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New York Biomedical Roundtable

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Our Open Letter to New YorkersWhy Is Medical Aid in Dying (MAiD) Important? Eve E. Slater, M.D. and Diane E. Meier, M.D. Allowance that terminally ill patients be prescribed a cocktail of lethal drugs for self-administration, MAiD, is currently legal in 13 US states and the District of Columbia. In 2025, six of these states attempted some relaxation of eligibility, and 18 additional states held hearings or voted to pass MAiD. Proponents are moved by the specter of terminally ill patients, but increasingly and unfortunately, other vulnerable individuals are allowed access to death by this method, for reasons other than death being reasonably foreseeable. Advocates for autonomy must open their eyes to these consequences. We are both doctors in New York and have cared for patients who sought our help to hasten their death. Most of the time, their sources of despair could be untangled and addressed to a point where they preferred to live. Once MAiD becomes law, vulnerable individuals are at risk. We say this because any law must protect people from societal pressures - whether overcrowded hospitals, diminishing resources, or unloving family members, all of whom would be better off if expensive or burdensome patients were dead. Increasingly, the thought of “becoming a burden” now accounts for as many as half of requests in the US. Once human life becomes dispensable, its value will be judged by productivity, skin color, or immigration status. This dystopian fantasy is already here. Imagine a hospital where there’s an area you go to die. That already exists in Canada, where 5.1% of all deaths occur by euthanasia (direct injection). Imagine a suite on Park Avenue, USA, where a lethal cocktail is provided to you by a doctor who helps people to die for a living. While formerly, US laws required time for reflection and state residency, newer proposed bills, as in NY State, require neither. All you must do is decide that that life is no longer worth living and find a licensed health professional willing to attest that you have a terminal condition. That terminal condition could be diabetes, if you choose to stop the insulin that keeps you alive. Or cancer, if you choose to stop your treatments. It could be a treatable eating disorder, as in Colorado. Unlike Canada, the US states fail to keep records necessary to ensure patient protections; registries are non-existent or incomplete (for some reason the death certificate can only state the underlying condition and cannot record the fact that the death occurred by assisted suicide). This belies the assertion that US practice is “safe”, as there is no way to keep track of dispensed medication, or its utilization, or the conditions of the patients choosing to die. More lethal medication has been dispensed than deaths recorded, leaving lethal poison sitting unsecured. There are no requirements that the provider(s) adjudicating eligibility has any prior relationship with or knowledge of the patient, no requirement for training in the identification and treatment of depression, or in assessing the many possible reasons for a patient’s despair. No law requires in-person examination. Just as cash-on-the-table store fronts have popped up all over for ketamine treatments for depression or pain (just google ketamine therapy), helping people to die will become a remunerative medical practice. It is ironic, as states expend much effort in suicide prevention. Depression is a major public health concern. A 2023 CDC Report on Youth Risk Behavior, reveals in the past decade, 42% of teens attested to persistent sadness and hopelessness (57% girls); 22% considered attempting suicide in the past year (30% girls); 18% had formulated a suicide plan (24% girls); and 10% had attempted suicide. General suicide rates increase. Data show in the US states where assisted suicide is legal, rates of general suicide have increased by approximately 18% (40% women). In Canada, eligibility now includes eating disorders, dementia, autism, refusal of life-sustaining treatments, and mental illness (implementation, March 2027). Individuals who needed 24-hour home care and could not afford to pay have been offered assisted suicide instead. Expansion in the US is following suit. The access to legal and medicalized suicide, signals that both our lawmakers and our doctors choose to condone suicide as an escape from human suffering, rather than working to provide proper care. Supporting MAiD is both cheaper and has the advantage of the patina of compassion. That these bills could become law just as unprecedented cuts in the social safety net are upon us, is a perfect storm conveying and enacting the dispensability of human life. The vision of MAiD storefronts must never become a reality in any state. Now is exactly the wrong and dangerous time to legalize and medicalize assisted suicide. ##

Talking Points

---Reasons to Oppose Physician Assisted Suicide---

Perverse Financial Incentives

Assisted suicide gives insurance companies and governments the ability to save money by prescribing lethal drugs that are less expensive than treatment. This has happened in Oregon and California, for example, where patients were refused coverage of life-saving treatment and offered lethal drugs instead. 

  • One of the founders of the assisted suicide movement, Derek Humphry, stated “….economics , not the question of broadened liberties or increased autonomy, will drive assisted suicide to the plateau of acceptable practice.” 
  • Canadian officials estimated that assisted suicide and euthanasia could reduce annual spending by between $34.7 million and $138.8 million compared to $1.5 million to $14.8 million spent on lethal drugs.

Mental Health

Only 66 (4%) of the 1,657 patients who died by assisted suicide in Oregon since its legalization in 1998 were referred for psychiatric evaluation.  

Pain is Not the Issue

Inadequate pain control is not among the top five reasons patients in Oregon and Washington request lethal drugs.   

Inaccurate Morality Predictions

A six-month prognosis for death is extremely difficult to predict accurately, with many patients living far beyond the six months. A major study of physician prognoses in Chicago revealed that of 468 predictions, only 20% were accurate in predicting when death would occur. In another study, “No group accurately predicted the length of patient survival more than 50% of the time.”  

Lethal Drugs not Limited to the Dying

Patients who are not dying may receive lethal drugs. The definition of terminal illness under assisted suicide laws includes patients who refuse treatment and might live for many years, and diabetes has been listed as a reason someone received lethal drugs.   

Higher Suicide Rates in States with Assisted Suicide

A CDC report reveals that from 1999-2010, suicide among those aged 35-64 increased 49% in Oregon as compared to a 28% increase nationally.  

Risk of Coercion

No trained medical personnel are required to be present at the time the lethal drugs are taken or at the time of death, creating the opportunity for an heir or abusive caregiver to coerce the patient to take the deadly drugs or put them in the patient’s food without the patient’s knowledge or consent.

Reading Material

Learn More:

Government Documents:

  • Sixth Annual Report on Medical Assistance in Dying in Canada (2025).
  • "Written Evidence Submitted Professor Theo Boer," UK Parliament Committees, 2023.


Academic Journals:

  • Christopher Lyon, Trudo Lemmens & Scott Y. H. Kim (2025) Canadian Medical Assistance in Dying: Provider Concentration, Policy Capture, and Need for Reform, The American Journal of Bioethics
  • Miller FG & Appelbaum PS.  Physician-Assisted Death for Psychiatry Patients – Misguided Public Policy. NEJM 2018; 378:883-888.
  • Lerner BH & Caplan AL.  Euthanasia in Belgium and the Netherlands: On a Slippery Slope? JAMA Internal Medicine 2015; 175:1640-1641.
  • Emmanuel EJ & Battin MP, NEJM 1998; 339:167-172.
  • Chochinov HM & Fins JJ. Is Medical Assistance in Dying Part of Palliative Care? JAMA. 2024.
  • Kussmaul III, WG. The Slippery Slope of Physician-Assisted Suicide. Annals of Internal Medicine. 2017; 167;595-596..
  • https://code-medical-ethics.ama-assn.org/ethics-opinions/physician-assisted-suicide
  • Thomas C, Alici Y, Breitbart W, et al.  Drugs, delirium, and ethics at the end of life. 2024; J Am Geriatric Soc ;72:1964-1972.


Media:

  • Beware Assisted Suicide’s Fog of Ambiguity, National Review
  • Dugdale LS. There Are Ways to Die With Dignity, but Not Like This. https://www.nytimes.com/2025/05/11/opinion/medical-aid-dying-new-york.html.
  • United Nations Committee directs Canada to repeal Track 2 euthanasia deaths, March 2025
  • UN Human Rights Experts: "Disability is not a reason to sanction medically assisted dying – UN experts" 
  •  Liz Carr's YouTube post “Better off Dead” 5/14/24 - 1 hour long but very worthwhile!
  • Letter from the Columbia BMR to the NY State Legislature
  • OpEd by Timothy Cardinal Dolan, 4/7/2024
  • Letter to the Editor in The Economist, Dr. Eve Slater
  • "Assisted Death and The Economist," Richard M. Doerflinger, The Public Discourse, 2024.
  • "Open Letter From Doctors" Against Assisted Suicide
  • AMA Retains Policy Against Assisted Suicide, National Review 
  • "A Change of Heart on Assisted Suicide", Diane Meier, New York Times, 1998.
  • "The Death Treatment", Rachel Aviv, New Yorker, 2015.
  • "What Euthanasia Has Done to Canada", Ross Douthat, New York Times, 2022.
  • "Euthanasia ‘Impossible to Police’ for Law-Breaking," Theo Boer, The Law Society of Ireland Gazette Magazine, 2023.
  • “Letter To New York Legislators Opposing Assisted Suicide Bill S.2445," Alex Schadenberg, Euthanasia Prevention Coalition, 2023.
  • www.nosuicideny.org


Books:

  • The Lost Art of Dying, Lydia Dugdale, HarperOne, 2020. 

/Users/eveslater/Desktop/CBMR edited.docx

Key Stats From Above 2023 Canadian Report

3,399

3,399

3,399

The number of Canadians who received AS/AD for isolation and/or loneliness

431

3,399

3,399

The number of Canadians who died by AS/AD and who sought but did not receive palliative care services

432

3,399

432

The number of Canadians who died by AS/AD and who required but did not receive disability support services

Other Resources

Other organizations with which to connect:

  • Patient Rights Action Fund
  • Euthanasia Prevention Coalition (EPC)
  • Christian Medical & Dental Association (CMDA)
  • Vivre dans la Dignite
  • International Doctors Say No

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This organization and its website only reflect individual views; it does not reflect any institutional views, including those of Columbia Vagelos College of Physicians and Surgeons or New York Presbyterian Hospital.

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