On His Deathbed, A Doctor Asks Legislature to Pass Medical Aid in Dying Act

By Robert Milch, MD, FACS | June 10, 2021

Dr. Milch passed away on June 4. He authored this OpEd two days before he died. His family wants to share with New York lawmakers and voters.

I am going to die soon. Very soon.

This is not hyperbole. Unfortunately for me, it is a simple and indisputable fact.

I am a retired surgeon and hospice physician with terminal cancer who is now benefitting from the hospice care I helped co-found in Buffalo in 1978.

I have had a wonderful life with no regrets. I have a loving family that means more to me than anything else. I’ve had an amazing career as a doctor, a surgeon, and as medical director at Hospice Buffalo. I lie here with the comfort of knowing that I have helped thousands of Western New Yorkers and their families over the last 40 years.

But I also lie here knowing that should my pain and suffering become unbearable – despite receiving the best palliative and hospice care – there is nothing I can do about it, except suffer.

That’s why I’ve been advocating for many years – this is not a deathbed conversion – for New York lawmakers to pass the Medical Aid in Dying Act (A.4321A/S.6471). This compassionate legislation would allow a mentally capable adult with an incurable and irreversible illness or disease to request a prescription that they can decide to self-ingest to die peacefully to end needless, intolerable suffering.

While 10 states, including New Jersey, Vermont, and Maine, along with Washington, D.C., have authorized medical aid in dying, lawmakers in Albany refuse to act – some of them won’t even talk about the bill – despite five years of debate on this issue.

Because of my life’s work in end-of-life care, I know that medical aid in dying is a natural extension of the options patients should have as they think about end-of-life care. The data from states where medical aid in dying is authorized shows that the vast majority of terminally ill adults who decided to use it were receiving hospice and/or palliative care services.

In fact, the first state to authorize medical aid in dying, Oregon, has one of the highest hospice utilization rates in the nation, while New York, which doesn’t yet allow terminally ill adults like me the option of medical aid in dying, has one of the lowest.

We know from polling that the majority of New Yorkers support medical aid in dying, just as we know the vast majority of doctors – nationally and in New York – support it. Not every physician, just as not every patient, is supportive of the idea. However, most thoughtful physicians support having an option should their patients want to avail themselves of it.

I think back to when my father was dying. What became clear was that his suffering was more than physical. And in the context of his values, life was really not something he wanted to prolong unduly any longer. He did not have that option.

I’ve heard from patients repeatedly that just knowing that the option is available is liberating, lifts a burden from their shoulders. But watching my father’s suffering was part of why I became engaged in hospice, and subsequently why I’ve supported medical aid in dying.

Suffering is something to be defined by each patient, by each person, in the context of their lives, their families, and what they are enduring. I would not presume to dictate to another human being what they must endure. I truly believe that had medical aid in dying been allowed in New York when I was practicing, I would have been a better physician.

The inaction by the Legislature to make medical aid in dying available to New Yorkers has become punitive. We have all the data we need from decades of experience in other states. Legislators, you need not endorse this end-of-life care option, but for goodness sake, don’t prohibit it. And by not acting on it, that’s exactly what you’re doing.

I was asked four years ago, long before I was touched by cancer whether I would want this option for myself. I said then: “Absolutely. Given the way I’ve lived my life, the values and philosophy I have, and knowing that my family shares those values and is supportive. I want the option.”

Well, I’m not going to get that option unless the Legislature pulls the proverbial rabbit out of the hat before adjourning on June 10. You see, I will be dead by the time the 2022 legislation session starts.

So, if our lawmakers don’t do it for me, I at least pray that they will pass this bill so no other New Yorker will suffer needlessly.

Robert A. Milch, MD, FACS, co-founded Hospice & Palliative Care Buffalo and spent 40 years in the practice of hospice and palliative care medicine. He will be sorely missed by family, friends, and the entire Western New York community.

You can watch an exclusive video that Dr. Milch recorded in 2017 about the importance of passing the Medical Aid in Dying Act: