In December, Illinois Governor JB Pritzker (Democratic) signed a measure allowing assisted suicide for terminally ill patients. At the signing, Pritzker highlighted how this law empowers individuals to avoid unnecessary suffering. Just five days later, New York Governor Cathy Hochul (D) announced her intention to pursue similar legislation, stating it would “reduce suffering, shorten death, not shorten life” for residents of New York.
If Hochul proceeds with New York’s assisted dying law this year, the state would become the 13th in the U.S. to legalize this practice, following Illinois.
Supporters of assisted suicide see it as a compassionate option, arguing it grants terminally ill patients no longer needed control over their circumstances—what they refer to as “death with dignity.”
While pain relief is the main argument made by activists, many patients often cite a broader range of reasons for choosing to end their lives. For instance, concerns about losing autonomy or becoming a burden to family members typically outweigh unmanaged physical pain.
In Canada, Medical Assistance in Dying (MAiD) has been implemented. According to a governmental report since its legalization in 2016, it has become the fifth most common cause of death. The primary reason people seek this option is unmanageable pain, with over 80% of recipients indicating a loss of independence and about 45% not wanting to be a burden. Similarly, Oregon’s data show a similar trend, noting that in 2024, 89% of individuals cited autonomy loss and around 42% expressed concerns about being a burden.
These statistics reveal a poignant narrative about cultural perceptions: that life without autonomy is deemed less valuable and that needing assistance equates to failure.
Dr. Brian Christine, Assistant Secretary for Health, Department of Health and Human Services. (Photo by Amy Rossetti/HHS)
As a physician, I empathize with the powerful emotions that fuel these beliefs. No one enjoys feeling powerless or imposing their suffering on others. Yet, enduring suffering doesn’t negate our responsibility to honor everyone’s inherent dignity. The Department of Health and Human Services does not endorse assisted suicide—not because we downplay the hardships of suffering, but because intentionally ending a life undermines human dignity. This dignity should not hinge on physical condition, cognitive ability, or health.
Pope John Paul II articulated this sentiment well in Evangelium Vitae, emphasizing that every person, even amidst struggles, has inherent worth and deserves the right to have that respected.
Should dignity rely solely on autonomy, the vulnerable—young individuals, those with cognitive impairments, people with severe disabilities, and the dying—would lose it at the times when they require the most protection. Dignity ought to steer our care practices. It’s not about acknowledging imminent death when autonomy falters, but rather about ensuring that communities provide support, care, and love for those who are vulnerable until their natural end.
Advocates frequently assure the public that assisted suicide laws are limited to “terminally ill patients,” those expected to pass within six months. However, this safeguard often proves flimsy. A doctor cannot reliably predict a patient’s lifespan, especially in cases of chronic or degenerative diseases. What may seem like a well-defined category can quickly expand.
Safeguards falter when societies accept that some lives are not worth sustaining. Experiences from Belgium and the Netherlands illustrate that assisted suicide measures have grown to encompass patients with chronic and mental illnesses and have even extended to children.
As the U.S. Assistant Secretary for Health, I advocate for a more humane approach—challenging, yes, but necessary. We should enhance comprehensive palliative and hospice care, prioritizing pain management while actively supporting all patients. Mental health services must aim to address despair rather than confirm it. Meaningful support for the sick, their families, and caregivers is essential to ensure that no one feels abandoned. Most importantly, we need to shift societal perceptions, recognizing addiction not as a failure but as part of the human experience.
Ultimately, society should be evaluated not on how effectively it mitigates suffering but on its commitment to standing by those in pain. We must choose a culture of compassion over one of despair. Every human life, from its inception to its natural conclusion, is inherently valuable.
