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Should We Legalize Assisted Suicide?
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New York might legalize assisted suicide. Two medical ethicists, Lydia Dugdale and David Hoffman, face off over what’s at stake, autonomy, access, and what we owe patients with terminal illness.

One of the most complex medical, ethical, moral, and religious questions of our era is that of physician-assisted suicide—also known as Medical Aid in Dying, or MAID.

Eleven U.S. states and Washington, D.C. have legalized some form of MAID for terminally ill patients. And New York might join them.

Over the summer, a Medical Aid in Dying Act passed New York’s state legislature. It is now sitting on Governor Kathy Hochul’s desk as she decides whether to sign it into law.

Under the proposed New York bill, terminally ill adults with a prognosis of six months or less to live would be able to access a prescribed, self-administered life-ending medication.

Supporters argue that this is a compassionate option—one that can relieve people of immense pain and suffering, allowing patients to choose when and where they die, and to do so surrounded by loved ones.

Opponents see this as a violation of physicians’ fundamental oath to do no harm. They also worry that while access may begin narrowly, it could expand over time to include people seeking death for reasons other than terminal illness—such as mental suffering or simply a desire to stop living. Cases like this have already occurred in Belgium, the Netherlands, Canada, and Switzerland.

Rafaela Siewert sat down with two experts who see this topic very differently for a heated debate.

David Hoffman is a healthcare attorney, clinical ethicist, and professor of bioethics at Columbia University. He argues that hypothetical future abuses of MAID shouldn’t outweigh the needs of terminal patients who need this option now.

Dr. Lydia Dugdale is a physician, medical ethicist, and professor of medicine at Columbia University. In her view, legalizing this practice of physician-assisted suicide risks undermining the responsibilities of governments, medical systems, and families to care for the mentally ill, the poor, and the physically disabled. And she fears that the potential for excessively expanded access over time is too great.

We are among the many Americans who do not know what the right answer is. We see both sides—which is why grappling with the nuances of this subject is so important.

This is a debate you won’t want to miss.

On how MAID works in theory vs. how it works in practice:

Lydia Dugdale: So you have to be 18 years of age. You have to be able to consent. You have to have a terminal diagnosis understood as six months or less to live. You have to be able to self-ingest.

David Hoffman: Some of the criteria vary from state to state with subtle nuance. For example, Oregon initially had a residency requirement that you had to be a resident of Oregon. Why? Because they feared—at the time I can understand why they would—that people would travel from around the world to Oregon, get their prescription for a lethal medication, go to the beach, watch the sunset, take the medication, and bodies would litter the shoreline. Well, that never happened. So Oregon eliminated its residency requirement. . .

LD: As did Vermont.

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