Youssef Cohen is an associate professor of political science at New York University. He is 68 years old, and has a deadly form of cancer: mesothelioma.
He has been combating the cancer for nearly four years, with chemotherapy, surgery and radiation. Recently, he enrolled in a trial of a new therapy at Memorial Sloan Kettering Cancer Center. Cohen hasn't given up on life, but he has one request: the option, when hope is exhausted, to choose a death without agony.
"I don't think I'm afraid of dying; I've accepted that," Cohen said in an interview. "But I have a lot of fear. I wake up in the night, and the fear is the fear of dying in agony unnecessarily."
Cohen works to control his fear with humor and laughter, but he dreads no longer being able to swallow, to breathe or to numb the pain. He is speaking out in support of New York State passing a death-with-dignity bill, which is the law in four states. The state laws allow a terminally ill adult who is mentally sound to request life-ending medication that can be self-administered.
"If I had that choice, I would be less afraid," Cohen says.
Listening to this brave, hopeful man who has lived on three continents and written three books, I want him to have that choice. He was raised in a Jewish home but isn't particularly religious. I was raised in a Catholic home and am not particularly religious. I don't know what I would do in his situation.
The Medical Society of the State of New York, the Catholic Church and the disability rights group Not Dead Yet oppose physician assistance in dying. They argue that it promotes suicide for people considered no longer useful or a burden to society. They say there are sufficient medicines to ease suffering at the end of life.
However, physician help in dying is gaining traction with the public. In September, a poll by EaglePoint Strategies found that 77 percent of New York voters said they support access to assisted suicide. Two advocacy organizations - End of Life Choices New York and Compassion & Choices - are lobbying in Albany and gathering grass roots support. Oregon has had an assisted suicide law for 18 years, and California passed a similar law in October.
California acted after the high-profile advocacy of 29-year-old Brittany Maynard, who moved from California to Oregon to access medical aid in dying after a terminal diagnosis of brain cancer. Maynard decided to end her own life on Nov. 1, 2014. Her case, youth, and courage gave a new face to the aid-in-dying debate, and her online video explaining her decision held the interest of audiences around the world. Oregon's law gave her the option of autonomy and self-determination to the end.
Dr. David S. Pratt is an Albany-area palliative care specialist whose position on aid in dying has changed over his 15 years of practice in pulmonary medicine. Some patients if his intensive care unit were on ventilators, weren't strong enough to live without them and hadn't made provisions to prohibit their use. The patients had arrived at the emergency room blue and breathless, he said, and "in some sense, they were stuck."
Another two of Pratt's patients ended their lives violently, with devastating effect on their families. These cases persuaded Pratt that there are insufficient compassionate tools for patients who wish to stop suffering.
Cohen has watched friends decline, including one with pancreatic cancer who didn't want aid in dying. "That's OK with me, it was his choice," he said. "But I wouldn't choose it."
We must add options for people like Cohen.