Support the Medical Aid in Dying Act

I have long known about medical aid in dying — legal in 10 states (including Vermont) and Washington, D.C., but not here in New York — but it wasn’t an issue I paid a great deal of attention to until Karen’s death two years ago in the Netherlands. To be clear, I’ve also long known the difference between medical aid in dying, palliative sedation (legal everywhere in the United States) and euthanasia (legal nowhere in the United States).

Karen had lived in the Netherlands for 42 years. In December of 2021, she was diagnosed with a rare and aggressive cancer. In 2022, she underwent surgery to remove the tumor, followed by radiation therapy. The prognosis was dismal, but she remained hopeful. I visited her several times, and she seemed to be doing well. A year after her diagnosis, however, she began to experience abdominal pain and other troubling symptoms. By the end of February of 2023, the cancer had metastasized to her liver at an alarming rate.

In 2022, Karen made plans to be able to die by euthanasia should she choose that option in the future. Euthanasia has long been legal in the Netherlands but is not legal in the United States. I feel strongly it should stay illegal here, although I would have supported Karen in whatever decision she made.

In March 2023, Karen’s pain had become unbearable, and she was hospitalized. I was scheduled to visit that same week. She called before I left to tell me that she planned to exercise her option to die on her own terms when my brother and I were with her.

My brother and I arrived, and we spent two days with Karen, laughing about events in our childhood and expressing our love for each other. Her two children were ever-present and comforting to her.

When her medication could no longer relieve her intense pain, she contacted her doctor, who arrived and dismissed everyone from the room and spoke privately with Karen for a half hour. They had decided on palliative sedation, which relieves distress in terminally ill patients, unlike euthanasia, which is the termination of life by someone other than the dying person.

My brother and I, her children and her grandsons all surrounded her with love and affection and said our goodbyes. Finally, she said, “I am ready.” The medication was administered and she immediately went to sleep and passed two hours later.

I have long been and continue to be a strong supporter of hospice and palliative care. I find it interesting — and maybe there is a correlation — that New York has one of the lowest hospice use rates in the nation, while Oregon, where medical aid in dying has been legal for nearly 30 years, has one of the highest. I consider this yet another reason to legalize medical aid in dying in New York.

To be clear: Medical aid in dying is only applicable to adults who can make healthcare decisions for themselves and have a terminal illness or disease — irreversible and incurable — with six months or less to live, as certified by two physicians. It is voluntary all around and the patient must self-administer the prescription that will put them to sleep and let them die peacefully.

I will always remember Karen as someone who lived her life exactly as she wanted, and this rang true for her dying. I have amazing respect for her decision, and if death can be joyous, this was an example that I will remember and respect forever.

I hope that when my time comes, I will have the same options to pass into the next world with dignity, comfort and some control as Karen did. That’s why I urge everyone to contact their state legislators and urge them to support the Medical Aid in Dying Act (A.136/S.138). It is a matter of the love that we have for each other.

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Chandler Ralph is the former chief executive officer at Adirondack Health in Saranac Lake. She lives in Lake Placid.