Legislature debates aid in dying

A bill under consideration by the Connecticut Legislature would allow doctors to prescribe lethal medications to terminally ill patients.

The “Aid-in-Dying” Bill, called “right to die” by its supporters and “assisted suicide” by its opponents, is modeled after Oregon’s “Death With Dignity” Act. If passed, the legislation would allow physicians to give life-ending medications to “competent” adults who have fewer than six months to live. Though the bill died in committee last year, the Public Health Committee is reconsidering it this legislative session, prompting support from right-to-die and civil liberties advocacy groups but concern from disabilities groups.

“I’ve heard stories of caregivers who are frustrated that they can’t help their patients with the one thing they want once medication hasn’t worked,” said Rep. Betsy Ritter of Waterford, Conn., who is spearheading the bill. “I can’t tell you if I would make that choice myself, but I believe that’s a choice people should be able to make.”

Advocates of the bill often cite statistics from Oregon, which passed an aid-in-dying law 16 years ago. Since that legislation came into effect, 1,173 people had prescriptions for lethal medication written, but only 752 people opted to use the medication. There have been no instances of coercion or abuse of patients reported, according to Ritter.

Democratic Rep. Phil Miller of Essex, Conn., a vice chair of the Public Health Committee, said he supports the bill.

“This is good legislation,” he said, adding that he is optimistic about the bill’s passage. “This is for terminally ill people with debilitating conditions to have a say in their death.”

The bill is supported by the 6,000-member American Civil Liberties Union of Connecticut and a national advocacy group called Compassion and Choices. The ACLU, which supported right-to-die legislation last year, is ramping up field support for the bill this year, according to Isa Mujahid, an ACLU field organizer.

Mujahid added that he supports the legislation because he views decisions of life and death as personal, and the bill moves “towards more liberty.”

A student group in support of aid-in-dying legislation has also formed this year at the Yale Medical School, comprising students and professionals from the medical school, the law school and other parts of the University.

“The doctor’s number one goal is to care for people in what they believe is right for them,” said Jay Patel MED ’16, a medical school student who founded the group. “I want to create more of an attitude in accepting death as a health care outcome rather than a health care failure. We’d like to take our message to every med school in the U.S.”

Patel said his support for right-to-die legislation comes from what he has seen at the Yale-New Haven Hospital through his participation in Comfort Companions, a program where volunteers sit with patients who are expected to die in two to three days.

Patel said “Aid-in-Dying” should be another option for patients in addition to palliative care.

Yet, just as it did last year, the bill continues to meet strong opposition.

“‘Aid-in-Dying’ would basically redefine what suicide is,” said Cathy Ludlum, a member of Second Thoughts Connecticut, a group advocating against the bill. “It would mean some people are going to get suicide prevention, and other people are going to get suicide assistance.”

Ludlum suggested aid-in-dying legislation could lead to higher suicide rates among teens and other age groups, though Ritter said her research team found no rise in suicide rates in states that have right-to-die laws.

John Kelly ’81, the director of Second Thoughts, argues that the legislation is discriminatory against people with disabilities and terminal illnesses.

“If someone at Yale feels like they want to kill themselves because their life has no dignity and worth, somebody would try to give them help to get better,” Kelly said. “But if it’s a disabled or terminally ill person, people say, ‘Of course you want to die.’”

Ritter said claims that the bill constitutes elder abuse do not make sense because the most support for right-to-die legislation derives from people in their 70s to 90s. She also emphasized that health care providers would not be obligated to provide patients life-ending medication if the bill was passed.

The bill includes safeguards to prevent people with depression and other mental illnesses from obtaining life-ending medication, such as evaluations by two physicians. It also requires the terminally ill person to self-administer the medication and mandates that witnesses affirm that the patient is competent to make the decision, Ritter said.

Still, opponents contend these safeguards are not enough.

Ritter cited pain as a driver for terminally ill people to want life-ending medication, but reports from Oregon show that the most frequently mentioned end-of-life concerns are “loss of autonomy,” “decreasing ability to participate in activities that made life enjoyable” and “loss of dignity,” according to the Oregon Death with Dignity Act’s 2013 report.

“From the perspective of disabilities groups, there’s a concern that what’s being justified is physicians helping people end their lives rather than live the same way people with disabilities live,” said James McGaughey, executive director of the state Office of Protection and Advocacy for Persons with Disabilities.

Miller said that, despite opposition on the Public Health Committee, he is seeing bipartisan support in the legislature, with Republican Sen. Toni Boucher, who is running in the Republican gubernatorial primary, and Republican Rep. Pamela Sawyer both supporting the bill.

Vermont joined Oregon, Montana and Washington last year in becoming the fourth state to legalize the use of self-administered lethal medications prescribed by a doctor. A bill similar to the one pending in Connecticut failed 52–48 percent in a statewide referendum in Massachusetts in 2012.

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