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Every state should pass medical aid-in-dying law

In the Hospital Sick Male Patient Sleeps on

In the Hospital Sick Male Patient Sleeps on the Bed. Heart Rate Monitor Equipment is on His Finger. Credit: Getty Images/iStockphoto/istock

After nearly seven years of legislative debate, New Jersey Gov. Phil Murphy ensured last month that terminally ill New Jerseyans will no longer have to suffer needlessly at life’s inevitable end when he fulfilled his pledge to sign the Medical Aid in Dying for the Terminally Ill Act the legislature passed in March.

Similar to bills introduced in New York and 17 other states this year, the New Jersey law will allow a mentally capable, terminally ill adult with six months or less to live to have the option to request a doctor’s prescription for medication that they can decide to take to die gently in their sleep if their suffering becomes unbearable. This option allows a terminally person to avoid the very worst, very last part of the dying process.

As New York Gov. Andrew M. Cuomo said three days before the New Jersey bill signing: “I say [to the State Legislature] pass the bill...the older we get and the better medicine gets, the more we've seen people suffer for too, too long.”

National polling shows more than 7 in 10 Americans support medical aid in dying with majority support across every demographic, political and religious spectrum. This compassionate option is available to nearly 70 million adults in eight states and Washington, D.C. And lawmakers are beginning to respond to their constituents demands for this peaceful option. It took 20 years to authorize medical aid in dying in the first four states (Oregon in 1994; Washington in 2008; Montana in 2009; and Vermont in 2013), but only five years to authorize it in the last five jurisdictions (California in 2015; Colorado in 2016; Washington, D.C. in 2017; Hawaii in 2018; and New Jersey in 2019).

Unfortunately, lawmakers in some other states considering medical aid in dying have been paralyzed by hypothetical scenarios, misinformation and one big false assumption raised by opponents who will never support this end-of-life care option. Their false assumption: the implementation of medical aid in dying will increase the likelihood that a nefarious doctor or family member will prematurely end a vulnerable person’s life.

The reality: if a malevolent doctor or family member wanted to prematurely end a terminally ill person’s life, they are not going to do it by committing a crime via the highly regulated practice of medical aid in dying when they have access to large quantities of opioids and benzodiazepines as a routine and necessary part of care for a dying person.  Medical aid in dying does not put a dying person in greater risk; it does, however, provide greater protections. Here’s why:

  • Medical aid in dying laws include more than a dozen regulatory requirements for a dying person to obtain the prescription.
  • Two doctors must certify that the patient is mentally capable, terminally ill with a prognosis of six months or less to live, is able to self-ingest the medication and is not being coerced.
  • There are witness forms, waiting periods and reporting requirements.
  • The patient is in charge of the process from start to finish: the patient must make the request, and ultimately ingest the medication.

Current medical aid in dying laws protect patients. In a combined 40 years of experience across 8 jurisdictions, there has not been a single documented incidence of abuse or coercion. In fact, in the 21 years of experience implementing the law in Oregon, fewer than 1,500 people total have decided to use the option.

Although the data and evidence clearly demonstrates that medical aid-in-dying laws protect patients, the trend within state houses is to attempt to add additional “safeguards” to address every possible way a nefarious doctor or family member could prematurely end a vulnerable person’s life. While this approach is well-intentioned, it is unnecessary, duplicative and ill advised.  

Unnecessary because the data demonstrate that medical aid-in-dying laws, with their current safeguards, protect patients. Duplicative because the practice of medicine is already highly regulated, with strict licensing laws designed to weed out or convict nefarious doctors. And ill advised because a dying person with limited time to live will never be able to obtain the prescription if we add more steps on top of the already cumbersome 12-step process outlined in medical aid-in-dying laws. If we hamstring doctors by legislating for hypothetical situations, they will be unable to either save lives or provide patients with a more peaceful death. A dying person needs end-of-life care policies that prioritize compassion over unnecessary government red tape and roadblocks.

It is heartbreaking to watch a dying person being robbed of this compassionate option year after year because false assumptions guide our policymaking. Medical aid-in-dying laws protect dying patients while providing them with a necessary and compassionate end-of-life care option. Only the dying person, in consultation with their loved ones and doctor, knows how much suffering is too much to bear. Terminally ill residents do not have time for endless deliberations.

I urge the lawmakers in New York and other states to let the evidence and data guide your policy making and bring this compassionate option to your state without further delay.  

Kim Callinan is chief executive of Compassion & Choices.