Governor Hochul Must Veto MAiD in New York

A few years ago I attended a funeral in my hometown. Unfortunately the story is a common one there. A friend’s father had been experiencing some very real difficulties—and had decided to take his own life.

“Even one suicide is one too many,” New York’s Governor Kathy Hochul has said. Throughout her term in office, the governor has prioritized suicide prevention, investing a billion dollars in mental healthcare and increasing funding to support veterans.

Given this, it’s deeply unsettling that Gov. Hochul has announced her intention to sign a bill that would legalize physician-assisted suicide for terminally ill New Yorkers.

It’s tempting to imagine that “Medical Aid in Dying” (MAiD) is not really suicide—or that if it is, it’s “justifiable suicide.” Yes, it looks a lot like suicide: Someone intentionally overdoses on pills, hoping to never wake up again. And yes, people choose MAiD for the same reason that anyone finds suicide attractive: The future seems bleak and—on the whole—not worth living through. But it can feel different because the person is terminally ill. He or she is reasonably likely to die within six months, and the expected progress of the disease may be pretty scary. When people are terminally ill, we rightly give them access to more aggressive pain relief—even if it means they may die sooner. And many people feel that it’s compassionate to offer MAiD to the dying, at least when they request it.

But the reality is that MAiD legalization devalues terminal lives and puts terminally ill people in a terrible position. Suddenly, it’s up to them to decide if their lives are worthwhile or if they’re too much of a “burden” to others. Instead of offering MAiD to the dying, we must offer them hope: hope that their final days are meaningful and valuable.

And the lives of the terminally ill are immensely valuable. People can often achieve great things while they’re terminally ill. Sometimes these are things that they would not have been able to achieve when they were healthy. This can happen whether they’re aware of it or not.

While dying of pancreatic cancer, my grandmother gave me something that she couldn’t give during the healthy part of her life—and my father-in-law did the same thing while dying of glioblastoma. It’s hard to describe what exactly this is, but I think it’s that vulnerability, dependence, and even loss of control can allow you to radiate love in a new way. When they were healthy, my father-in-law and my grandmother were both generous and loving people, and they were also very able people. My father-in-law was a pediatrician, and my grandmother was nicknamed “the CIA” because she was so effective at tracking what was going on in the lives of the hundreds (or thousands?) of people she cared about. Seeing them persist in loving everyone while losing their abilities and being in pain and being taken care of made something very clear: The way they treated us when they were healthy was not just about having an identity as a “helpful person”; they loved us no matter what role they would have to take in the relationship. And they were able to persist in their love while undergoing something very difficult.

I’m not sure if either of them were aware of how much they achieved in the final months of their lives, but it was extraordinary. They showed us who they are. They showed us their love. And they also showed us what it looks like to die well. 

Now, obviously it would be wrong to ask my grandmother or my father-in-law to go through all of this just for my sake. And it’s tempting to imagine that offering MAiD to people in their situation is simply about making this kind of suffering optional. A MAiD advocate might say, “If you want to stay alive to bless your family and friends just don’t get MAiD. But if your prognosis is particularly scary, or you’re not feeling up for it, or you don’t think your final days will be a blessing to anyone (or if you’d just prefer to give your kids cash), MAiD allows you to skip the whole thing. It’s just an extra option.” But this is a deeply unrealistic way of thinking about this.

The reality is that MAiD is not really about making death better for the dying; instead, it’s about making their death more convenient for everyone else. Or, to put it more charitably, MAiD is about sparing the dying from needing to inconvenience anyone.

We can see this clearly if we look at the reasons that people request MAiD. In the U.S., people typically do not list pain as a reason for requesting MAiD. We actually have very good pain control available, at least for people with terminal illnesses. (The pain situation can be trickier for those without terminal illnesses.) In fact, the only way in which MAiD is “superior” to palliative care is that it’s cheaper and more convenient for medical providers and family.

Instead, people request MAiD to avoid disability. In Oregon, the state with the longest-standing assisted suicide program, the most common reasons for requesting assisted suicide involve loss of autonomy, loss of ability, loss of “dignity,” and a fear of “burdening” others.

But the terminally ill are not “a burden.” To the extent that their illness is “inconvenient” to others, this inconvenience is worth it. Because they are worth it. We owe it to the terminally ill to tell them this. Both individually, and also as a society.

We cannot hand them a loaded gun and say, “If you feel like you’re too much of a burden, we respect that assessment.” This is essentially what MAiD legalization does.

And inevitably, the availability of MAiD will lead to situations where many people feel like they have to choose MAiD, even if they don’t want it.

Conscientious parents may worry that they are “wasting” their kids’ inheritance on their own treatment, or “inconveniencing” their kids by dying on an uncertain timeline with home hospice, rather than dying efficiently, at an agreed-upon time, via state-sanctioned suicide.

More broadly, the availability of MAiD will lead to norms against natural death, at least in certain circumstances. You’ll begin to hear snippy comments about old so-and-so who put his children through hell by not killing himself at the appropriate time. And you won’t want people making those snippy comments about you.

It may be that a tiny fraction of the terminally ill actively want the right to end their own lives—but this simply is not worth it, particularly when it means that many other people will feel like they have no choice but to end theirs.

The terminally ill give us so much, and we owe them something in return. At the very least, we need to let them know that they’re needed and valued, that they are not “a burden.”

Gov. Hochul, please tell terminally ill New Yorkers the truth: Their lives are incredibly valuable. And to do this, you’ll need to veto MAiD in New York.

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_{Image by Metropolitan Transportation Authority, licensed via Creative Commons. Image cropped.}