Commentary on New York Medical Aid in Dying Proposal

SUMMARY

The City Bar’s Bioethical Issues Committee, Health Law Committee, Legal Problems of the Aging Committee, Mental Health Law Committee, and Science & the Law Committee have issued a white paper providing commentary and urging further public debate in New York on the issue of “Medical Aid in Dying,” sometimes understood or referred to as “physician-assisted death,” “physician-assisted suicide” or “death with dignity.”  The paper encourages and seeks to “foster more robust debate and deliberation about proposed Medical Aid in Dying in New York and urgent public policy and public health policy issues, including foreseeable and unforeseeable risks to equitable access to care among vulnerable persons and groups, such as the elderly, the poor, racial and ethnic minorities, and the disenfranchised.” In particular, the paper voices concern about access to appropriate mental health services and qualified mental health professionals.  

The paper presents some of the ethical arguments surrounding end-of-life care, and particularly the evolution in thinking regarding the right to refuse treatment. The paper identifies several points of consideration specific to the 2017 Medical Aid in Dying Act (A.2383/S.3151), including gaps with respect to the bill’s beneficiaries (i.e., no residency requirements or safeguards for institutionalized persons), and a lack of specificity with regard to financing, delivery systems, and qualifications for mental health professionals and English-language interpreters. The committees also urge funding for research on the experiences of terminally ill patients and their views and attitudes toward Medical Aid in Dying.

Observing the many issues surrounding Medical Aid in Dying, the paper concludes with a call “for more robust debate on important matters of public policy including issues of equity and adequacy of health systems, as well as funding for well-designed research studies.”