Advocates for two Massachusetts bills that would allow terminally ill people to end their own lives say the contentious topic has made it further than ever before on Beacon Hill.
During a virtual briefing held Tuesday, the Compassion & Choices Action Network and the Death with Dignity National Center said they're hoping public support for aid-in-dying — exemplified by a new Suffolk University/Boston Globe poll, which found that nearly 77% of residents support the idea — could propel it to become law in the commonwealth.
“We have huge momentum,” said Melissa Stacy, northeast regional advocacy manager for Compassion & Choices Action Network, a national organization advocating for laws to assist terminally ill people in ending their lives with medication.
As of 2021, ten states and the District of Columbia have passed legislation to allow some form of physician-assisted death.
Massachusetts' End of Life Options Act would allow adults with six months or less to live to request medication that would end their lives, provided they follow several steps. The written request must come at least 15 days after the initial oral request. The patient must have terminal diagnosis, and be approved by a mental health professional, among other requirements. They must be able to physically take the medication themselves after being cleared by many doctors and mental health professionals over an extended period of time.
The act is comprised of two comparable bills, introduced in the Senate by Sen. Jo Comerford, D- Northampton, and in the House by Rep. Jim O’Day, D-West Boylston, and Rep. John Mahoney, D-Worcester. It was reported out of the Joint Committee on Public Health but has yet to advance out of the Joint Committee on Health Care Financing, which has a June 1 reporting deadline.
Rep. Ted Philips of Sharon in a virtual hearing recounted how his predecessor Rep. Lou Kafka filed a similar bill in 2008 after he was approached by a constituent dying of stomach cancer.
“He wanted to be able to choose to end his suffering if it got to be too great,” said Philips.
Sen. Susan Moran said she was close enough to the possibility of her life ending from breast cancer that the bill would have been a source of strength.
"There were a couple of years I thought about dignity in dying as a potential element of control, as breast cancer was robbing me of my energy, my family time and the integrity of my body,” she said.
Sen. William Brownsberger was lead sponsor on the legislation in the past, and recounted how his psychiatrist father advocated for the bill, and saw patients at the end of their lives as a hospice director.
“When [patients] they face a terminal illness, the prospect that they might spend days, weeks or months in a state of enormous discomfort or even agony, is something that's scary,” he said. “Knowing they have the ability to break the glass and choose to pull the lever and choose to exit, is something that is potentially very, very comforting to them.”
Massachusetts' act specifically says it will not refer to “the practice of aid in dying” as “suicide” or “assisted suicide,” which is the terminology used in other states' efforts to promote or dissuade policies for helping the terminally ill end their lives.
But it’s that term “terminal” which is seen as dangerous to opponents.
The National Council on Disability has been critical of assisted suicide laws and their effect on people with disabilities.
“These laws are communicating dangerous, discrimination-filled messages to people with disabilities and the public that common disability experiences, like requiring assistance with personal care activities, are understandable and acceptable grounds for ending one’s life," the council's Executive Director Anne Sommers McIntosh told members of the Massachusetts Joint Committee on Public Health last October.
Philips said people with chronic disabilities won’t be impacted by the bill.
“We have created a very, very, very high bar that you have to clear in order to even be able to request this medication — you have to have a terminal condition,” he said.
New placeholders exist this session to keep patients from being intimidated into the decision by someone who can benefit. Two individuals have to witness the written request and attest that the patient is acting voluntarily and wasn’t coerced to sign it. One of the witnesses has to be an individual who isn’t a relative, associated with the health care facility they may be living in, or someone who would financially benefit.
The patient can rescind their request for the medication at any time.
“I want an option to limit pain and suffering for me and others as we near our end of life,” said Dr. Roger Kligler, a retired Falmouth physician with advanced prostate cancer, and a prognosis of less than five years. He’s had five surgical produces, five courses of radiation, and several other medical treatments.
He recounted the death of David Folger, a Falmouth resident, as dictated to him by Folger’s widow, Janet. Folger was a pancreatic cancer patient with an implantable pain pump on hospice and palliative care.
“In agony, he felt he was no longer able to tolerate the suffering, and was told he should use voluntary stopping of eating and drinking,” Kligler read. “He died 11 days later with uncontrollable pain, uncontrollable shortness of breath, agitation, and bedsores. His death scarred me and my family.”
Physicians will track the number of requests they get, prescriptions written, number of requests rescinded, the demographic information and any physical disability of the patient, which will be reported to Department of Public Health annually and shared with the public.
This proposed legislation and the 2012 ballot measure have faced stark opposition from the Catholic Church, and disability rights groups like Second Thoughts Massachusetts.
“Over the last 15 years, the Mass. legislature and, in 2012, the people of the state, have wisely rejected the legalization of assisted suicide as too dangerous,” said John Kelly, director at Second Thoughts. He said the legislature should reject the measure, “which despite its name does not provide dying people "end-of-life options."
Kelly himself is paralyzed from the neck down as a result of an accident. On Tuesday, he said people who choose physician-assisted death often do it because they feel like a burden, not because of pain.
He said he understands that sentiment. "My own father wished that I had died in the accident," he previously told GBH. "And people have told me they would rather be dead than be like me.”
In 2012, the Archdiocese of Boston launched an intensive campaign against the ballot measure, writing then that “suicide is always a tragedy.”
Kligler said there’s a lot of misconceptions, including that the 2012 ballot initiative showed what the public wanted.
“Ten years ago, the Archdiocese dumped $5 million in the last couple of weeks [before Election Day] on mainly misleading ads,” he said.
Advocates say public perception of how and if people should be able to end their lives changed in the past decade, and especially as the coronavirus pandemic brought death to the forefront of public discussion.
“I think so many people in our community have lost loved ones, have seen over a million deaths as a result of COVID. I think it's an issue that has really been brought to the forefront a little bit more than it might have been over the past seven or eight years,” said O’Day. “I just think that people have a different viewpoint on how we can deal with it with death and dying and dignity.”
It’s a contentious issue that has reached the state’s highest court. In March, the Massachusetts Supreme Judicial Court heard arguments in a case brought by Kligler and Dr. Alan Steinbach on whether a person can control the way they end their life, and whether doctors can legally prescribe the medication to do that.
The Massachusetts Medical Society filed a brief in the case saying it’s taking a position of neutrality given that each patient’s case is different, and cited studies showing prediction of survival rates in terminally ill patients are only 20% correct.
Attorney General Maura Healey’s office argued in court that this was an issue for the legislature, not judicial system, to consider, and that physicians could be prosecuted for manslaughter if they assist.
In 2019 a lower court ruled providing aid-in-dying medication is manslaughter, even if the patient administers the drugs alone.
