Legal Medical Aid in Dying: The Paradox of Privacy

Are medical aid-in-dying deaths natural? New York seems to think so. Consistent with other jurisdictions in the United States, New York’s Medical Aid in Dying Bill determines that on the death certificate, the manner of death will be listed as natural, and the terminal condition that established the person’s eligibility for assisted dying will be recorded as the cause of death, for example, metastatic cancer. Regardless of one’s position on the legalization of assisted dying, how these deaths are documented on death certificates raises important ethical questions about vital statistics and individual privacy.

These categorization decisions are not issues of semantics or ideology. Instead, they stem from an implicit acknowledgment of the social anxieties about certain forms of dying. There is an inherent and widespread paradox here, which the bioethics community has largely overlooked. On one hand, if a person dies from a socially problematic or value-laden condition or method, accurately recording this could be viewed as the final, bureaucratic mark of stigma. On the other hand, a distorted or sanitized report diminishes the integrity