NJ Supreme Court refuses to reinstate restraining order against NJ Assisted Suicide law-case will move forward

N.J.’s highest court upholds law giving terminally ill patients the option to end their lives

The state’s controversial “Aid in Dying” law won the support of the state Supreme Court Tuesday afternoon, upholding a decision from earlier in the day dismissing a restraining order that prevented patients from pursuing their own death.

The “Medical Aid in Dying for the Terminally Ill Act” Gov. Phil Murphysigned in April took effect Aug. 1, but the law was put on hold due to the legal challenge.
Tuesday’s rulings means the law is in effect again.
A doctor in Englewood, Yosef Glassman, sued to overturn the law because he said it violates his religious beliefs and his oath as a physician to preserve life. Glassman won a restraining order on Aug. 14 preventing any doctors or pharmacists from dispensing lethal medication.
“We are, of course, disappointed with the Supreme Court’s ruling but nevertheless respect it,” Glassman’s attorney Richard Grohmann said.
Corinne Carey, state senior campaign director for Compassion & Choices, which helps pass death with dignity laws, praised the appeals court’s decision for putting patients’ wishes first.
“On balance, the harm to patients who relied on the law duly authorized by the Legislature far outweighed the hypothetic harm” cited by the doctor, Carey said. “This doctor had no relationship to a patient who made a request. This was a theoretical harm. The court wisely noted he has a right to refrain from participating.”

The state Attorney General’s Office, which is defending the law against the challenge, did not respond to requests for comment.

Susan K. Livio may be reached at slivio@njadvancemedia.com

Judge Halts NJ Assisted Suicide Law

Judge halts N.J.’s Aid in Dying law

Gov. Phil Murphy signed the "Aid in Dying" law in April allowing terminally ill people to obtain a prescription to end their lives.

Gov. Phil Murphy signed the “Aid in Dying” law in April allowing terminally ill people to obtain a prescription to end their lives.

A state judge has granted a request to stop New Jersey’s “aid in dying” law from taking effect, preventing any physician from writing a lethal prescription for terminally ill patients to end their lives.

State Superior Court Judge Paul Innes, sitting in Mercer County, granted the temporary restraining order Wednesday at the request of a physician from Bergen County who opposes the law for religious and professional reasons, said E. David Smith of Bloomfield, the physician’s attorney.

The law took effect on August 1, but required a two-week waiting period before a physician could fill a patient’s prescription. That two-week period would have come due Friday, Smith said.

“We wanted to put a stop to it,” Smith said.

The law passed after eight years of legislative hearings, and aggressively fought by religious leaders and disability advocates who said elderly and sick people would feel compelled to end their lives so as not to burden their families. But the right-to-die movement gained momentum after Brittany Maynard, a 29-year-old California woman with terminal brain cancer, publicized her decision to relocate to Oregon for its aid-in-dying law and avoid the the final and most painful stage of her disease in 2014.

The legislation stalled while Gov. Chris Christie was in office, but Gov. Phil Murphy, who was sworn-in in January 2018, signed the law four months ago.

“This was a really hard one for me, particularly given growing up as a Catholic,” the governor added. “This was not an easy one to get to. But I got convinced that it shouldn’t be the law that dictates how things end. That it should be you and your loved ones.”

The restraining order is in effect until at least the next court date, scheduled for Oct. 23, according to court documents.

Smith predicted that would not be enough time for the state to write and seek public comment on the regulations required to carry out the law.

Doctors are not mandated to participate, but they are required if they refuse to aid a patient’s death to refer patients to another physician. As a physician and orthodox Jew, Grossman said he could not condone any participation, even if it involved transferring a patient’s file, Smith said.

Grossman believes “the right to human life is sacred and should not be taken under any circumstances,” Smith said.

The law applies to adults who have received a terminal diagnosis — defined as an incurable, irreversible and medically confirmed disease that will end the person’s life within six months.

The written declaration must be witnessed by two people who attest that the patient is acting voluntarily. One of the two witnesses cannot be a person who stands to financially gain from the patient’s death or the patient’s doctor or nursing home employee.

State Assemblyman John Burzichelli, D-Gloucester, the law’s prime sponsor, said he was “surprised” by the challenge. “The work we did was carefully structured with guidance from others,” he said.

Marie Tasy, executive director for New Jersey Right to Life, issued a statement thanking the doctor for “challenging this terribly misguided law which is both incompatible with a physician’s role as healer and clearly a danger to our most vulnerable citizens.”

Tasy noted the legislation would never have passed the Senate health committee had Democratic leaders not substituted members that daywho opposed the bill.

NJ Advance Media staff writers Brent Johnson and S.P. Sullivancontributed to this report.

This is a breaking story. More information will be reported later in the day.

The state Health Department has created this webpage explaining the 

NJ Assisted Suicide law goes into effect 8/1/19 – A Truly Sad Day for the Garden State

Note to our website visitors:

Below is an article on NJ’s Assisted Suicide law which goes into effect on 8/1/19.  At the urging of the pro-death lobbying group, Compassion & Choices, sponsors of the legislation agreed to change the title of  the legislation to the “NJ Medical Aid in Dying for the Terminally Ill Act” to make it more palatable and marketable to the public. In reality, the Act legalizes Assisted Suicide and does not  “Aid”  in anyone’s “Dying,” rather, it hastens a person’s death and is intended to do so.

In addition, the NJ Assisted Suicide law’s “so-called” safeguards are hollow. The Act is riddled with loopholes which are a recipe for abuse.  Contrary to media reports, this law does not give patients complete autonomy and is especially dangerous for our most vulnerable populations.  The legislation passed by the narrowest of margins (by only one vote) in each of the Houses of the NJ Legislature.

Shortly after the bill narrowly passed both Houses of the Legislature by the slimmest of margins, Asm. Robert Auth (R-39)  introduced A5525, a bill to Repeal the Medical Aid in Dying for the Terminally Ill Act and A5469, a bill which makes it a crime of the first degree to coerce a patient to request medication pursuant to the Medical Aid in Dying for the Terminally Ill Act, or to forge a patient’s request for such medication.

Action Needed: We are grateful to Assemblyman Auth and the legislators who co-sponsored these bills and ask that you contact your State Senator and two Assembly Members to urge them to support and co-sponsor A5525 and A5469.  Thank you.

How did your Two State Assembly Members Vote? Click on the red hyperlink below to find out

A1504/S1072 Assembly Vote

How did your State Senator vote?  Click on red hyperlink below to find out 

A1504/S1072 Senate Vote

 

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NJ doctors can help terminally ill patients die beginning today

Stacey Barchenger, North Jersey RecordPublished 5:06 a.m. ET Aug. 1, 2019

Gov. Phil Murphy signed a bill making New Jersey the eighth state to allow terminally ill residents to end their lives with medical help. Michael V. Pettigano and Nicholas Pugliese, North Jersey Record

Janet Colbert made talking about death, a taboo topic, a normal part of her life.

When the retired oncology nurse received her own diagnosis — it was a rare form of liver cancer — in 2013, she began advocating that doctors should be allowed to prescribe lethal medication to terminally ill patients.

It was an option she wanted for herself.

“I feel that it would just give me so much more peace of mind,” Colbert said in 2015, just months before her death.

Today, four years later, it becomes legal for New Jersey doctors to prescribe lethal medication to patients with less than six months to live. New Jersey is one of eight states that allow what is called medically assisted suicide or medical aid in dying, depending on what side of the controversial issue you are on.

Even as advocates welcome the law for which they’ve fought for years, and declare victory for patients’ rights, there remains uncertainty within the medical profession about carrying it out.

The state boards that license doctors, pharmacists, mental health professionals and others have yet to implement regulations called for in the law. It wasn’t until late Wednesday afternoon that the New Jersey Department of Health published requirements for doctors, who must report information such as when prescriptions are issued and when patients die from them.

“It is a life-or-death issue,” said Larry Downs, chief executive officer of the Medical Society of New Jersey, which opposed the law on ethical grounds. “Physicians would probably be wise to wait for that regulatory guidance before deciding to engage in it.”

Supporters say the law is detailed enough to allow doctors to proceed, and there are doctors who are on board, but that doesn’t mean prescriptions will be written today. The New Jersey Attorney General’s Office, which oversees the regulatory boards, says rule-making isn’t required before the law goes into effect. Meanwhile, multiple hospital and medical associations have published extensive guidance for health care professionals.

“There are going to be doctors ready to practice on Day One, and there are going to be doctors who — it may take a patient who they’ve treated for along time to present a compelling case for them to use this law,” said Corinne Carey, who led advocacy for the New Jersey law and works for Compassion & Choices.

Other doctors, she said, may wait for additional guidance from state agencies.

What the law says

Janet Colbert has been diagnosed with a form of liver cancer sure to kill her. She’d like to see the Aid in Dying bill passed so she could end her life if her condition became unbearable. (Photo: Andrew Ford)

Formally called the Medical Aid in Dying for the Terminally Ill Act, the law comes with extensive rules and a waiting period meant to ensure that patients make informed, voluntary decisions about ending their lives.

The law stalled at least twice before in the Legislature. Supporters say sick people should have a right to end their suffering on their own terms, while opponents worry over what they say is a lack of safeguards to protect vulnerable residents. There is debate within the medical community over ethical implications of helping patients die, and religious leaders have also opposed the law.

“I think some leaders in religious communities want to paint this as patients are giving up hope,” said Susan Boyce, a 56-year-old Rumson resident and supporter of the law. Boyce suffers from an auto-immune disease that reduces her lung function.

“We are all fighting and living our lives as full as we can,” she said. “This isn’t hopelessness; this is just the desire to not suffer that last little bit that we don’t want to suffer through.

“It’s a very narrow bill. It has tight rails on it to keep it from being abused.”

Which patients qualify

Susan Boyce of Rumson, who suffers from Alpha-1 antitrypsin deficiency, talks about what it means to her that the legislature has passed the Medical Aid in Dying bill Danielle Parhizkaran, NorthJersey

Patients with less than six months to live can request the medication. According to the law, two doctors must confirm the diagnosis of a terminal illness and that patients are capable of making a sound decision to end their lives.

Patients must be residents of New Jersey. They have to make two requests for life-ending medication at least 15 days apart, and also submit a written request that includes witness signatures.

Behind-the-scenes preparation

When Gov. Phil Murphy put pen to paper and signed the law, he also cued state agencies and health care associations and companies to roll out guidance on how to implement it.

“We knew there was a relatively short window until the enactment date,” said Theresa Edelstein, vice president of post-acute care policy and special initiatives for the New Jersey Hospital Association. “It’s been a process where we started with some basics, the explanation of the law, the summary of the law, and just started to build upon it.”

Now the hospital association has extensive resources online, including sample forms for doctors and patients and draft policies for health care professionals who opt out. The new law does not obligate doctors to prescribe lethal medication.

It’s uncertain how many doctors will act on the law — no prescriptions can be issued for at least 15 days — and it’s up to the Department of Health to collect reports from doctors about prescriptions that are issued and the number of deaths that result.

Doctors themselves are divided. A group of more than two dozen wrote in support of the law in a post on NJ.com earlier this year. Other doctors are vocal opponents.

“Assisted suicide deeply undermines the physician/patient relationship and runs counter to the physician’s oath as a healer,” Dr. Matthew Suh, a general surgery specialist in Newton, said in a statement.

Following others’ lead

New Jersey joins seven other states and Washington, D.C., in allowing doctors to write deadly prescriptions. Maine is the most recent state to approve a law, and Oregon was first, according to the Death with Dignity National Center, an Oregon-based advocacy group.

In July, the Oregon law was amended and the 15-day waiting period was removed over concern that it caused patients in deteriorating condition to suffer for longer. Over time, states have seen increasing participation, but the number of people who take lethal medication remains minuscule. Check out the chart below to learn more.

Enduring controversy

Oregon’s law has been challenged twice before the U.S. Supreme Court since it was enacted in 1994.

While other states have seen court action, none has been taken in New Jersey. Instead, opposition is coming from inside the Statehouse, where lawmakers in both the Senate and Assembly eked out — by one vote — enough support to pass the bill in March.

Four Republican assemblymen are backing a bill that would repeal the law.

Assemblyman Robert Auth, R-Bergen, introduced the bill in June alongside co-sponsors Parker Space, R-Sussex; Ronald Dancer, R-Ocean; and John DiMaio, R-Warren. Auth expressed concern that nefarious individuals would exploit the law and encourage patients to take the medication for their own gain, even though the new law includes rules to prevent that.

Garden State lawmakers, however, are off for the summer, and with Democratic majorities in the Legislature, it is unlikely the effort to repeal will go anywhere soon.

Auth raised concern that oversight bodies such as the Board of Medical Examiners haven’t yet issued guidance on complying with the law.

“There’s no protocol in place by the state,” Auth said. “It’s kind of like the wild wild west.”

Stacey Barchenger: @sbarchenger; 732-427-0114; sbarchenger@gannettnj.com

 

 

NJ Senate Health Committee Replaces two Senators to get votes to release Assisted Suicide Bill

On February 7, 2019,  the Senate Health and Human Services Committee released S1072, the NJ Assisted Suicide bill from Committee.  The bill can now be voted on at any time in the full Senate.

The Assembly bill (A1504) is cirrently awaiting a vote by the full Assembly

Please contact your State Senator and two assembly members now and urge them to Vote No on A1504/S1072.

Please sign up for our Action emails to keep updated on this important issue.  Thank you.

You can read the article reporting on the February 7 Senate hearing here:   https://www.nj.com/news/2019/02/nj-just-moved-a-step-closer-to-letting-terminally-ill-people-end-their-lives.html

 

Canadian Doctors Get Ready for Child Euthanasia

Canadian Doctors Get Ready for Child Euthanasia

In the United States’ most culturally aligned nation, a race toward the once-unthinkable accelerates.It never made any sense. The assurance that active euthanasia would always be limited to terminally ill, competent adults just never made any sense. Here’s the problem: Once a society widely supports eliminating suffering by eliminating the sufferer and redefines as a “medical treatment” the act whereby doctors kill seriously ill patients, there is no logical argument for limiting euthanasia to adults with legal decision-making capacity. After all, children suffer too, so how can they be logically refused “medical aid in dying” — or MAID, the current euphemism for euthanasia and assisted suicide — only because of their age?

Euthanasia has popular support in the Netherlands as well. There children down to age twelve are permitted to be euthanized, with parental permission required until age 17. Infanticide is also practiced openly by Dutch doctors, even though it is technically illegal. Indeed, the “Groningen Protocol,” a bureaucratic checklist published by Dutch pediatricians, describes which terminally ill and seriously disabled babies can be put down.

The Canadian Supreme Court in 2015 created a right to be euthanized, followed by enabling legislation in the national and provincial parliaments. The law basically guarantees the availability of euthanasia to adults experiencing intractable suffering — as defined by the patient — in circumstances where death is reasonably foreseeable. Serious discussions are now underway to expand that license to children. That development is especially alarming for the United States, given that Canada is our closest cultural cousin.

Member pediatricians were polled about the question. Only one-third of respondents opposed expanding Canada’s euthanasia law to children in all circumstances. Almost half (46 percent) were in favor of extending the MAID option to “mature minors experiencing progressive illness or intractable pain.” (According to the report, “the mature minor doctrine recognizes that a patient’s comprehension of the nature and consequences of a treatment has determinants beyond age, and that children’s wishes should be granted degrees of deference that reflect their evolving maturity.”) There’s more: Twenty-nine percent of answering respondents believe in making euthanasia available to mature minors experiencing “intolerable disability,” while 8 percent would even extend the killing to mature minors with “intolerable mental illness as the sole indication”!

Some parents are already open to having their sick children killed. A startling 40 percent of those responding to questionnaires reported having already held “exploratory discussions” with parents about killing their seriously ill mature children — and that’s while child euthanasia remains illegal in Canada.

While the paper did not take an explicit position on legalizing child euthanasia, it is not reticent about forcing doctors’ participation once it becomes legal. Even though only 19 percent — still a startling figure — of responding doctors stated they would personally euthanize children, the society argued that, on legalization, dissenting doctors would have the ethical obligation to “inform” patients about the euthanasia option and to “refer requesting patients or families appropriately” to doctors known to be willing to do the deed. (In Canada, this is known as an “effective referral.” An Ontario judge has even ruled that Catholic and other dissenting doctors morally and religiously opposed to euthanasia must so participate in adult euthanasia or get out of medicine. One presumes that the same coercion would apply to pediatricians should pediatric euthanasia become legal.)

The authors assume that pediatric euthanasia will be soon legalized in Canada, at least for mature minors — a good bet, as the government has planned legalization as a two-step process, starting with competent adults and then potentially expanding to the legally incompetent. Accordingly, the paper describes the bureaucratic process the hospital plans to implement once minors can be given lethal jabs.

I found this point particularly startling: Doctors will be allowed to euthanize “capable minors” — akin to a “mature minor,” as previously described — without parental consent or even their notification (my italics):

If . . . a capable [legally underage] patient explicitly indicates that they do not want their family members involved in their decision-making, although healthcare providers may encourage the patient to reconsider and involve their family, ultimately the wishes of capable patients with respect to confidentiality must be respected. If we regard MAID as practically and ethically equivalent to other medical decisions that result in the end of life, then confidentiality regarding MAID should be managed in this same way.

The paper was not as explicit about doctors euthanizing children who do not have the perceived mental capacity to decide for themselves. But the paper does state that lethal jabs should be considered “practically and ethically equivalent to other medical practices that result in the end of life.” That means parents would be able to request pediatric euthanasia in the same way they can now order the removal of life support in an ICU.

The members of the working group are also intent on doing what they can to normalize pediatric euthanasia as a standard part of medical practice, stating, “We will . . . as an institution, publicly discuss the provision of MAID in an effort to normalise this procedure and reduce social stigma for everyone involved.” Good grief. Sometimes “social stigma” serves a positive social purpose by preventing immoral acts regardless of legality.

Here’s the bottom line: Countries such as the Netherlands, Belgium, and now our most culturally aligned nation, Canada, demonstrate that once a society popularly accepts euthanasia, there are no brakes to prevent the steady expansion of the killing license, to include eventually even children and babies — acts that, until very recently, were universally condemned in the civilized world. Those with eyes to see, let them see.

WESLEY J. SMITH — Wesley J. Smith is an author and a senior fellow at the Discovery Institute’s Center on Human Exceptionalism.

**Updated 8/2/16 ** Physician Assisted Suicide Bill (A2451/S2474) Reintroduced in Both Houses. Take Action

stop physician assisted suicide

 

**Updated 8/2/16**

“No matter how much proponents try to portray their support for this misguided bill as compassionate, the reality is that the bill is anything but,” said Marie Tasy, executive director for New Jersey Right to Life. “The legislation is deeply flawed and will place the lives of our most vulnerable populations at risk of misdiagnosis, coercion and abuse.”

Senator Nicholas Scutari (D-22) reintroduced The Senate version of the Physician Assisted Suicide bill (S2474) on August 1, 2016.  According to an article written by Star Ledger reporter Sue Livio,  proponents are pushing for action on the bill by the fall of 2016.  Read the article

 

 

Assemblyman John Burzichelli (D-3) reintroduced the Physician Assisted Suicide Bill (2451) in February of 2016.  The text of the new bill, A2451, is now available on-line, is the identical to the previous version.  We expect the Senate version to be introduced shortly.

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/S2474 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/S2474 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/S2474.

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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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?