Forgoing the long, expensive, and unpredictable ballot proposal process, an increasing number of states are pushing legalized assisted suicide through their legislatures.
The bills are having mixed success. Maryland defeated an eighth attempt to pass assisted suicide legislation when a bill failed to gain traction before the Maryland General Assembly ended its session for the year on April 7. State assemblies in Nevada and New York (April 17, May 2) passed assisted suicide bills, but the measures have an uncertain future in their state senates and with their governors. On May 20, Delaware Gov. Matt Meyer signed House Bill 140 allowing adults six or fewer months to live the option to request lethal drugs from a doctor so they can end their lives.
The bills, often termed “medical aid in dying” or MAID, allow terminally ill and mentally competent adults with six months or less to live to request medication to end their life. The New York bill prompted a strong rebuke from U.S. Rep. Elise Stefanik (R-NY).
“Instead of investing in palliative care, mental health support, and life-affirming resources for those facing terminal illness, this legislation offers an immoral shortcut that devalues human life,” said Stefanik in a news release on May 1. “It sends a chilling message to our seniors and disabled communities that their lives are expendable.”
MAID Stampede
Today, seven states have MAID laws through legislation, six of them enacted in the past nine years. The states include California (2016), Hawaii (2018), Maine (2019), New Jersey (2019), New Mexico (2021), and Vermont (2013). Assisted suicide became legal in Montana in 2009 as the result of a lawsuit.
Vermont allows nonresidents to enter the state for assisted suicide.
There have also been 10 ballot initiatives to legalize or ban assisted suicide since 1991. Four proposals were successful. After failed attempts in Washington and California to legalize assisted suicide, Oregon became the first state to approve an assisted suicide ballot proposal in 1994, followed by Washington in 2008, and Colorado in 2016.
In addition to New York and Nevada, Delaware and Illinois are currently considering legislation for assisted suicide. The Oregon and Vermont bills would expand legalization to allow nonphysicians to prescribe the lethal drugs, and Washington is trying to reduce the waiting period for terminal patients.
“Proponents usually work through the legislature but decide which states should propose a ballot measure, and that is usually a political calculation depending on the demographics of the state,” said Jason Negri, an attorney for the Patients’ Rights Action Fund.
Bipartisan Opposition
Both Republicans and Democrats have opposed the legalization of assisted suicide for a variety of reasons, says Negri.
“[These include] issues like concern for the vulnerable, health care cost control, and elder abuse,” said Negri. “For example, last month in New York, after over a decade of pushing legislators—including such tactics as disrupting Assembly sessions and cornering legislators in elevators—assisted suicide proponents received a floor vote in the Assembly. Over 20 progressive democrats voted against it, citing racial and health-care disparities that make this policy so dangerous for marginalized communities.”
Though proponents pitch “safeguards,” that can be misleading, says Negri.
“Such ‘safeguards’ include waiting periods, residency and witness requirements, and conscience protection for doctors who don’t want to help their patients die,” said Negri. “The safeguards are a calculated move to garner support from people who are uncertain about assisted suicide.”
The safeguards are often removed within a few years, says Negri.
“Proponents characterize them as ‘barriers to care,’” said Negri. “Their goal is death on demand, and the ‘safeguards’ they put in are only temporary and for show.”
Ranking Lives
The push to pass assisted suicide bills coincided with the expansion of Medicaid to cover able-bodied people, which sent costs soaring. Norm DeLisle, a policy consultant with the Michigan Disability Coalition, says MAID laws target the disabled, says DeLisle.
“Every time I hear someone support laws enabling assisted suicide, what I really hear is that my disabled life isn’t worth living,” said DeLisle. “Trust me, we in the disability community feel this kind of judgment daily. Our lives are seen as less valuable, less meaningful, less worth protecting than yours. The message is, ‘Better Off Dead.’”
People are more inclined to end their lives when they are in the hospital, DeLisle says.
“If you have a permanent disability, there is no place that drains your personal worth faster than a hospital,” said DeLisle. “Even medical staff have written books about this loss of self when they become patients. Each day chips away at your sense of self as you lose more control over even tiny decisions in your life. You are an object, and you never feel more powerless than when others decide what your life is worth without asking you. No experience can make you more vulnerable to pressure you to die.”
Death a Poor Option
Opposing MAID does not necessarily mean disregard for pain and suffering near the end of life, says Heidi Klessig, M.D., author of The Brain Death Fallacy.
“The medical profession exists to help people live until they die, not to push them over the edge,” said Klessig. “Resources other than death are available for people who are suffering through palliative care and proper hospice techniques. We need to let people know that they are valuable and cherished even when they are very sick and disabled at the end of life.”
Suicide Advocate
The assisted suicide controversy erupted decades ago when the public expressed shock and outrage after learning about Jack Kevorkian, a Michigan pathologist who used a “suicide machine” to aid some 100 deaths.
Kevorkian dodged several murder charges, and one jury acquitted him. Kevorkian lost his medical license, and his actions prompted the governor at the time to sign the state’s first ban on assisted suicide in December 1992. On April 13, 1999, a jury convicted Kevorkian of second-degree murder, and a judge sentenced him to 10-25 years in prison, where he served just over eight years’ time. Kevorkian died in 2011.
AnneMarie Schieber ([email protected]) is the managing editor of Health Care News.
AnneMarie Schieber is a research fellow at The Heartland Institute and managing editor of Health Care News, Heartland’s monthly newspaper for health care reform.
