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.

  • enness

    “There have been no instances of coercion or abuse of patients reported, according to Ritter.”
    That’s because doctors self-report and the state agencies you would expect to investigate actually admit they have no authority to do so. There are numerous cases to be found for those willing to do even a tiny bit of research.

    I think we all ought to be skeptical whenever someone tells us that yet another piece of legislation is a “move toward more liberty.”

    “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.”
    Oh sure, like abusers are going to be so obvious! Is it that hard to convince an already vulnerable person that something like this was his or her own idea?

    “She also emphasized that health care
    providers would not be obligated to provide patients life-ending
    medication if the bill was passed.”
    It won’t matter, because if they refuse people can keep trying until they get what they want. It’s called doctor-shopping and it has happened in Oregon.

    The bill includes safeguards…and mandates that witnesses
    affirm that the patient is competent to make the decision, Ritter said.”

    Only ONE of them has to be disinterested (i.e. not a relative, heir, beneficiary, etc.) — the other one can. As far as I can tell that part is not substantially different from last year.

    I do thank the doctors and politicians who have taken a public position. With all due respect, it tells me who to avoid at all costs.

  • Leslie Wolfgang

    The countries of Belgium and The Netherlands thought they could contain their “aid in dying” laws to just “competent” adults, but now euthanize people with mental disabilities, the disfigured, depressed and now, “competent” children. Unless CT wants to welcome those debates also, we should focus the government’s interests elsewhere . . perhaps to reducing stigmas against palliative care.

    Montana did not legalize assisted suicide, that is a talking point of Compassion & Choices and we can do better than to regurgitate their rhetoric. At least you did not include New Mexico. In Montana, their Supreme Court outlined some defenses for physicians who, in theory, were charged with murder for assisting suicide . . that is not the same as having assisted suicide laws and the people of that state are awaiting clarification. Also, it is the Big Lie of Big Suicide that there have been no abuses in Oregon, and I see Ritter has modified the talking points to say no coercion or abuse have been “reported”. She must not mean reported by any news sources or by patient advocates or regular people, because those are too numerous to list here, and they include doctor shopping, neglect, and criminal mistreatment. There are no penalties under the law for mis-reporting to the state, so it’s absurd to rely on self-reports by Oregon regarding abuse.

    In 2013, the state of Oregon issued their own report about the alarmingly high rate of suicide in their state . . when after declining before their law was adopted, it is now 41% above the national average. It has been a tremendous expense and drain on their economy and healthcare system. From Margaret Dore of Washington . . .

    “I mentioned that there had been a significant increase in other suicides in Oregon after assisted suicide legalization. This is consistent with a suicide contagion (legalizing and thereby normalizing one type of suicide encouraged other suicides).

    Of course, a correlation does not prove causation.

    However, as set forth below, there is a significant statistical correlation between the two events. Moreover, the financial cost to Oregon from the other suicides is enormous. Please see the data below:

    Oregon’s assisted suicide act went into effect in 1997. See top line at this link:http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/index.aspxBy 2000, Oregon’s regular suicide rate was “increasing significantly” Seehttp://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf(“After decreasing in the 1990s, suicide rates have been increasing significantly since 2000”)
    In 2010, Oregon’s other suicide rate was 35% above the national average. http://maasdocuments.files.wordpress.com/2013/02/oregon-suicide-info_001.pdf

    In 2012, the most recent report, Oregon’s other suicide rate was 41% above the national average. http://choiceisanillusion.files.wordpress.com/2014/02/oregon-suicide-report-2012-through-2010-pdf.pdf Moreover, this report, page 3, states:

    “Suicide is the second leading cause of death among Oregonians ages 15-34, and the 8th leading cause of death among all ages in Oregon. The cost of suicide is enormous. In 2010 alone, self-inflicted injury hospitalization changes exceeded 41 million dollars; and the estimate of total lifetime cost of suicide in Oregon was over 680 million dollars. The loss to families and communities broadens the impact of each death.”
    The report, itself, does not address the possible influence of assisted suicide legalization. But, again, the significant statistical correlation is there. The cost to the state is enormous.”

  • Hondok

    As one of the people interviewed, I wish more was included about our opposition.

    There is no way for a state to run a suicide program and protect vulnerable people. This bill, like Oregon’s, gives doctors untrained in psychological evaluation the authority to judge whether someone’s judgment is impaired or not. Specialists simply don’t have that ability, which partially explains the outrageously low consult rate in Oregon. For the last four years, only 2% of suicide program participants were referred for consultation. People could look up Michael Freeland, the Oregon man with a lifelong history of depression, suicide attempts and paranoia, whose prescribing doctor opined that a consult was not “necessary.”

    And what is unimpaired judgment anyway? Based on Oregon and other reports, it seems to be the desire to die when one is dependent on others and feels like a burden. As a disabled person who depends on others for my care, I resent the acceptance of such suicidal reasons as “loss of dignity” (i.e., personal humiliation) and “feeling like a burden” (more personal humiliation).

    And then, once the prescription is written and goes home, the prescribing doctor has no further involvement. The only “aid” offered is a prescription for poison. There is no witness required at the death. This establishes a situation in which financial or other motive could lead someone to administer the poison to the person. You could look up Thomas Middleton and Tami Sawyer, now serving nine years in prison

    This paragraph is terribly silly:

    “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.”

    Come on logic students, spot the fallacy! While there are supporters in their 70s and 90s, there are other people who are getting abused, estimated at 70,000 or more per year.

    Finally, I’m disappointed to see the Yale Daily News participate in the euphemising of physician assisted suicide, a long-standing medical term generally understood by the public. Just because the people promoting assisted suicide want to call it something else, such as “aid in dying” or” death with dignity,” doesn’t mean that newspapers have to follow suit. The word “suicide” doesn’t poll well, as one might guess.

    John B. Kelly, ‘ 81

  • Hondok

    Just to correct the facts regarding Oregon’s suicide rate, higher than other states and increasing more rapidly than nationally:

    http://www.oregonlive.com/health/index.ssf/2013/05/report_oregons_suicide_rate_hi.html

    Oregon saw a 49.3 percent increase in suicides among men and women aged 35-64 from 1999-2010, compared to 28 percent nationally.

    A 2012 report on suicide trends and risk factors for the Oregon Health

    Authority found the state’s overall suicide rate was 41 percent higher

    than the national rate, that rural counties have higher rates of suicide

    than urban ones, and that white men lead other demographic groups.

  • Stephen Mendelsohn

    You can tell a movement by it’s slogan. The civil rights movement sang “We Shall Overcome.” The disability rights movement proclaims “Nothing About Us Without Us.” Both emphasize community and interdependence. It’s not just about the almighty self. By contrast, Compassion and Choices slogan is radically self-centered: “MY Life. MY Death. MY Choice.” Supporters of assisted suicide do not care about the considerable collateral damage their proposal causes. Rep. Betsy Ritter lies through her teeth when she claims that suicide rates in states that have legalized assisted suicide are no different. Oregon’s suicide rate 35% higher than the national average and has been rising dramatically since 2000. http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf What else does one expect when “my death” becomes “my choice”?

    When mercilessly bullied autistic or LGBT teenagers see this slogan “MY Life MY Death MY Choice.” on stickers, billboards, Facebook pages, and in the Capitol concourse, they pick up a loud and clear message that suicide can be the answer to their suffering.

    It is also worth noting that no law or bill legalizing so-called “aid-in-dying,” including HB 5326 http://www.cga.ct.gov/2014/TOB/H/2014HB-05326-R00-HB.htm requires family to be notified of the lethal prescription and death. It is purely the patient’s option. Suicide typically leaves surviving relatives devastated—and so does “aid-in-dying” suicide. Because for proponents, family does not matter; it’s all about me, myself, and I. It’s “my choice” to “my death” because I do not want to live with a disability, and all of the harm to others does not matter. It is an ethic far more in common with the reactionary hyperindividualust Ayn Rand than the Reverend Dr. Martin Luther King, Jr. and the civil rights movement.

  • rebecca gagne henderson

    As a palliative care provider I know that the vast majority of patient’s who are terminally ill continue to be denied access to proper palliative care. I find it disheartening that rather than providing these patients excellent spiritual, emotional and physical support they require as they near the final milestone of their life we simply offer them a way to end their lives. I have witnessed incredible growth, reconciliation and acceptance of the dying process when patient’s and families’ have been offered excellent palliative care. When provided impeccable symptom management in the company of superb emotional and spiritual support dying well can be achieved. As is true of any person committing suicide it is the result of devastating despair. Dying well is hard work, but it is well worth it.