Death  ̶  the life event we will all experience, but no one likes thinking about.

Proposed legislation in Minnesota, however, is forcing us to contemplate what death means to us as individuals and as a society. And that’s a good thing. Because inevitably, no matter who we are or how we go, our hearts will one day stop beating.

What isn’t good is what this bill proposes: the legalization of “medical aid in dying,” or what the American Medical Association (AMA)  ̶  the largest democratically elected body of physician leaders  ̶  calls “physician-assisted suicide.”

I serve as one of Minnesota’s AMA delegates, and as a physician and palliative care expert, I’ve worked closely with patients living with chronic conditions and disabilities for more than 30 years. Based on these experiences, I’m troubled by the consequences this proposed legislation would have on Minnesota’s health care system.

If our elected officials approve this bill, it would obligate Minnesota physicians to not only function as healers, but also as the gatekeepers and ultimate decision-makers of who can receive narcotics to end their life. This would be a drastic change in our health care culture. Doctors would be required to offer assisted suicide as a treatment option in qualifying situations, and refer patients to providers who will prescribe the lethal drugs, even if a patient has never considered or previously requested it.

The AMA has spent years evaluating this question. We examined data in states like Oregon and countries like Canada where physician-assisted suicide or euthanasia are legal. In 2019, 80% of the more than 600 elected physicians representing every state and specialty voted to reaffirm a code of ethics that opposed assisted suicide. That opinion states, “Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.”

Interestingly, the same data shows the primary reason individuals choose assisted suicide isn’t inadequate pain control. Advances in palliative care have made great strides in managing pain, and proactive end-of-life planning can eliminate the risk of prolonged suffering.

Instead, people are largely opting for assisted suicide out of the fear of becoming a physical or financial burden on their loved ones.

This makes me particularly concerned about the impact this legislation would have on elderly patients, a group I’m honored to serve in my daily practice. What will they think as they fight loneliness and wonder of their value? Will their quiet thoughts of, “Am I better off dead?” now be affirmed? And when they encounter medical concerns, will they feel pressure to end their life?

I also fear this bill would have the greatest negative impact on the poorest and most marginalized Minnesotans who already struggle to pay for treatments to live comfortably. Many of the Medicaid patients I serve cannot even receive timely wound care for pressure sores. What will happen when insurance companies reject requests for treatments that are more expensive than assisted suicide? Many patients don’t have the means to fight denials of coverage.

The AMA’s view of assisted suicide as uncontrollable reflects the reality of how legalization has played out in other jurisdictions. In Canada, like the bill currently proposed in Minnesota, restrictions originally focused only on the terminally ill; they now permit assisted suicide for young people and individuals living with disabilities and mental health conditions who are not actively dying. In 2016, Canada had 1,100 people opt for assisted suicide or euthanasia. By 2022, that number had increased to 13,241.

This is more than a personal decision; these choices will affect all of us and the culture of our communities. I ask our esteemed legislators – especially my physician colleagues – to not open this Pandora’s box.

Dr. Dennis O’Hare of West St. Paul is a board-certified physician in geriatric and family medicine, a palliative care expert, elected Minnesota delegate in the American Medical Association and member of the Alliance for Ethical Healthcare. He practices with Bluestone Physician Services, which is headquartered in Stillwater.