NEW YORK — J.J. Hanson has stared death in the face and fought back: first as an infantry officer with the Marines in Iraq and then again, years later, when doctors told him he had terminal brain cancer and less than six months to live.
But two years later, having beaten the odds and now in remission, Hanson is once again putting up a fight against death: this time in New York, where the battle is against legalizing assisted suicide, and the stakes are the lives of vulnerable patients like himself.
“Doctors can be wrong,” he said. “I’ve been alive for two years and doing quite well.”
These days, the combat veteran, who worked for the Spitzer and Paterson administrations, heads the anti-assisted suicide Patients Rights Action Fund and finds himself lobbying lawmakers in Albany opposite Dan Diaz, the husband of Brittney Maynard, who killed herself in Oregon by assisted suicide in 2014. But what links Hanson and Maynard is that they both had the same terminal diagnosis for brain cancer: stage-four glioblastoma multiforme (GBM).
Current literature indicates GBM is practically a death sentence: Most patients do not survive the year, and only 3% of patients have survived five years.
While Maynard accepted the doctor’s diagnosis and then took her own life in 2014, Hanson dared the odds and opted for a treatment of brain surgery, chemotherapy, radiation and an experimental drug regimen. So far, he told the Register, his scans show him free and clear of cancer.
“Assisted suicide is not fixing the problem,” he said. What has Hanson particularly concerned is that the push toward assisted suicide will discourage clinic trials on experimental drugs that may one day do for GBM patients what insulin did for persons with diabetes and modern medicine has done for HIV/AIDS patients: allow them to live long and healthy lives with diseases that were once known as terminal illnesses.
“If you’re an insurance company, and you have a choice between funding a $200,000 annual cost for a series of drugs that would help someone who is considered terminal or a $100 bottle of suicide pills, what you think they are going to do?” he said. “They’re going to choose the cheaper option, and that’s where the danger lies.”
The New York Legislature is in the early stages of considering two competing bills that would legalize assisted suicide in the state. Both the “End of Life Options Act” and the “Patient Self-Determination Act” have been introduced in legislative committees.
A broad coalition of religious groups, disability-rights advocates and health-care associations — including the Medical Society of the State of New York — have banded together as the New York Alliance Against Assisted Suicide to oppose the legalization of assisted suicide in the state.
“We have a better way,” Michael Burgess, spokesman for the New York Alliance, told the Register.
Burgess, who served as director of the state’s Office of the Aging under Democratic Govs. Eliot Spitzer and David Paterson, from 2007 to 2010, said New York needs to improve its access to palliative care and hospice care, noting that the state ranks 48th in palliative care.
He added that the state also needs to take geriatric mental health seriously and do more to provide the elderly with counseling for depression.
According to the 2015 data coming out of Oregon, the top three cited reasons for seeking doctor-assisted suicide were “Less able to engage in activities making life enjoyable” (96.2%), “losing autonomy” (92.4%) and “loss of dignity” (75.4%).
Burgess said these are issues related to depression. Those seeking suicide over “inadequate pain control or concern about it” were less than three out of 10, whereas nearly one out of two who wanted to kill themselves felt like a “burden on family, friends/caregivers.”
He said that the assisted-suicide bills have no protections for victims of elder abuse and financial elder abuse.
“What about aid in living?” Burgess said. “Why don’t we make sure that older people who are alone and facing the end of life are given palliative care or social and spiritual support, love and a helping hand, instead of just saying: ‘Let’s give them the option of taking these [suicide] pills?’”
New York Is Critical
According to Burke Balch, director of the National Right to Life Committee’s Robert Powell Center for Medical Ethics, New York is the next critical battleground for assisted-suicide advocates, now that California has legalized the practice.
“New York is such a large state, in terms of population and influence, that if it goes the way of a larger state such as California, it may tip the balance and set the ball rolling on legalizing assisted suicide [nationally] that will be very hard to halt,” he said.
Balch said there is a concern that the U.S. Supreme Court could find in favor of a constitutional right to assisted suicide, if enough states pass laws legalizing the practice. Balch explained it was vital to deprive assisted-suicide advocates of gaining political momentum from legislative victories in New York and other states and prevent them from giving the high court an opening to reverse precedent set in 1997 that affirmed states had rational concerns that gave them the right to ban assisted suicide and other forms of doctor-assisted euthanasia.
Balch said one thing the data coming out of Oregon makes clear is that the claim most people are seeking assisted suicide over “intractable pain is simply incorrect.”
“Doctors today are quite good at controlling physical pain,” he said. However, the demand for assisted suicide has arrived at this time, as opposed to the early 20th century, “because of a shift in values and this notion that death is an appropriate treatment.”
But Balch warned that the assisted-suicide debate in the legislature may be New Yorkers’ only opportunity to stop it and prevent the legalization of voluntary and non-voluntary euthanasia. If the pattern of the courts broadening the scope of medical statutes holds true, he explained, the courts may expand the law to legalize non-voluntary euthanasia based on prior precedent, established in the 1970s and 1980s, that says an unconscious or incompetent person cannot be denied the rights of a conscious, competent person on the basis of “equal protection of law.”
Balch noted that the courts have held that since conscious persons can voluntarily disregard extraordinary medical measures that would prolong their lives, it would be unconstitutional to deny that right to a person incapable of communicating his or her own wishes. Therefore, the courts ruled a legal surrogate could make the decision, on behalf of the patient, to pull the plug on his treatment.
But once the courts accept the argument that there is no difference between refusing active treatment options and actively killing oneself by taking a lethal dose, a court case will rely on this past precedent to allow non-voluntary euthanasia, where surrogates make the decision to kill patients.
Ultimately, Balch added, the logical end result is involuntary euthanasia, where doctors and medical ethics committees will likewise extend their ability to overrule a patient’s surrogate on providing lifesaving treatment to ordering the patient’s direct killing out of the patient’s “best interest.”
“If you’re going to say, which the Canadian Supreme Court, for example, has done, that there is no difference between the two … then it follows that you would use the same practices you use to deny lifesaving medical treatment and apply them to direct killing, even against the express will of patients,” he said. “And we’re seeing it happen in countries like Belgium, the Netherlands and Switzerland.”
The New York State Catholic Conference sees the assisted-suicide legislation as putting enormous pressures on society’s most vulnerable persons to end their lives, particularly the poor, the elderly and the disabled.
Kathleen Gallagher, director of the Catholic Conference’s pro-life activities, pointed out that California foreshadows how legalizing assisted suicide takes options away from the terminally ill. She thought Gov. Jerry Brown would, at the very least, have signed a “right to try” bill that would have given terminally ill patients the option to try non-FDA approved drugs in a bid to save their lives.
“He did the opposite,” she said: They only got the suicide pills.
Gallagher said the Church is working with the New York anti-assisted suicide coalition to build an informed grassroots opposition that will engage the public on the moral, medical and legal ramifications of assisted suicide.
“We’re encouraging this training throughout the state,” she said. There was an initial training in November, followed by a February conference in Rochester. Other parishes and dioceses are mobilizing locally.
Gallagher noted that the assisted-suicide lobby, Compassion and Choices (the re-branded Hemlock Society), was targeting public libraries as a venue for engaging the public. She noted that Catholics should take advantage of that forum, as well as engage in letters to the editor and encourage their doctors to speak out.
“What it really boils down to is: Assisted suicide is abandonment, where we don’t want to deal with the burden of caring for someone or paying for the care of someone’s needs — so this is the easy way out,” she said. “It leaves people alone, and as a society, we have to have something better to offer.”
Peter Jesserer Smith is a Register staff reporter.