In Canada, ‘reasonably foreseeable’ death has been the key marker
Robust debate is an important part of good decision-making, so I take issue with the arguments Jeff Jacoby presented in his June 12 Opinion column, “For assistance in dying, please press 1.”
When medical assistance in dying, or MAID, became legal in Canada in June 2016, there was no requirement for terminal illness and there never has been — only that a person’s natural death be “reasonably foreseeable.” This requirement was indeed removed in March 2021, due to its unconstitutionality. But national data show that at least 96.5 percent of all MAID deaths since that time have nevertheless been provided to those whose death is reasonably foreseeable, a far cry from any of the “skyrocketing” of new access Jacoby suggests.
Having a 24/7 information hotline does not “expedite” anything, except access to accurate information, and rather than any “soaring” numbers of Dutch residents accessing euthanasia for mental disorders, their data show a consistent 1.3 percent across the years.
Dr. Stefanie Green
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Victoria, British Columbia
The writer is a practitioner of medical assistance in dying and the author of “This Is Assisted Dying.”
California’s end-of-life option is a good model for proposed Mass. law
Jeff Jacoby rightly warns us about the risk from legalizing medical aid in dying (or physician-assisted suicide). Indeed, in Canada the expanding eligibility for medical assistance in dying has led to an alarming increase in assisted deaths.
Yet the example of California’s end-of-life option should be reassuring to those who have concerns about pending legislation in Massachusetts. Since physician aid in dying was made legal in California, the number of assisted deaths has increased only from 407 in 2017 to 853 in 2022. In contrast, in Canada, with a similar population to California, the number of MAID deaths has increased from 2,838 in 2017 to 13,241 in 2022.
Why? In California, the patient must be of sound mind and have a terminal illness, and these criteria have not changed. The physician cannot administer a lethal medication but rather must prescribe one that the patient can take if and when wanted. In contrast, in Canada, patients without a terminal illness are eligible, and the lethal medication can be administered by the physician, if requested by the patient, as well as prescribed, thus allowing “voluntary euthanasia” as well as medical aid in dying. Indeed, of the 13,241 deaths in 2022, the medication was self-administered in fewer than seven cases.
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The bill under consideration in Massachusetts, which I support, has the same criteria as in California. If passed, the Massachusetts Legislature and state courts can choose to follow the lead of California, not of Canada.
Dr. Paul Sorum
Jamaica Plain
The writer is professor emeritus of internal medicine and pediatrics at Albany Medical College in Albany, N.Y.
Safeguards have been in place for US medical aid in dying laws
Jeff Jacoby is wrong to equate other nations’ euthanasia laws with US medical aid in dying laws, whose core safeguards have remained unchanged since Oregon voters approved the 1994 Oregon Death with Dignity Act.
Every US medical aid in dying law strictly limits this option of gently dying to mentally capable, terminally ill adults with six months or less to live who can self-ingest the medication.
The same is true of the proposed Massachusetts End of Life Options Act. In addition, the Massachusetts legislation requires the attending physician to advise anyone requesting medical aid in dying about “the feasible end-of-life care and treatment options for the individual’s terminal disease, including but not limited to comfort care, palliative care, hospice care, and pain control.”
The safeguards work. That’s why it’s no surprise that 78 percent of Massachusetts voters with disabilities, like me, who were surveyed support the Massachusetts End of Life Option Act after they learn about its safeguards, according to a 2023 Beacon Research poll.
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Michael Martignetti
Lexington
The writer was diagnosed in 1990 with Friedreich’s ataxia, a progressive neuromuscular disease, and is reliant on a wheelchair.
Activists within the disability rights community have justifiable fears
Jeff Jacoby’s column “For assistance in dying, please press 1” warns against the legalization of assisted suicide, especially highlighting its significant risks. As a disabled person, I share these concerns deeply.
Activists within the disability rights community fear that legalized assisted suicide could lead to coercion. Families might see it as a way to avoid caregiving; insurers might prefer it over costly treatments; and health care professionals, influenced by biases about quality of life, could steer patients toward this irreversible option.
Despite claims of compassion, legalizing assisted suicide risks perpetuating systemic ableism and potential abuse. Instead of offering death as a solution, we should prioritize bolstering support systems and health care for disabled individuals.
Comprehensive support services are crucial but often neglected. We already lack equitable and robust disability support systems, and the resulting problems lead to the underlying issues that push individuals toward considering assisted suicide.
Massachusetts must heed these concerns. Legalization of assisted suicide threatens the fundamental rights of disabled individuals to live with the respect and supports we deserve.
Ellen Leigh
Arlington
The writer is a member of Second Thoughts MA: Disability Rights Advocates Against Assisted Suicide.
