Opinion: In the debate on Medical Aid in Dying, facts matter

By STEVEN M. GORDON

Published: 05-01-2024 3:44 PM

Steven M. Gordon lives in Hopkinton and is senior counsel to Shaheen & Gordon.

A recent Concord Monitor Letter to the Editor argued that the passage of the bipartisan NH End of Life Options Act (HB 1283) that would allow medical aid in dying as an option for mentally capable, terminally ill adults will undermine this state’s suicide prevention efforts. Attempting to provide supportive facts to this assertion, the letter looked to Oregon, where medical aid in dying has been the law in effect since 1997, and proclaimed that Oregon’s experience is the reason why New Hampshire should reject HB 1283. Starkly put, he argued, it puts our youth at risk, proclaiming “[d]espite legal options, suicide rates [in Oregon], especially among teens surged.”

I found this statement surprising. Having been familiar with the Oregon law and because I knew of no statistical evidence that supported this statement, I wrote the author asking for the data that supported his statement — public dialogue is best when we seek to understand the facts that support another’s opinion. Kindly, he responded.

The data in the articles was contrary to the statement. The lede of the article was that youth suicide in Oregon was dropping, not surging. In 2018, Oregon had the 11th highest youth suicide rate in the United States (16.9 percent 100,000). In 2021, it dropped to the 22nd highest youth suicide rate (12.4 percent per 100,000). This is not a surge, it’s a decline.

Another article highlighted that suicide is complex but there are patterns. The rates are higher in western states; ease of access to firearms is a singular cause for the high rates of suicide in the western states. Rugged individualism, lack of mental health counseling, and changing economic conditions contribute to rising suicide rates among adults, not children. The article stated that statistics show that 80 percent of suicides are by men and, according to the CDC, more than 70 percent of older male suicides involve a firearm. If we are truly interested in suicide prevention and rely on facts when enacting legislation, should additional restrictions be placed on firearm purchases? New York, with its more restrictive gun laws, ranks 50th in suicides in the country.

For example, 2021 suicide rates increased in New Hampshire (+9%) and Oregon (+18%), rural states with high firearm ownership, but decreased in urban states with medical aid in dying laws, California (-3%) and New Jersey (-6%). Does that mean suicides in those states declined because of this option? I think not and that is the danger of bias extrapolation.

In our exchange of information, we did reach common ground on one point: the bill is about people, not numbers. For me, those people are the ones who meet the rigorous requirements of the bill. Asserting your own personal autonomy under these circumstances does not devalue the life of another.

A debate and vote on HB 1283 should be based on fact, not emotion, experience, not speculation. The intent and purpose of HB 1283 is to enable mentally competent adults who have less than 6 months to live to be able to end their suffering and die peacefully surrounded by their loved ones. Experience and data in the states that have adopted medical aid in dying show no correlation in increased suicides among the young or with the disability community. Facts matter.

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A 2020 University of Pittsburgh School of Law report concluded the experience in the numerous states and Washington, D.C., where medical aid in dying is authorized, “puts to rest most of the arguments that opponents of authorization have made, or at least those that can be settled by empirical data. The most relevant data, namely, those relating to the traditional and more contemporary concerns that opponents of legalization have expressed, do not support and, in fact, dispel the concerns of opponents.” (A. Meisel, A History of the Law of Assisted Dying in the United States, (2020).

In 2019, the former executive director for 33 years of Disability Rights Oregon (DRO), which has federal authority to act as a watchdog for people with disabilities confirmed in a letter written shortly before his retirement, that “DRO has never to my knowledge received a complaint that a person with disabilities was coerced or being coerced to make use of the [Oregon Death with Dignity] Act.”

Experience and data in the states that have adopted medical aid in dying show no demonstrable correlation in increased suicides among the young or within the disability community. Facts matter.