”
Overby says there’s also the concern that legislation would undermine the public health efforts to prevent suicide. She says states with aid in dying laws have seen an increase in “unintentional” suicides because some see it as a rational way to deal with suffering. Dr. Millar with the medical society says the legislation should not be seen as an alternative to hospice, for example.
“We don’t want anyone to have to suffer at the end of their life. So, we want adequate pain control, both emotionally and physically. One thing that the medical society is looking into now are educational opportunities is residency for our physicians and physicians who are practicing so physicians are aware of all the options for their patients.”
Dr. Overby with Cornell says medical aid in dying is so complex, with its almost unlimited number of circumstances that it’s very difficult to properly address with legislation.
“One of the major concerns for both clinicians and individuals is there may be some decisions opting for this practice that may not have been made had the person had access to other supports. For example, concern about untreated or inadequately treated depression or other mental health issues. There is variability in access to mental health, hospice, palliative care, and social support services.”
Read more at WAER Syracuse University…