Abortionist Who Lost License Manages Clinics

NJRTL’s comment:

Marie Tasy, executive director for New Jersey Right to Life, said she “applauded the Attorney General for pursuing this case and hopes their case against Kaji and Brigham will prevail.”

“This is just more of the usual legal semantic gymnastics and abuse of the law we have come to expect from Brigham and Kaji,” Tasy added. “The fact that Brigham is still in charge of these clinics in an administrative capacity is deeply disturbing and in contravention of New Jersey law. The real losers in all of this are unsuspecting women who frequent these clinics.”

steven brigham abortion doctor
Steven Chase Brigham, seen in this file photo at a Board of Medical Examiners hearing, manages the abortion clinics he said he no longer owns. The state revoked his license in 2014.

Susan K. Livio | NJ Advance Media for NJ.comBy Susan K. Livio | NJ Advance Media for NJ.com
Email the author | Follow on Twitter
on February 02, 2016 at 11:53 AM, updated February 02, 2016 at 4:45 PM

TRENTONThe doctor stripped of his license for committing “gross negligence”while performing late-term abortions is managing the seven clinics he used to own, according to a document released Tuesday by the state Board of Medical Examiners.

The revelation that Steven Brigham is still linked to American Women’s Services was contained in a 24-page decision from state’s physician disciplinary board that said the true ownership of the clinics ought to be decided by a judge.

The ruling is at least a temporary victory for Vikram Kaji, the clinics’ long-time medical director whom Brigham tapped to take ownership after the board revoked Brigham’s license in 2014. He had to divest himself from the business because the state requires medical practices to be owned by a physician.

In June, Deputy Attorney General Bindi Merchant asked the medical board to immediately suspend or revoke Kaji’s license for fraud, alleging the transfer from Brigham to Kaji was a “sham.”

Instead, an administrative law judge will decide the matter and turn the recommendation over to the board for a final decision.

N.J. Attorney General: Abortion doctor unlawfully owns clinics

N.J. Attorney General: Abortion doctor unlawfully owns clinics

The allegations accuse 79-year-old gynecologist Vikram H. Kaji of fraud for claiming he had assumed ownership of clinics after Steven Brigham’s license was yanked for gross negligence. Brigham has appealed the decision.

Merchant produced statements Kaji made to a state investigator in April and a committee of the board in May, denying he was the owner. “He expressly testified that ‘there is no other person around, (Brigham’s) the only one who runs the show,” according to the Merchant’s complaint.

But Joseph Gorrell, the attorney for both Kaji and Brigham, challenged the state’s case, producing records and new testimony from Kaji who he claimed was “confused” by the questions. No property had changed hands, and the business itself was losing money, so there was no actual sale, according to the decision.

Gorrell produced a contract that showed Kaji had hired Fidelity Venture Services, a management company owned by Brigham.

“He has absolutely no clinical responsibilities. He is acting as a manager which does not require a license,” Gorrell said. The management company was established long before the dispute, he added.

The board ultimately agreed that it could not move ahead on a decision about Kaji’s license under a summary judgment motion. “There are material facts that are genuinely disputed,” according to the decision.

“We are pleased with the decision, which we believe is correct because there are significant factual disputes in the case,” Gorrell said.

Marie Tasy, executive director for New Jersey Right to Life, said she “applauded the Attorney General for pursuing this case and hopes their case against Kaji and Brigham will prevail.”

“This is just more of the usual legal semantic gymnastics and abuse of the law we have come to expect from Brigham and Kaji,” Tasy added. “The fact that Brigham is still in charge of these clinics in an administrative capacity is deeply disturbing and in contravention of New Jersey law. The real losers in all of this are unsuspecting women who frequent these clinics.”

The board suspended Brigham’s license in 2010 after the state argued he used the two-state process to evade New Jersey’s requirement that terminating pregnancies must take place in a hospital or licensed health care facility after 14 weeks. Brigham did not have hospital privileges at the time and is not an obstetrician or a gynecologist. His license was revoked in 2014, but Brigham has appealed.

From his main office in Voorhees, Brigham inserted Laminaria, a device to expand his patients’ cervixes, and administered a shot of Digoxin to cause “fetal demise.” At his instruction, his patients later drove to drive to a clinic in Elkton, Md. where the fetus would be surgically removed by another doctor in consultation with Brigham.

One patient was severely injured during the medical procedure in Maryland and needed to be airlifted to a hospital.

Brigham was not licensed to practice medicine in Maryland, but he thought he was following Maryland law that allowed its doctors to consult with out-of-state physicians, his attorney said.

Susan K. Livio may be reached at slivio@njadvancemedia.com. Follow her on Twitter @SusanKLivio. Find NJ.com Politics on Facebook.

Physician Assisted Suicide Bill (A2451) Reintroduced in the Assembly. Take Action

stop physician assisted suicide

 

 

We have learned that Assemblyman Burzichelli (D-3) has reintroduced the Physician Assisted Suicide Bill (2451).  The text of the new bill, A2451, is not yet available on-line, but we expect it to be the same or very similar as the previous legislation.

Background on NJ Physician Assisted Legislation

The previous bill (A2270/S382) passed the NJ Assembly by one vote on November 13,  2014, but failed to garner enough support in the NJ Senate, and consequently, expired in the last session.  Read the January 12, 2016 Press Release from the Alliance Against Doctor Prescribed Suicide here

11/13/14 State Assembly Vote

To see how your Two Assembly Members voted on November 13, 2014 and for background information on the Assembly legislative process in the last session, please click here

More information on efforts to legalize physician assisted suicide in NJ can be found on our webpages.

Take Action:

If you don’t know who your legislators are, go to the tab on the njrtl webpage marked, “Legislation” and add your 9 digit zip code.  Once you add your 9 digit zip code, click “Go.  A page will open that will provide pictures and names of your federal and state elected officials. (Helpful hint:  you will need to use the scroll bar on the right hand side and scroll down to the bottom of the page to find your State Senator and Two Assembly Members.)

If your Two State Assembly Members voted No previously, please contact them and thank them for their No vote. Urge them to vote No again on A2451 if it comes up for a vote.

If your Two State Assembly Members Voted Yes, please contact them and tell them you are disappointed in their vote and that you expect them to vote No on A2451 if it comes up again.

If one or two of your State Assembly members are newly elected, schedule a meeting to speak with them and educate them about the dangers of Bill A2451.

Teachers Shouldn’t be ATM’s for Partisan Super PACs

Mary Pat AngeliniTeachers Shouldn’t Be ATM’s For Partisan Super PAC’s

Millions in outside Super PAC spending has become the new norm in New Jersey politics. In fact, nearly half of all money spent in last month’s elections came from these Super PAC’s which, by raising and spending unlimited sums of money, have dramatically altered the political landscape in our state.

Sadly, most of the millions spent to fund personal attacks against candidates across New Jersey didn’t come from donors who offered their financial support to the candidate of their choice. It came primarily from hardworking teachers who have no say on how their union dues are spent and are likely unaware that a portion of their hard-earned salary was used to assail an award-winning charity which exists to counteract the harmful effects of substance abuse and violence.

Anyone in the Monmouth County area with a radio or a television likely heard the relentless attack ads that sought to damage my political career by grossly distorting how the agency I run operates.

However, in a sign of the new political reality, these ads were not funded by my opponents; instead, they were an independent expenditure of the General Majority PAC–a Washington, DC-based political operation run by Senator Harry Reid’s former chief of staff, Susan McCue who also serves on the Rutgers Board of Governors despite the fact that she doesn’t even live in New Jersey.

This year the NJEA funneled nearly $4 million in member dues to the General Majority PAC which funded ads against legislative candidates across New Jersey. And a sizable chunk of that money—more than $1.5 million–was used, in part, to create and disseminate radio and television commercials that denigrated a non-profit that gives young people the tools to avoid alcohol, tobacco and other drugs, as well as other negative behaviors.

Ironically, the very program attacked by this NJEA-backed group partners with educators in the classroom to help keep children healthy and safe. One can’t help but wonder if the teachers working side-by-side with prevention specialists and substance abuse professionals were even aware that their union dues were funding the assault on the agency providing these resources to their students.

Unfortunately, these and other valuable programs that seek to protect our children are nothing more than collateral damage in the effort to secure a political victory.

In today’s hyper-partisan world, we have come to expect the heated rhetoric and negative attacks which seem to dominate every election cycle. What is troubling, however, is when the vicious attacks are coming not from the politicians themselves, but from outside groups that care little about the destruction they inflict in pursuit of their political goals.

And, even more troubling, is that the men and women who dedicate their professional lives to preparing our young people for success can be used like human ATM’s by political groups that will destroy anyone or anything that gets in their way.

But it doesn’t have to be this way. In my professional and political life, I have met scores of wonderful teachers who are doing incredible work in classrooms throughout our state. And while we may not agree on every issue, I am confident that the vast majority of educators would object to their union dues being used in this manner.

As such, I urge the teachers of New Jersey to reject these underhanded tactics by demanding that their union leaders stop funneling money to political groups that that engage in this type of slash-and-burn politics. Otherwise, they should replace their union leadership with individuals who recognize that teachers, who play such a vital role in our children’s lives, do not want their paychecks used to fund the vicious personal attacks that marked the last election cycle.

In addition, the aforementioned McCue, a Virginia resident and an extreme partisan with ties to some of the biggest Democrats in the country, should no longer be allowed to serve in a prominent role at our state university. Governor Christie should demand her immediate resignation and replace her on the Rutgers Board of Governors with a New Jersey resident who will put the interests of the children and residents of this state ahead of their political agenda.

Slanderous, personal attacks from unaccountable Super PACs might be the new norm for politics, but our state should not reward unqualified partisan hacks with powerful positions at our state institutions and our teachers shouldn’t be used as ATM’s to fund campaigns that have nothing to do with improving education in our state.

______

By Assemblywoman Mary Pat Angelini

Assisted Suicide bill dies in NJ Senate: An Important Victory That Bolsters Opposition Nationwide

NJassisted suicide

 

 

For Immediate Release

January 12, 2016

 

Contact: Tim Rosales

929.244.3297

Assisted Suicide Bill Dies in New Jersey Senate

An important victory that bolsters opposition nationwide

Trenton, NJ – “The New Jersey Alliance Against Doctor-Prescribed Suicide applauds the New Jersey Senate for recognizing the dangers to older people and those with disabilities and allowing S 382, legislation to legalize assisted suicide, to die without a vote on the floor of the Senate,” stated Kate Blisard of Not Dead Yet.   “People are surprised to learn that all major national disability groups that have taken a position on the issue oppose the legalization of assisted suicide because the dangers of misdiagnosis, coercion and abuse put us at great risk.”

 

“A bi-partisan group of New Jersey Senators took the time to listen to the disability-rights community and to understand why it is important that doctor-prescribed suicide not become law in New Jersey,” continued Democratic Senator Peter Barnes. “It became clear that this bill would have a detrimental impact on vulnerable populations and expose them to abuse, coercion and possible denial of health care because it costs more than suicide drugs. While the bill’s few, vocal supporters educated legislators as to their personal concerns, it became clear that there are other solutions than doctor-prescribed suicide to address end-of-life pain.  For that reason, there was never a groundswell of support for this bill and, on balance, we heard from many more voices opposed to this bill.”

 

The New Jersey Alliance exposed the following flaws in S 382:

 

  • No requirement of mental health evaluation or pain relief consultation.
  • Permits an heir to witness a death request.
  • Requires no oversight on whether the patient was willing to take the lethal drugs.
  • No requirement that a medical person be present to supervise the ingestion of lethal drugs.
  • Allows a third party familiar with how the patient communicates to make the death request.
    • Permits lethal drugs to remain in a patient’s home without securing them.
    • Relies on the inaccurate premise that a doctor can predict death within six months.
    • No distinction as to whether the death prediction is with or without treatment of the patient.
    • No required notification of family members.
    • Immunizes from prosecution anyone participating in administering lethal drugs,  even if their participation was coercive and out of self-interest
    • Falsely certifies the cause of death.

 

The New Jersey Alliance Against Doctor-Prescribed Suicide is a broadly-based, diverse coalition of organizations strongly opposed to the legalization of assisted suicide.  Alliance organizations include:

 

Resources for Independent Living

Dial, Inc. Center for Independence

Center for Independent Living

Heightened Independence and Progress – Bergen

Heightened Independence and Progress — Hudson

Progressive Center for Independent Living

Total Living Center

National Council on Independent Living

Not Dead Yet

Disability Rights Education & Defense Fund

Autistic Self Advocacy Network

Association of Programs for Rural Independent Living

United Spinal Association

New Jersey Catholic Conference

New Jersey Right to Life

New Jersey Family Policy Council

American Academy of Medical Ethics

 

The Alliance website is located at www.noassistedsuicidenj.org. It can also be found on Facebook at: https://www.facebook.com/NoAssistedSuicideNJ/ and followed on Twitter at: @NoNJSuicide

 

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Op-Ed by JJ. Hanson: I was given 4 months to live; assisted suicide isn’t the answer

assisted suicide

I was given 4 months to live; assisted suicide isn’t the answer | Opinion

on January 11, 2016 at 11:18 AM, updated January 11, 2016 at 5:10 PM

By J.J. Hanson

I am a 30-something Marine Corps veteran who was given four months to live 20 months ago — diagnosed with glioblastoma brain cancer. I fought for treatment that was so difficult there were times when I questioned if the struggle was worth the pain. My experience is similar to that of thousands of New Jersey residents who every year face terminal diagnoses. Often, I wonder if I would still be alive if I had the legal assisted suicide drugs at my bedside when I was fighting through those difficult days.

When I was at my physical and emotional worst, I became aware of a young California woman named Brittany Maynard who faced the same horrible diagnosis as mine. She took her cancer story public, and it was used to headline a national effort to “normalize” assisted suicide; a notion that had previously been rejected by dozens of states. The message sent to patients across the country, who, like me, wanted to fight and live was now — “assisted suicide may be the best option for you.” I recognized this as a huge danger.

harper(2).JPGValerie Harper announced she has terminal brain cancer in March 2013. (Inside Jersey file photo)

My experience has provided me perspective and made me a strong opponent of S382, the legislation currently in the New Jersey Senate to legalize assisted suicide. My personal story is a clear example to why vulnerable and very sick people like me should not be offered suicide as a medical treatment. In May 2014, I was attending a business meeting when I suddenly felt something in my body going horribly wrong. I woke up in an ambulance to find out I had suffered a grand mal seizure.

READ: Christie has ‘grave concerns’ about physician-assisted suicide

I was rushed to the hospital where an MRI revealed two lesions in my brain. A brain biopsy gave the worst possible news. Growing in my left temporal lobe was stage 4 glioblastoma, one of the most aggressive and deadliest forms of cancer, capable of doubling in size in just two weeks.

My wife, Kris, was dealt the devastating news that I had terminal brain cancer and given a grim prognosis. Even though I was perfectly healthy a few days before, doctors believed that, based on the location and growth rate of my cancer, I had roughly four months to live. The doctors told my wife the tumors were inoperable and that we should enjoy the time we had left together. If assisted suicide were legal and based on that diagnosis, I could have gone to any doctor regardless of whether I had a previous relationship with them or not, and received a lethal prescription in a matter of days; and my insurance company would have likely paid for it — saving them hundreds of thousands of dollars.

Instead, assisted suicide was not an option and Kris and I worked hard to get a second and a third opinion; ultimately, finding a doctor who was able to remove the majority of the cancerous tumors. I then underwent radiation, chemotherapy and participated in a clinical trial for a new experimental drug.

The last 20 months have not been easy. I endured a lot of physical and emotional pain and had 11 seizures. There were days when I completely lost all of my most basic physical abilities. I couldn’t talk, walk, read or write. During those times, I questioned whether it was worth it. Would it be easier if I just gave up?

I can’t help but think about if I had the choice to request assisted suicide drugs, and if I had used those drugs during those difficult moments. I would have lost the opportunity to make memories with my wife and son. I was terminal and I qualified under the New Jersey proposal, and a similar bill offered in New York. Assisted suicide is a decision that you can’t unmake. My wife would be without a husband and my son without a father.

ALSO: Reluctant N.J. Senate panel releases ‘Aid in Dying’ bill

The Senate Health, Human Services and Senior Citizens Committee voted 5-3 to let the “Aid in Dying” bill to proceed to the full 40-member Senate, but did so in a way that registered committee members concern and uncertainty by approving it “without recommendation.”

My cancer is now in remission. My experience led me to join the national organization Patients Rights Action Fund as its president to help counter assisted suicide, and so that my story can serve as an example of hope to those who may feel hopeless due to a terminal diagnosis. I urge the New Jersey Legislature with every fiber of my being to reject the idea that lethal drugs are an answer to serious illness or terminal diagnoses. Without a doubt, people similar to me facing desperate situations will feel like assisted suicide is their only option. In our society we should be focused on giving hope to the vulnerable and the sick at their greatest time of need, not taking hope away.

J.J. Hanson is president of the Patients Rights Action Fund, the nation’s leading organization protecting the rights of patients and people with disabilities by opposing assisted suicide legalization efforts.

Being an Egg Donor Gave Me Terminal Cancer

When news broke last week that two triplet-bearing surrogate mothers face legal battles with parents who want them to abort one of the fetuses, the spotlight returned to the pressing debate about whether to legalize commercial surrogacy in New York state — which could occur as early as next year. Critics claim that, if allowed, the move would tempt New York women to risk their health by “renting out” their wombs or donating their eggs. Cancer victim Maggie Eastman, a 34-year-old 911 operator from Seattle, is the subject of the documentary “Eggsploitation: Maggie’s Story,” produced by theCenter for Bioethics and Culture network, a watchdog for the rights of surrogates and egg donors. Here she tells Jane Ridley her heartbreaking story about her time as a serial egg donor.

Waking up from the anesthesia, I sleepily ask the nurse how many eggs have just been harvested from my ovaries.

“You lit up like a Christmas tree!” she exclaims, referring to the ultrasound that showed I’d produced more than 20 for that particular retrieval.

Her remark might be crass, but I feel proud — it is good for my reputation as one of the clinic’s most prolific egg donors, helping infertile couples achieve their dream of having children.

Little did I know that this hyperstimulation of my reproductive system — caused by the estrogen injected into my body — was putting my health in jeopardy.

Now, 13 years after the first of my 10 egg retrievals over the span of a decade, I have been diagnosed with Stage 4 breast cancer. It has spread to my bones, lymph nodes and liver. I don’t know how much longer I have to live but, while I’m still on this Earth, I want to warn other young women that egg donation can come at a cost.

My experience began in 2002, when I was studying at Pacific Lutheran University in Tacoma, Wash. I met a woman at a party who worked at a nearby in vitro fertilization (IVF) clinic who said I’d make an ideal egg donor.

Infertility was close to my heart because some longtime friends had struggled with the condition. I loved the idea of helping desperate couples have babies of their own. Though the compensation was hardly a fortune at $1,200 per cycle, the money would help me buy books for school.

Since I was 5-foot-7, slim, well-educated and “traditionally attractive,” the coordinator assured me I was likely to get a call soon.

She was right — within weeks, I was injecting twice-daily hormones into my stomach for around 10 days, followed by a trigger shot to stimulate release of the eggs before retrieval. My ovaries swelled to the size of apples and I put on at least 10 pounds.

My parents were none too happy with my actions. My mom, a teacher, accused me of “selling her grandchildren.” But the matter was never brought up again.

Following a second cycle, I moved to a different IVF center in the Seattle area. It was there that I read a sentence in the paperwork saying that, in the 1970s, it was thought there was a link between fertility drugs and cervical cancer, but that had been proven false.

At the second clinic, I was paid $2,000 each for eight retrievals between spring 2004 and August 2012. I trusted the doctor and never once thought he might be putting me in danger. I’ve since found out that the clinic ignored guidelines by the American Society for Reproductive Medicine recommending a woman should donate eggs no more than six times.

During that period, in November 2007, I married my boyfriend, Jonathan. He was supportive of my decision to continue donating my eggs, and we used the money toward a mortgage down payment — though sadly, we amicably divorced five years later.

Then, in January 2014, at age 32, it was confirmed that a lump in my breast was Stage 4 cancer. I was devastated to hear it had metastasized and, in August 2014, was given a hysterectomy — ironic, since I’d helped create an untold number of babies for strangers but would now never become a mother myself.

My oncologist was baffled because my disease — estrogen-positive, invasive ductal carcinoma — was “unheard of” in women my age and most common among post-menopausal black women.

It was only after news emerged that brain cancer victim Brittany Maynard — who hit the headlines in the fall of 2014 for her “right to die” case — had been an egg donor that I began to explore the link between egg donation and cancer.

Trouble is, since IVF and egg donation is relatively new, this area of medicine is underresearched. (When contacted by The Post, Dr. Charles L. Shapiro, director of translational breast cancer research for Mount Sinai Hospital, said: “The bulk of the literature on this topic says there is no relationship between IVF, hormone priming or egg harvesting and increasing risk of breast cancer … It’s usually not one [factor that causes breast cancer], but a whole host of different circumstances, most of which we don’t know about.” Meanwhile, Dr. Anthony Caruso, director of A Bella Baby OBGYN in Chicago and consultant to the Center for Bioethics and Culture network, says, “High-estrogen states generated artificially for women are potentially putting them at a greater risk for estrogen-related cancers.”)

‘I worry about a growing “breeder class” of women like me.’

 – Maggie Eastman

As the demand for egg donors and surrogates has exploded in the past few years, I worry about a growing “breeder class” of women like me. If New York state legalizes commercial surrogacy, thousands of young women — particularly bright NYC students — might be seduced by the cash incentives and schmaltzy ads urging them to “give the gift of life” by donating their eggs to childless couples.

There’s a certain amount of shame and embarrassment going public in this way — after all, it was my decision to receive payment as a donor — but I don’t believe I gave my informed consent. I feel like I was prostituted and kept in the dark about the possible toll on my health. Any woman considering egg donation needs to step back and ask herself whether it’s worth risking her life.

From The New York Post
© 2015 NYP HOLDINGS, INC. ALL RIGHTS RESERVED |

The Dangerously Contagious Effect of Assisted Suicide laws

assisted suicide not safe

Action: Contact your State Senator today and urge him or her to Vote No on S382, The Physician Assisted Suicide bill!

You can obtain your Senator’s contact information by calling 1-800-792-8630 or visiting the NJ Legislature webpage HERE

 

Opinion: The dangerously contagious effect of assisted-suicide laws

By Aaron Kheriaty November 20, 2015

Published in the Washington Post

Aaron Kheriaty is an associate professor of psychiatry and director of the medical ethics program at the University of California at Irvine School of Medicine. This piece is adapted from a longer commentary that appeared in the Southern Medical Journal in October.

The debate over doctor­assisted suicide is often framed as an issue of personal autonomy and privacy. Proponents argue that assisted suicide should be legalized because it affects only those individuals who — assuming they are of sound mind — are making a rational and deliberate choice to end their lives. But presenting the issue in this way ignores the wider social consequences. What if it turns out that the individuals who make this choice in fact are influencing the actions of those who follow?

Ironically, on the same day that Gov. Jerry Brown (D) signed the bill to legalize physician­assisted suicide in California last month, an important study was published by British scholars David Jones and David Paton demonstrating that legalizing assisted suicide in other states has led to a rise in overall suicide rates — assisted and unassisted — in those states. The study’s key findings show that, after controlling for demographic and socioeconomic factors and other state­specific issues, physician­assisted suicide is associated with a 6.3 percent increase in total suicide rates. These effects are greater for individuals older than 65 (for whom the associated increase was 14.5 percent). The results should not surprise anyone familiar with the literature on the social contagion effects of suicidal behavior. You don’t discourage suicide by assisting suicide.

Consider what social scientists call the Werther effect — the fact that publicized cases of suicide can produce clusters of copycat cases, often disproportionately affecting young people, who frequently use the same method as the original case. The name comes from Goethe’s 18th­century novel “The Sorrows of Young Werther,” in which the protagonist, thwarted in his romantic pursuits, takes his own life with a pistol. After the publication of this immensely popular book, authorities in Germany noted a rash of suicides among young men using the same means. This finding has been replicated many times since in rigorous epidemiological studies, including research demonstrating this effect following cases of doctor­assisted suicide.

Because this phenomenon is well validated, the U.S. Centers for Disease Control and Prevention, the World Health Organization and the U.S. surgeon general have published strict journalistic guidelines for reporting on suicides to minimize this effect. It is demoralizing to note that these guidelines were widely ignored in the reporting of recent instances of assisted suicide, with the subject’s decision to end his or her life frequently presented in the media as inspiring and even heroic.

A related phenomenon influences suicide trends in the opposite direction, however; the so­called Papageno effect suggests that coverage of people with suicidal ideation who do not attempt suicide but instead find strategies that help them to cope with adversity is associated with decreased suicide rates. The name comes from a lovesick character in Mozart’s opera “The Magic Flute,” whose planned suicide is averted by three child spirits who remind him of alternatives to death. The case of Valentina Maureira, a 14­year­old Chilean girl who made a YouTube video begging her government for assisted suicide, illustrates the Werther and Papageno effects. Maureira admitted that the idea to end her life began after she heard about the case of Brittany Maynard, a 29 ­year­ old woman with terminal brain cancer who campaigned prominently for the right to assisted suicide before ending her life last year. But Maureira changed her mind after meeting another young person also suffering from the same disease, cystic fibrosis, who conveyed a message of hope and encouraged her to persevere in the face of adversity. With our laws, we can encourage vulnerable individuals in one of these two directions: the path of Werther or the path of Papageno.

Aside from publicized cases, there is evidence that suicidal behavior tends to spread person to person through social networks, up to three “degrees of separation” away. So my decision to take my own life would affect not just my friends’ risk of doing the same, but even my friends’ friends’ friends. No person is an island.

Finally, it is widely acknowledged that the law is a teacher: Laws shape the ethos of a culture by affecting cultural attitudes toward certain behaviors and influencing moral norms. Laws permitting physician­assisted suicide send a message that, under especially difficult circumstances, some lives are not worth living — and that suicide is a reasonable or appropriate way out.

This is a message that will be heard not just by those with a terminal illness but also by anyone tempted to think he or she cannot go on any longer. Debates about physician­assisted suicide raise broad questions about our societal attitudes toward suicide.

Recent research findings on suicide rates press the question: What sort of society do we want to become? Suicide is already a public health crisis. Do we want to legalize a practice that will worsen this crisis?