End-of-Life Choice, Palliative Care and Counseling

Montanans’ right to ‘aid in dying’ reaffirmedby Sonja

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By Anders Blewett and Dick Barrett
Great Falls Tribune
May 11, 2011

Last week we celebrated the Legislature’s adjournment with great satisfaction that Montanans’ access to aid in dying had been reaffirmed. Two bills introduced in the state Senate threatened to outlaw physician aid in dying, as established by the Montana Supreme Court. A bipartisan majority of the Senate Judiciary Committee, and the full Senate, rejected the bills, thus preserving the right of terminally ill patients to make their own end-of-life decisions..

On Feb. 16, the committee voted 7 to 5 to table defeat SB116, which would have revoked the right of terminally ill patients to request aid in dying from their physicians.

Doctors, patients, family members, clergy, hospice nurses and doctors — including the Montana Medical Association and the National Association of Social Workers Montana Chapter — testified against the bill repealing physician aid in dying.

And when the sponsor of SB116 tried to bring the bill before the full Senate for consideration, lawmakers of both parties opposed it, 35 to 15.

The Judiciary Committee also defeated SB169, increasing penalties for “suicide predators,” because its ambiguous language could have created a backdoor deterrent to aid in dying.

Most of us have experienced loved ones’ deaths that were not in harmony with how they lived their lives. We think every Montanan, when approaching the end of life, should have the right to choose his or her own path.

The defeat of this these bills was a victory for individual rights over government control. These are decisions that should be — and now can continue to be — made by the terminally ill patients whose lives, deaths and suffering are at stake, based on their own religious, spiritual and family beliefs.

It now falls to Montana physicians to develop the standard of care to respect and protect their patients’ end-of-life decisions. Montana’s medical community is certainly up to the task of including aid in dying as one of the options available for patients with end-stage cancer and other terminal diseases.

Also tabled by the Senate Judiciary Committee was SB167, which would have provided specific practice guidance and immunities for physicians who honor their terminally ill patient’s’ end-of-life medical decisions.

“It is unfortunate that the Legislature did not go further to codify the court’s decision, providing physicians with additional protections for honoring patients’ decisions,” said Dr. Stephen Speckart, an oncologist from Missoula. “However, Montana’s medical community can rest assured the Senate examined this issue closely, and concluded that it is proper public policy for physicians to respect a dying patient’s decisions.”

The Montana Supreme Court Dec. 31, 2009, in Baxter vs. Montana, recognized that the statutes empowering patients to direct their end-of-life care, even when decisions may advance the time of death, reflect public policy in favor of patient autonomy.

The court recognized that Montana public policy allows competent dying patients to choose aid in dying, and established that physicians who provide aid in dying at the behest of their terminally ill patients are acting with the consent of their patients and are protected from prosecution.