Assemblyman Singleton has written a very thoughtful post on this issue. Many aspects of the Brittany Maynard publicity, however, may not be immediately apparent to people relatively new to this debate.
The first is that we don’t know who told Brittany Maynard that “even drugs might not be able to alleviate the pain.” I am not a doctor. I am an attorney who has represented people with disabilities on a range of issues, including end-of-life. But it is important for anyone contemplating this question to know that all of the medical authorities, and the bill’s sponsor, and the bill’s most prominent supporters—including Compassion & Choices, who are promoting Brittany’s story—all agree that if a patient in pain is willing to accept palliative sedation, pain is—in their words, not mine—“Not an issue.”
Palliative sedation can be provided in the patient’s home. It consists of sedation or anesthesia to the point where, if necessary, the patient becomes unconscious. Death will ensue, sometimes possibly more rapidly than if the patient were conscious, and sometimes more slowly, since the sedation suppresses stress response, among other effects. Palliative sedation is also referred to as “terminal sedation.”
A debate on physician assisted suicide without full discussion of palliative or terminal sedation will ill serve the general public, who have been led, by Compassion & Choices, to presume patients elect assisted suicide due to fear of pain, and that that fear is justified. Writing that incorrect presumption into law, will make it that much harder for people to ensure their doctors are up to date on palliative care, and to insist upon end-of-life pain relief.
Additionally, people should understand that the primary reasons actually given for seeking assisted suicide in Oregon (where pertinent records have been kept the longest) are not fear of pain, but, rather, distress over “being a burden,” desire to maintain “control,” and fear of inability to pursue previous life activities. These are, quintessentially, disability issues.
And that is one reason why this question is not akin to gay marriage or other areas of civil liberty. In the case of assisted suicide, there are people who would be directly threatened if this bill became law. In the case of legalizing gay marriage, there are not.
Assisting suicide—any suicide—is illegal in New Jersey. This bill would carve out an exception to that, if the person requesting suicide has a medical prognosis of terminal illness. This is not an exception for a person who is actively entering the process of dying. It is not an exception for someone in severe pain who would prefer immediate death at their own hand to palliative sedation. It is an exception because we feel uncomfortable at the disability issues associated with the late stages of terminal illnesses, and inclined to recognize that fear of disability as a valid reason for suicide. What will be recognized next? Oregon’s general suicide rate is unusually high, and rising. Acceptance of the “courage” and “nobility” of disability-avoidant suicide may have a role in that. And, if someone with a terminal illness may request a lethal dose of medicine to keep in their drawer or purse, why not a person suffering from psychologically agonizing, treatment-resistent depression or PTSD?
The bill has many immediate dangers, as well: no requirement for a psychological assessment, no requirement that the patient communicate directly with the physician (communication may be via someone “familiar with the patient’s manner of communicating”), no witness of the actual ingestion of the lethal drugs, no witness to the death, falsification of the death certificate, witness to the request for drugs may be an heir, etc.
I am not religious and I do not approach this topic from the point of view of religion. I approach it from the point of view of logic, and a concern that Compassion & Choices, the well-funded organization promoting this bill, on the one hand acknowledges freely that end-of-life pain can be treated, and on the other is all too happy to leave the public confused on that point.
Nor does Compassion & Choices acknowledge the broad array of disability-rights groups who oppose these bills. Every group to have taken a position on this issue, including all of the following, oppose these bills as far too dangerous. For the few dozen people a year who might seek to take advantage of this bill (based on statistics compiled in Oregon), hundreds of thousands of others will be in danger, including people with disabilities who may feel the pressure of being “a burden,” and people with suicidal ideation who, if Oregon’s experience is any guide, will take this as a license to seek their own relief. That is why this question is one of public health and appropriate for public policy.

Alliance Center for Independence
American Academy of Medical Ethics (AAME)
American Disabled for Attendant Programs Today (ADAPT
Association of Programs for Rural Independent Living (APRIL)
Autistic Self Advocacy Network (ASAN)
Disability Rights Education and Defense Fund (DREDF)
Disability Section of the American Public Health Association
International Life Services
Justice For All (JFA)
National Council on Disability (NCD)
National Council on Independent Living (NCIL)
National Spinal Cord Injury Assocation (NSCIA)
New Jersey Medical Society
New Jersey Statewide Independent Living Council (NJSILC)
New Jersey Progressive Center for Independent Living (PCIL)
Not Dead Yet (NDY)
Patients Rights Council
Physicians for Compassionate Care
Resources for Independent Living, New Jersey (RILNJ)
Second Thoughts
TASH
The Center for Bioethics and Culture Network (CBC Network)
World Association of Persons with Disabilites (WAPD)
World Institute on Disability (WID)