End-of-Life Choice, Palliative Care and Counseling

Blick v Connecticut

Dedicated to a Cause

by Barbara Coombs Lee
March 26, 2013

Last Wednesday, March 20, the Connecticut Assembly’s Public Health Committee began its consideration of a bill modeled after Oregon’s Death with Dignity Act. What a day! In my 22 years of legislative work, this hearing was the most grueling — and the most inspiring — I have ever witnessed.  Compassion & Choices volunteers and supporters showed themselves to be as passionate, judicious, intelligent and dedicated as citizens can ever be. They are committed to a world of justice and mercy. And they trust in democracy to make it so.

They came because they want choice and control in their own mortal endings. But mostly, they came for others who could not — their neighbors and loved ones and people unknown to them. They came that others need not suffer against their will, and that all may have the opportunity to face death in comfort and peace of mind. My heart swelled as I sat with them and heard the witness of these decent, altruistic, dedicated people.

The day began early, as aid-in-dying supporters travelled hours to Hartford by bus, car and train to be in line by 7:00 am.  Sign-up began at 9, but being in line by 7 helped ensure an opportunity to speak. The hearing began at 10 and our bill, Compassionate Aid in Dying for Terminally Ill Patients (HB 6645), came up about noon. Representative Betsy Ritter, the bill’s chief sponsor, spoke with eloquence and authority. Other legislators followed, and then the committee shifted gears and heard unrelated bills.

For many hours our supporters kept each other’s spirits up as they sat patiently through testimony about nursing technicians, dental hygienists, something called advance practice collaboration agreements, and tattoo artist licensure.

Some of our valiant and dedicated supporters just had to leave when their bus departed or their backs gave out. But others stayed until 1 am for their chance to speak. Yes, you read that right — they endured this process from 7 am until 1 am without complaint!!

Here are a just few of the heroes:

Shannon Sanford, a Yale-educated nurse who did her masters thesis on Oregon’s Death with Dignity Act.  ”Compassion & Choices were great to me when I was working on my thesis.  I can stay to the bitter end,” she told us. She had to, attending the entire 15-hour hearing as the last person to testify at approximately 1:30 am.

It fell to Shannon to present the committee with letters from all over the state. The stack was nearly a foot high, making a thump on the table.

Placing her hand on this tower of paper, Shannon said:  ”I brought my friends who are all in support of House Bill 6645″.  A legislator asked, ”I have to know, how many people signed letters?”  Shannon had a snappy response despite sitting 15 hours in a hearing room:  ”I stopped counting after 1500.”

Hunt Williams traveled over an hour to the state Capitol and waited twelve more to tell his story.

Hunt told the committee the story of his manslaughter arrest for merely cleaning a weapon his terminally ill friend, John Welles, used when he was dying of cancer. Only due to the overwhelming support and advocacy in his community of Cornwall, Connecticut, was Hunt sentenced to accelerated rehabilitation, a process that took over a year. The committee and the entire room sat in complete silence as they listened to Hunt’s riveting experience.

“Thank you sir, thank you for giving testimony.  I think I was taken aback by what you had to say,” a stunned co-chair of the committee, Senator Terry Gerratana, said.

Gloria Blick, aged 91, is a passionate advocate for end-of-life choice, as is her son Dr. Gary Blick.

When called to testify, Gloria and Dr. Blick held hands and both walked confidently to the microphone and sat together supporting each other.  Luckily, Gloria has not had a significant illness, but with her active volunteerism in the senior community, she has witnessed first-hand the pain and suffering of those at end of life, and it disturbs her greatly.

She made it clear to the committee she had been too active and too well to see her life end in a slow, relentless spiral of deterioration. Nor would she want her family, including Dr. Blick, to suffer unnecessarily with her.  ”I would never want to do that to my son,” she said.

Lillian Kaplan sat for hours waiting for her opportunity to speak out in favor of HB 6645, offering moving testimony regarding the difficult and painful death of her son-in-law Steven Kahn, who wanted to die on his own terms.  Lillian read into testimony a letter Steven wrote prior to his death.

“I am writing to you so you will not have to wonder…I’m not asking for your approval, only that you honor my judgment,” he wrote.

At the conclusion of her testimony, the Senate Chair of the Committee respectfully asked her age:  ”Well, in a year and a half I will be 100.”

Lillian, Gloria, Gary and Shannon and so many others showed themselves to be amazing and inspiring advocates. It is an honor to be able to work beside them for choice and control at life’s end.

Legislative Public Hearing: Aid-in-Dying Bill Wednesday, March 20, 10:30am

by Compassion & Choices staff
March 19, 2013
(Hartford, CT) — The legislature’s Public Health Committee will hold a public hearing Weds. March 20 on a bill that would allow terminally ill people in Connecticut to obtain a prescription to self administer for a safe and humane death.
The bill, H.B. No. 6645 (RAISED) AN ACT CONCERNING COMPASSIONATE AID IN DYING FOR TERMINALLY ILL PATIENTS, was raised by the committee in January. The legislature has considered similar bills in past years, but Wednesday will mark the first time proposed legislation has been brought to a public hearing here.
The states of Washington and Oregon have allowed aid-in-dying for more than a decade after being approved by public referendum; a court case resulted in aid-in-dying being legal in Montana.
Supporters of HB6645, including patients, doctors, nurses, and clergy, are expected to testify starting at 10:30 am.

WHAT: Public hearing on HB6645 – Compassionate Aid-in-Dying for Terminally Ill Patients

WHO: Legislature’s Public Health Committee

WHEN: Wednesday, March 20 – 10:30 am

WHERE: Room 1D, Legislative Office Building 

Take Action in Connecticut: Attend the Public Hearing

BCL in CT

We have had great success in this year’s legislative session in Connecticut with the introduction of “An Act Concerning Compassionate Aid in Dying for the Terminally Ill“.

The next step is a public hearing, where we all must make our voices heard. That hearing will take place:

Wednesday, March 20, 2013 10:30 a.m.
Legislative Office Building — Room 1D
300 Capitol Avenue, Hartford

The proposed Connecticut law is similar to laws passed in Oregon and Washington state. It offers dignity at the end of life and gives terminally ill patients in great pain the choice to ease and end their suffering. The law includes key safeguards: The patient must have six months or less to live and be deemed mentally competent.

It guarantees we — not the government — will make our own end-of-life decisions. Furthermore, as we know, “Death with Dignity” laws have worked without abuse with the same safeguards the Connecticut law would have.

BUT we still have a lot of work to do.

Right now, we want legislators to hear from Connecticut citizens like you. If you can attend the hearing, contact Tim Appleton today at tappleton@compassionandchoices.org or by calling 860.922.1988 to help send a message to legislators during the public hearing.

We know our opponents will be there, so please come show your support as well.

You can also help by following this link to contact Connecticut lawmakers. It’s quick, easy and impactful!

Doctors, Patients Disappointed in Court Decision

Connecticut physicians, terminally ill patients and Compassion & Choices, the nation’s largest and oldest nonprofit organization working to improve care and expand choice at the end of life, today expressed disappointment with the recent Blick et al v. Connecticut court decision.  On June 2, 2010, Judge Julia Aurigemma ruled to dismiss a case that sought to clarify the ability of mentally competent, terminally ill patients to obtain aid in dying from their physician if they find their dying process unbearable. Attorneys for the State of Connecticut filed a motion to dismiss the case, which asked whether a physician providing aid in dying is subject to criminal prosecution under an old nonspecific statute that makes it a crime to aid another to ‘commit suicide’.

“We are disappointed that the court dismissed this important case,” said Kathryn Tucker, Director of Legal Affairs for Compassion & Choices and co-counsel to the plaintiff physicians. “The court reached the ultimate issue in the case at the motion to dismiss stage, denying plaintiffs the opportunity to make their case. We are considering all options including appeal, hoping the higher court may permit a full review of the merits. It is essential for Connecticut physicians to know whether providing aid in dying subjects them to criminal prosecution. At present it is not clear and this creates an environment of uncertainty, leaving patients unsure if they will be able to access aid in dying if they find themselves confronting an unbearable dying process.”

Sheldon Smith, an 86-year old terminally ill Bethany man with Stage IV abdominal cancer, said, “I’ve had three years now to consider the effects of my cancer, and to prepare for the end of my life due to this terminal disease. However, I’m quite concerned about how the very end of my life will unfold. I know the type of pain that abdominal cancer can cause, and I’d like a physician to be able to prescribe medication that I could consume to bring about a peaceful death if my dying process becomes intolerable. I want to leave this world with the same dignity with which I’ve lived my life.”

Norwalk infectious disease specialist Dr. Gary Blick and Greenwich primary care internist Dr. Ron Levine, the plaintiffs in Blick, asserted that the choice of a mentally competent, terminally ill patient for a peaceful death is not ‘suicide’ and therefore a physician providing such a patient with a prescription for medication the patient can ingest to achieve a peaceful death is not subject to the law. The Montana Supreme Court recently decided a similar case, Baxter v. Montana, in physicians’ and patients’ favor.

Dr. Blick is the Medical and Research Director of CIRCLE Medical, LLC in Norwalk, Ct. His specialty is in infectious disease and treatment of HIV/AIDS.  Dr. Blick was a Resident at Yale University School of Medicine and Greenwich Hospital in Greenwich, CT.  He was both an attending and consulting physician at Greenwich Hospital and was the Founder and Chairman of the Greenwich Hospital AIDS Task Force.

Dr. Levine is a primary care internist in Greenwich.  He served his internship and residency at Albert Einstein College of Medicine, Montefiore Medical Center in New York. Dr. Levine is both an Attending Physician and a Clinical Instructor at Greenwich Hospital in Connecticut.  He is also a Clinical Instructor at Albert Einstein College of Medicine, Montefiore Medical Center in New York.

The physician plaintiffs are represented by Compassion & Choices Legal Director Kathryn Tucker, Connecticut appellate specialist Dan Krisch and noted Connecticut civil-rights attorney Jamie L. Mills.

The Complaint and the court’s decision can be viewed here.

Terminally ill need choices, compassion

New Haven Register
Letter to the Editor
Barbara Coombs-Lee

The editorial May 28, points out that the tragic deaths of the Vanacores in North Haven “are the exception.”

Thankfully, that is true, yet we should not be satisfied with the status quo. Gun deaths among the terminally ill are not unheard of in Connecticut. Across the country, on average, an elderly person dies by suicide every two hours, most of them with a gun.

Those violent, tragic deaths devastate families, and they can be prevented.

The counselors at Compassion & Choices get calls from many people who feel that ending their lives is their only solution.

We do not offer a one-size-fits-all prescription: some people need help finding resources to help them make it through, others want only a sympathetic listener.

Our services are provided without charge in the context of a relationship, and we welcome anyone who seeks them at www.compassionandchoices.org.

We also speak to people with terminal illnesses who want to meet death on their own terms and avoid prolonged, needless suffering.

They need not resort to violent means when they have the legal ability to plan a peaceful, intended death.

The availability of legal physician aid in dying provides a nonviolent alternative for the few who request it, and great comfort to others in knowing the option exists.

A mentally competent patient, wishing to live but knowing they are terminally ill, who asks their doctor for a prescription they can self-administer to achieve a peaceful ending, does not seek death, only a measure of control over their last days.

We hope the court, in Blick v. Connecticut, will recognize that is not suicide, and clarify that doctors who respond to such a request are not assisting a suicide.

The existence — the possibility — of that choice could be the difference in those exceptional, but tragic deaths.

Barbara Coombs Lee
Portland, Ore.