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In 2023, progress against physician-assisted suicide

As we glance back at 2023, opponents of physician assisted suicide can reflect on a year marked by unwavering opposition and quiet victories in our fight. While the legislative landscape was busy with bills introduced in more than a dozen states, it has been more than two years since any new assisted suicide laws were enacted in the U.S.

These victories are not a sign of surrender by suicide proponents, but rather a sign of the persuasiveness of the arguments against it and the growing opposition and public awareness of the dangers inherent in these laws. We will continue to make the case in capitol buildings and the courtroom alike.

My organization joined United Spinal’s plaintiff group, which took legal aim last year at California’s physician-assisted suicide law. They argued that the law violates the Americans with Disability Act, the Rehabilitation Act and the Due Process and Equal Protection clauses of the 14th Amendment. California law creates even more unequal treatment for people with disabilities, puts us at greater risk of coercion, and makes us more vulnerable to a system preventing access to the care we need. It effectively funnels us toward death too soon. That’s not equal protection — it’s eugenics.

California and New Mexico had adopted laws that would have forced physicians who oppose assisted suicide to participate in the process. This forced participation is a violation of Sec. 1553 of the Affordable Care Act and a profound threat to patient trust. If left in effect, it would have dramatically limited the choices of patients who want the option of medical providers they know will not devalue their lives and, in a dark moment, usher them along toward suicide at their duress-induced request to end it all.

Fortunately, successful lawsuits resulted in an injunction on the provision in California and induced the New Mexico legislature to amend the law, protecting the rights of patients to receive care from non-participating doctors without fear.

Last year also saw the American Medical Association (AMA) reject a proposal to soften its longstanding opposition to assisted suicide. Two resolutions were offered that would have changed the AMA’s position from opposition to neutral. While this may not sound significant, a neutral position from the AMA would have had the same impact as being in favor of physician assisted suicide. The vote to reject represents a crucial affirmation of the AMA’s commitment to the trust upon which the patient-physician relationship is built, the protection of vulnerable patients, and the preservation of the physician’s role as healer.

Not all professional organizations initially followed the AMA’s lead. The Alzheimer’s Association’s recent collaboration with a prominent pro-assisted suicide group raised eyebrows and concerns. This partnership, announced in late 2022, threatened to erode trust in an organization whose focus is, and should remain, on supporting families facing the immense challenges of dementia. After this partnership was made public, strong objections from the Alzheimer’s community and others quickly surfaced, and the association ended the partnership, saying, “Their [proponents’] values are inconsistent with those of the association.”

Finally, the American Association of Suicidology’s decision to “retire” its previous position on assisted suicide was a sound and important decision in the field of mental health. In 2017, it had adopted a position that said, “suicide is not the same as physician aid-in-dying.” The recission of this previous position strengthens the profession’s commitment to suicide prevention. Assisted suicide is suicide, no matter what euphemisms proponents try to push.

Defenders of vulnerable people, including within the disability community, medical professionals and caregivers will continue to fight against proposals to legalize physician-assisted suicide. We will fight for legislation that safeguards the equal human dignity and value of the lives of people with disabilities, older adults, and other historically underrepresented groups.

We will promote hospice and palliative care as true end-of-life care. Above all, we will remain a source of hope for those facing life’s most difficult moments, offering unwavering support and advocating for access to high-quality, comprehensive end-of-life care, equitable and affordable homecare, and long term services and supports.

Matt Valliere is executive director of the Patients’ Rights Action Fund and Institute for Patients’ Rights, as well as a volunteer emergency medical services first responder.

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