To the Editor:
Re “We Implemented Canada’s Assisted Dying Law. We’re Concerned,” by Gary Rodin and Madeline Li (Opinion guest essay, nytimes.com, Oct. 5):
As a physician who has assessed and provided medical assistance in dying (MAID) in Manitoba for nearly a decade, I read this essay with concern. I agree that patients considering MAID deserve careful exploration of their suffering and access to counseling, palliative care and social supports. But counseling should support patients’ decisions, not be another test they must pass before their choice is respected.
The authors say clinicians focus on whether patients can receive MAID rather than whether they should. There is an important distinction between understanding why people want MAID and deciding whether they should want it. Medicine often follows the golden rule, treating patients as we would want to be treated. When a patient’s experience differs profoundly from our own, the platinum rule serves better: treating patients as they would want to be treated.
I have asked patients requesting MAID what they would need to no longer want it. Overwhelmingly, the answer is not counseling, housing or companionship. It is a cure, or a reversal of irreversible decline, something that medicine cannot offer.
Shared decision making means listening, exploring alternatives and identifying vulnerability. But in the end, intolerable suffering belongs to the person living it.
Kristen Creek Winnipeg, Manitoba
To the Editor:
As a retired cardiologist and an advocate of increasing access to medical aid in dying in the United States, I appreciated the concerns raised by Drs. Gary Rodin and Madeline Li. However, it’s important to highlight the differences between Canada’s MAID process and America’s.
Thirteen states and Washington, D.C., have legalized MAID, with legislation pending in at least 16 other states. Opponents of MAID are quick to refer to Canada and suggest that America is on the “slippery slope” that these authors describe.
Here, access to MAID is state-based, while Canada has established a federal right to it. In the United States, the patient must be terminally ill with less than six months to live, which is not the case in Canada. Finally, American patients must be able to self-administer the medication; in Canada, the physician can participate in the administration, often by IV.
Opponents of this choice for Americans raise fears that we will “become like Canada.” However, this hasn’t happened in almost 30 years of experience, starting with Oregon’s passage of MAID legislation in 1997.
Shannon J. Winakur Baltimore
To the Editor:
There is no reason to involve medical or legal professionals in one’s end-of-life decision. No one else needs to be deciding as if we were children. Whether pain or sadness or poverty leads one to choose death, all that matters is the decision.
All the hand-wringers who complicate the issue would do a greater service by providing access to therapies without forcing these on people who know they are ready to die.
I should be able to purchase from a pharmacy the necessary means to a serene death at the time of my choosing. Period.
Beatrice Shushan Carlsbad, Calif.
If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.
An Assault on Federal Science
To the Editor:
Re “Science Agency Diverts Money Meant to Fund Basic Research” (news article, Oct. 4):
Your report that the National Science Foundation withheld $1.4 billion — 19 percent of its primary research budget — describes one part of a much larger assault on federal science.
In the first 18 months of President Trump’s second term, more than 10,000 scientists and health professionals with doctorates left federal service. Thousands of research grants that had survived peer review were terminated, suspended or delayed.
Scientific advisory committees were abolished or reconstituted; databases and observing programs were disrupted; foreign students and scholars faced new restrictions; and the United States withdrew from international scientific and public health efforts.
Some measures have been blocked by Congress or the courts. But the cumulative effect reaches far beyond any single budget.
American scientific leadership was built over decades on stable institutions, peer review, continuity and international cooperation. Once those foundations are weakened or dismantled, they cannot simply be restored by reversing a policy or replenishing a budget.
James Lawrence Powell Buellton, Calif. The writer is the author of “The Rise and Fall of Federal Science: From Jefferson’s Republic of Knowledge to Trump’s War on Science.”
The post Defending the Right to Choose Death appeared first on New York Times.
