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Tag Archive: Aid in Dying

  1. Maine House of Representatives Defies Voters, Fails to Pass End-of-Life Options Legislation

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    The Maine House of Representatives voted against LD 347, an Act Supporting Death with Dignity, also known as medical aid in dying, today by a vote of 61 to 85. The Senate advanced the legislation last Thursday by a vote of 16 to 15.

    Medical aid in dying is an end-of-life medical practice in which a terminally ill, mentally capable individual who has a prognosis of six months or less to live requests, obtains and—if his or her suffering becomes unbearable—self-ingests medication that brings about a peaceful death.

    “Even though the end-of-life options legislation was defeated today by the House, the will of the people of Maine will eventually prevail,” said Lynne Tobin, a West Boothbay Harbor resident and advocate for Compassion & Choices. “By voting against this legislation, House members are threatening a vital end-of-life option for Mainers living with terminal illnesses who are already fighting against the clock and may now never live to utilize it. That is the real cost of our lawmakers thwarting this crucial bill.”

    “The House has discounted the will of the people of Maine and the action of the Senate,” said Maine aid-in-dying advocate, Shawn Lewin, Boothbay Harbor. “The choice to utilize medical aid in dying is between an individual, their faith and their loved ones. It is a dangerous precedent to set for government to inflict its will on that of its constituents.”

    “We are deeply disappointed that members of the House didn’t see fit to join over 70 percent of Maine residents who want the option of medical aid in dying,” said Tim Appleton, Multi-State Campaign and Outreach Manager at Compassion & Choices. “The personal opinions of certain lawmakers and others should not interfere with the will of Mainers who overwhelmingly support this legislation and should not take away the peace of mind that this option brings to those who are terminally ill and enduring unbearable suffering.”

    Large majorities of Americans believe that a dying person’s decision whether to end their suffering belongs between them and their doctor, based on their own values.

    • A 2017 Public Policy Polling survey showed that 73% of Mainers support the proposed right to die legislation.
    • 74 percent of Americans support the right of a terminally ill adult to end their suffering at life’s end, according to a 2014 Harris Poll.
    • 59 percent of Christian Americans, and 70 percent of Americans of other religions, agree that: “When a person is facing a painful terminal disease, it is morally acceptable to ask for a physician’s aid in taking his or her own life,” according to a 2016 LifeWay Research online survey.
    • 57 percent of U.S. doctors support medical aid in dying, backing the rights of patients with an incurable illness to seek a dignified death, according to a 2017 Medscape poll.

    If enacted, LD 347 would allow Maine to join six other states and the District of Columbia in authorizing medical aid-in-dying legislation. Oregon, where aid in dying has been legal for two decades, has been joined by Washington, Montana, Vermont, California, Colorado and Washington, DC.

  2. Maine Senate Advances End-of-Life Options Legislation

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    The Maine Senate advanced  LD 347, an Act Supporting Death with Dignity, also known as medical aid in dying, today by a vote of 16 to 15. The bill will now move to the House of Representatives, which is expected to vote on it as soon as Friday. In 2015, end-of-life options legislation lost by a single vote in the Senate and this year, it won by a single vote. It marks a historic moment, as the legislation has never had an affirmative vote in the Senate before today.

    Medical aid in dying is an end-of-life medical practice in which a terminally ill, mentally capable individual who has a prognosis of six months or less to live requests, obtains and—if his or her suffering becomes unbearable—self-ingests medication that brings about a peaceful death.

    “Mainers overwhelmingly support medical aid in dying, and while most will never choose to utilize it, they want the option because it provides comfort to those facing pain and suffering in the end stages of a terminal disease,” said Lynne Tobin, a West Boothbay Harbor resident and advocate for Compassion & Choices. “By advancing this end-of-life options legislation, the Senate has shown a commitment to improving end-of-life care for all Mainers.”

    “We applaud the Maine Senate for passing this vital medical aid-in-dying bill and hope that the House members realize the importance of this option to the more than 70 percent of Maine residents who want it,” said Charmaine Manansala, National Director of Political Advocacy at Compassion & Choices. “The vote today shows that the time is now for the legislature to honor the will of the public and act to ensure that Maine joins six other states and the District of Columbia in authorizing medical aid in dying.”

    Large majorities of Americans believe that a dying person’s decision whether to end their suffering belongs between them and their doctor, based on their own values.

    • A 2017 Public Policy Polling survey showed that 73% of Mainers support the proposed right to die legislation.
    • 74 percent of Americans support the right of a terminally ill adult to end their suffering at life’s end, according to a 2014 Harris Poll.
    • 59 percent of Christian Americans, and 70 percent of Americans of other religions, agree that: “When a person is facing a painful terminal disease, it is morally acceptable to ask for a physician’s aid in taking his or her own life,” according to a 2016 LifeWay Research online survey.
    • 57 percent of U.S. doctors support medical aid in dying, backing the rights of patients with an incurable illness to seek a dignified death, according to a 2017 Medscape poll.

    If enacted, LD 347 would allow Maine to join six other states and the District of Columbia in authorizing medical aid-in-dying legislation. Oregon, where aid in dying has been legal for two decades, has been joined by Washington, Montana, Vermont, California, Colorado and Washington, DC.

     

  3. Medical Aid in Dying: The Cornerstone of Patient-Centered Care

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    The following article originally appeared in the May 2017 American Society of Aging Generations Magazine – End-of-Life Care edition. 

    In his brilliantly written book, Being Mortal, renowned surgeon Dr. Atul Gawande succinctly outlines the dichotomy between the amazing advances in twenty-first century medical technology and our society’s unwillingness to confront death and the dying process and, more specifically, to learn about end-of-life care options. He notes these advances have not only led to increased longevity, but also to associated complications, prolongation of disease states, and suffering:

    “Modern scientific capability has profoundly altered the course of human life. People live longer and better than at any other time in history. But scientific advances have turned the processes of aging and dying into medical experiences, matters to be managed by healthcare professionals. And we in the medical world have proved alarmingly unprepared for it” (Gawande, 2014).

    Medical ethics also have evolved in concert with this newfound technology and the acknowledgement of its sometimes negative impacts on patients. The tenets of patient autonomy and social justice have risen to become paramount ideals in the doctor− patient relationship, and a movement toward “patient-centered” or “person-centered” care has emerged. While the definitions of these terms differ, the common concept is that it is the patient’s preferences, needs, and values that guide clinical decisions.

    The Brittany Maynard Effect

    No instance exemplifies this concept more clearly than the case of Brittany Maynard, a young woman from California who in 2014 was dying of brain cancer. Even after undergoing a sophisticated surgery and numerous cancer treatments, her growing tumor was causing debilitating headaches and seizures. After exhausting all treatment options to try to cure her cancer, Brittany left her home and friends and moved to Oregon to take advantage of the state’s Death with Dignity Act. On November 1, 2014, she willingly self-administered aid-in-dying medication to end the unbearable suffering she was experiencing. Within thirty minutes of drinking the medication, Brittany died peacefully in her sleep with her family at her bedside.

    Before she died, Brittany became a champion for the rights of terminally ill people. She had been informed of all her end-of-life care options by her medical team and in consultations with our country’s best specialists. She knew what she wanted. She was an autonomous thinker, mentally capable, under no duress or coercion to make her choices, and incredibly brave and gracious. In videos she created, Brittany eloquently outlined her reasons for considering medical aid in dying. She wanted to die on her terms, with her family, in her home, with her poems and her songs. Having the medication available meant knowing she could prevent the very worst, the very last part of dying, if she chose.

    Brittany’s story exemplified person-centered care. It was an example of the medical system allowing the patient’s values and priorities—including control over their own death—to be respected. This is why millions of people worldwide responded so powerfully to Brittany’s story, because through her actions, she firmly established that she, the patient, was making her own medical decisions. If healthcare systems truly want to deliver on their commitment to be “person-centered,” then they must implement policies that respect the values of their consumers, including a patient’s control over the circumstances of their looming death. In other words, adopting policies that support giving terminally ill patients the option of medical aid in dying is a hallmark of person-centered care.

    A Palliative and Compassionate Medical Practice

    Medical aid in dying has been authorized in Oregon since 1997 (Oregon Legislature, 1997). During the past eighteen years, Oregon physicians have been allowed to discuss the full range of options in end-of-life care. As an unexpected consequence, hospice and palliative care in Oregon are unsurpassed in quality. State residents who consider medical aid in dying are almost always enrolled in a hospice program (93 percent), and an overwhelming majority (90.1 percent) are able to die at home, which is an avowed goal of most elderly and dying individuals (Oregon Public Health Division, 2016).

    There has been no evidence of abuse of the Oregon Death with Dignity Act, and no evidence that the financially disadvantaged, the uninsured, or persons with disabilities are at risk of coercion (Battin et al., 2007).

    The medical aid-in-dying laws in Oregon (1997; 2016), Washington (2008), Montana (Baxter v. Montana, 2009), Vermont (2013), California (2015), and now Colorado (2016) have core safeguards, including strict eligibility requirements, to ensure the laws are safe and work as intended. Two physicians must concur that the dying individual has a terminal illness, with a prognosis of six months or less to live, is mentally capable to make his or her own healthcare decisions, and is under no duress to request an aid-indying prescription. Written as well as oral requests must be made by the patient, and may not be made by a surrogate. If a terminally ill individual presents to the clinician with any symptoms that would indicate impaired judgment, a third opinion from a mental health specialist is necessary to confirm mental capacity before a prescription can be written. Additionally, there are waiting periods before a prescription can be written.

    Authorizing medical aid in dying also has the potential to transform the end-of-life experience for dying patients and their families. The law requires doctors to review all available end-of-life care options with their patients— from pain and symptom management to hospice and palliative care—before they can write a prescription for aid in dying. A study in Journal of the American Medical Association (Ganzini et al., 2001) credited Oregon’s Death with Dignity Act with contributing to better conversations between doctors and patients, better hospice care, and better training of physicians on pain management and comfort.

    Access to Peaceful Dying and Peace of Mind

    The act of obtaining an aid-in-dying prescription is palliative in and of itself. Approximately one-third of terminally ill people do not end up taking the aid-in-dying medication (Oregon Public Health Division, 2016), but just having it on hand—to know that they can take the medication if their suffering were to become unbearable, and that their physician respected and honored their choice—is a great comfort.

    Near the conclusion of his book, Dr. Gawande writes: “Life is meaningful because it is a story . . . and in stories, endings matter” (Gawande, 2014). In states where medical aid in dying is authorized, more people do not die because of medical aid in dying; but certainly, fewer people suffer.

    Barbara Coombs Lee, R.N., P.A., F.N.P., J.D., is president of Compassion & Choices in Denver, Colorado. David Grube, M.D., is national medical director of Compassion & Choices.

    References

    Battin, M., et al. 2007. “Legal Physician-assisted Dying in Oregon and the Netherlands: Evidence Concerning the Impact on Patients in ‘Vulnerable’ Groups.” Journal of Medical Ethics 33(10): 591–7

    Baxter v. Montana. 2009. 449, 354 Montana. 234, 224 P.3d 1211 (2009). www.compassionandchoices.org/userfiles/MontanaSupreme-CourtOpinion.pdf. Retrieved September 1, 2016.

    California Legislature. 2015. California End of Life Option Act. ABX2-15 End of life. (Sacramento, 2015). http://leginfo.legislature. ca.gov/faces/billTextClient. xhtml?bill_id=201520162AB15. Retrieved September 1, 2016.

    Colorado Legislature. 2016. Colorado End-of-Life Options Act. Proposition 106. (Denver, 2016). www.sos.state.co.us/pubs/ elections/Initiatives/titleBoard/ filings/2015-2016/145Final.pdf. Retrieved April 15, 2016

    Ganzini, L., et al. 2001. “Oregon Physicians’ Attitudes About and Experiences with End-of-life Care Since Passage of the Oregon Death with Dignity Act.” Journal of the American Medical Association. 285(18): 2363–9.

    Gawande, A. 2014. Being Mortal: Medicine and What Matters in the End. New York: Metropolitan Books.

    Oregon Legislature. 1997. Oregon Death With Dignity Act. Oregon Revised Statute. Chapter 127. (Salem, 1997). http://public.health. oregon.gov/ProviderPartnerRe sources/EvaluationResearch/ DeathwithDignityAct/Pages/ors. aspx. Retrieved September 1, 2016.

    Oregon Public Health Division. 2016. Oregon’s Death with Dignity Act: 2015 Data Summary. https:// public.health.oregon.gov/Provider PartnerResources/EvaluationRe search/DeathwithDignityAct/ Documents/year18.pdf. Retrieved September 1, 2016.

    Vermont Legislature. 2013. Vermont Patient Choice and Control at the End of Life Act. Act 039, Chapter 113. (Montpelier, 2013). www.leg.state.vt.us/docs/2014/ Acts/ACT039.pdf. Retrieved September 1, 2016.

    Washington Legislature. 2008. Washington Death with Dignity Act. Complete Chapter 70.245 RCW. (Olympia, 2008) http:// apps.leg.wa.gov/RCW/default. aspx?cite=70.245. Retrieved September 1, 2016.

  4. Senate Health and Human Services Committee Advances Nevada Medical Aid-in-Dying Bill

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    The Senate Health and Human Services Committee advanced medical aid-in-dying legislation (SB 261) in a Work Session today by a vote of 3 to 2.  The bill, introduced by Sen. David Parks (D-Las Vegas) and co-sponsored by Sen. Ben Kieckhefer (R-Reno), will now proceed to the Senate floor. It received a work session after a hearing by the Committee last week.  

    Medical aid in dying is an end-of-life medical practice in which a terminally ill, mentally capable individual who has a prognosis of six months or less to live requests, obtains and—if his or her suffering becomes unbearable—self-administers medication that brings about a peaceful death.

    Ashley Cardenas, Policy & Programs Director for Compassion & Choices and Las Vegas native, stated: “Courageous people living with terminal illnesses attended last week’s hearing and told their personal stories, urging lawmakers to pass the bill so they could have the option of medical aid in dying if and when no other treatment provides relief for their unbearable suffering. Hundreds more have visited their legislators, submitted testimony and made their voices heard in support of medical aid in dying. By advancing SB 261, the Committee members have shown a commitment to improving end-of-life care for all Nevadans.”

    Large majorities of Americans believe that a dying person’s decision whether to end their suffering belongs between them and their doctor, based on their own values.

     

    • Nearly three out of four Nevada voters (72%) support legislation introduced in the state legislature that would give mentally capable, terminally ill adults with six months or less to live the option to get a doctor’s prescription for medication the could decide to take die peacefully in their sleep if their suffering becomes unbearable, according to an April survey by Public Policy Polling.
    • 74 percent of Americans support the right of a terminally ill adult to end their suffering at life’s end, according to a 2014 Harris Poll.
    • 59 percent of Christian Americans, and 70 percent of Americans of other religions, agree that: “When a person is facing a painful terminal disease, it is morally acceptable to ask for a physician’s aid in taking his or her own life,” according to a 2016 LifeWay Research online survey.
    • 57 percent of U.S. doctors support medical aid in dying, backing the rights of patients with an incurable illness to seek a dignified death, according to a 2017 Medscape poll.

     

    If enacted, SB 261 would allow Nevada to join six other states and the District of Columbia in authorizing medical aid-in-dying legislation. Oregon, where medical aid in dying has been authorized for two decades, has been joined by Washington, Montana, Vermont, California, Colorado and Washington, DC.

  5. Supporters from Across the State Travel to Advocate for Medical Aid in Dying at Compassion & Choices New York Lobby Day

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    On May 9, Compassion & Choices New York was joined by over 100 supporters from across the state in calling on the New York State Legislature to do what the public wants and pass the Medical Aid in Dying Act (S.3151/A.2383). Legislators, advocates and people who have been personally affected by the death of a terminally ill loved one who died without access to medical aid in dying, made their voices heard and shared their compelling stories at a press conference held in the Capitol Building.

    “New Yorkers overwhelmingly support medical aid in dying and now the legislature needs to catch up to the public,’ said Corinne Carey, Compassion & Choices New York Campaign Director. “Lawmakers seeking reelection next year should be paying attention to what their constituents want, and they should act to make sure that New York joins six other states and the District of Columbia in authorizing medical aid in dying before Election day 2018.”

    P1030192“I want to live more than anything else. I want to see my son graduate college, I want to see him finish medical school, I want to someday hold my grandchildren,” said Rochester resident Susan Rahn, who was diagnosed with stage four breast cancer four years ago. “What I don’t want is to suffer and be in uncontrollable pain while my body shuts down for what could be weeks and I don’t want my son and my family to have to watch me go through that. Medical aid in dying is a choice I should be able to make for myself and for my family.”

    “I cared for a patient who took his own life with a shotgun to end his suffering from COPD. His violent death had a profoundly negative impact on his family, and it changed my understanding of suffering. It strongly influenced my choice to become an advocate for medical aid in dying,” said David Pratt, MD, former Schenectady County Commissioner of Public Health Services, and a palliative care provider. “New Yorkers should not have to take desperate and violent measures when pain and suffering become too much to bear. They should have access to the peaceful and sound option of medical aid in dying.”

    18404199_658371067688553_8208374984691205832_oLindsay Wright, wife of Youssef Cohen, a professor of politics at New York University, who died from incurable mesothelioma, said: “My husband died last year after fighting an incurable disease for four years. He wanted to die at home, surrounded by friends and family. But he knew he couldn’t have full control over his own death in New York. We moved to Oregon so that Youssef could take advantage of their aid in dying law.  New Yorkers with terminal illnesses deserve to have the right to choose the kind of death they want here in New York. I urge our legislators to come together now to pass medical aid in dying legislation so that no New Yorker is forced to do what we did – leave their family and friends behind to die somewhere else. Make us all proud to be New Yorkers.”

    Janet Green, who lost her partner of 26 years, Harry, one year ago today, May 9, 2016, said: “Harry loved life, with a passion for hunting, fishing and camping. Even after being diagnosed with brain cancer eight years ago, he continued to try do things he loved. In February 2016 he fell. Diagnostic testing revealed bone cancer. He realized his life would continue to be painful. At that point, he wanted me to shoot him. Of course, I would not.

    “Hospice came to our home and provided support for me, and pain medication for Harry. They were wonderful but it was not enough. His pain often broke through and became unbearable.  He often said, ‘please help me die.’  It was agonizing to watch the man I love suffer so much. I believe terminally ill adults should have legal options that help them die without prolonged suffering, and that’s why I’m asking lawmakers to support the Medical Aid in Dying Act,” Green said.

    P1030204Former Assemblymember Janet L. Duprey (R-Clinton/Franklin/St. Lawrence Counties), said: “I am so supportive of the Medial Aid in Dying legislation, I’m returning to Albany for the first time since I retired at the end of 2016.  Although I’ve always preferred to keep my personal life private, I am sharing the story about my parents’ suffering during their last days.  If legislators will consider the agony of watching loved ones die slow tortuous deaths, they will realize the importance of allowing people to have the ability to choose their own destiny.”

    P1030161Advocates then made in-person visits to their legislators to discuss why their support is crucial in passing medical aid-in-dying legislation.  

    There is a steady groundswell of support building for medical aid in dying in New York. The Medical Society of the State of New York recently voted to authorize a survey of physicians on medical aid in dying and the New York State Public Health Association has now endorsed the legislation, as has the New York Civil Liberties Union. These organizations have now joined groups like the Statewide Senior Action Council, ACT UP-New York, Harlem United, the Rochester Breast Cancer Coalition, Mobilizing Preachers and Communities, and Housing Works in support.

    “It’s hard to talk about death and dying, but our work is to sit down with each lawmaker one-on-one to hear their questions and concerns about this legislation. New Yorkers are counting on their lawmakers to face this difficult issue with a clear understanding of what the bill would do, not clouded by misinformation or distortion,” Carey said. “We are confident that groundswell of public support will be well represented in the Legislature.”

  6. Maine doctors softening stance on [medical aid in dying]

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    This post is from the Portland Press Herald

    For much of his medical career, Erik Steele didn’t think he and his fellow doctors should help terminally ill patients get the medicine that could kill them.

    “When you make these decisions, you will make mistakes, whether it’s capital punishment or physician-assisted suicide,” he said, recalling his old views on the subject. “If you take 1,000 patients, there will potentially be a few where you will make mistakes. And if you make mistakes, you should make them on the side of life.”

    But around 2010, two things happened that forced Steele, a family doctor who has worked all over Maine, to reconsider his views. One of his patients, a terminally ill man named David, died after shooting himself in the chest. And after physician assisted-suicide was legalized in Oregon and Washington, Steele was encouraged by research coming out of those states.

    He eventually came to support the right of terminally ill patients to end their lives with lethal medicine prescribed by a doctor, so long as certain conditions are met.

    “I think giving a terminally ill patient who’s well cared for, who has good hospice care and good palliative care, the option to end their life, on their own terms, in a peaceful manner, is consistent with my Hippocratic oath,” he said in an interview this past week. “On a very personal basis … the thought of a patient shooting himself in desperation, when I think about it years later, that still chokes me up.”

    Steele, who worked in Bangor for 20 years and now sees patients in the Portland area, was particularly open about his new position, describing it in a 2012 newspaper column. But many physicians, here and across the nation, are rethinking their attitudes about assisted suicide as the population ages and more states legalize it.

    This spring, Maine lawmakers have considered a proposal to allow physician-assisted suicide here. The bill, sponsored by Sen. Roger Katz, R-Augusta, is similar to a law passed by Vermont in 2013 and a bill that was rejected narrowly by the Maine Legislature in 2015.

    Under the proposal, patients who are ill and deemed by their doctors to be within six months of dying could request medication to hasten their deaths. They would be required to make two separate spoken requests for the medication, at least 15 days apart, and to sign a written request, among other steps. Two disinterested witnesses also would have to sign that request, vouching that the patient understands it and does not appear to be under duress or undue influence.

    Physicians and pharmacists would not be required to grant those requests, according to the bill, and physicians would not be allowed to end a patient’s life by directly administering a lethal injection or other means.

    The bill faces an uphill battle, as it failed to earn majority support in the Health and Human Services Committee and Gov. Paul LePage has said he will veto it.

    However the bill fares, Maine doctors have shifted enough in their views that the Maine Medical Association, which represents them in the Legislature, has dropped its long held opposition to physician-assisted suicide and taken a neutral position, at least temporarily, said Gordon Smith, executive vice president of the group.

    The association’s board voted to drop that opposition last week, following a recent survey of more than 600 members that showed an even divide between respondents who supported and opposed the old position, Smith said. Now, the association will organize a task force to research physician-assisted suicide and what positions it could take going forward.

    The Maine Medical Association took its old stance in 2000, ahead of a citizen referendum that would have legalized physician-assisted suicide in Maine. It took guidance from the American Medical Association’s code of ethics, Smith has said, as well as the Hippocratic oath, which states “First, do no harm.” But the survey results, as well as input the group received from the public, has led to its new stance.

    “Having physicians assist in bringing about someone’s death prior to their natural death raises conflicts for physicians,” said Charles Pattavina, an emergency room doctor in Bangor and president of the Maine Medical Association. “For that reason, we’ve traditionally been opposed to it. But we do realize public opinions change over time, and that includes the opinions of physicians.”

    Other options

    One factor in that change may have been the highly publicized case of Brittany Maynard, a 29-year-old woman with terminal brain cancer who died in 2014 after taking a fatal dose of barbiturates prescribed by a doctor in Oregon. That year, a survey of 21,000 U.S. doctors found that for the first time, more than half – 54 percent – supported assisted death. Two years later, the same group found that 57 percent of doctors supported it.

    But Pattavina draws a distinction between assisted-suicide – which he personally opposes – and other end-of-life practices that doctors have become more comfortable with in the last decade, such as removing intravenous fluids from a terminally ill patient. That question faced Pattavina in late 2015, when his father died in a hospital in the Boston area.

    “We had to make a decision to stop IV fluids when it was clear he wasn’t going to recover from this acute illness,” said Pattavina, who had made plans with his father and had power of attorney. “It almost felt like we were hastening his death. If we kept him on IV fluids, he would have lived longer, even if that is an artificial means of keeping people alive. That wasn’t what he would have wanted. I was raised Catholic, and certainly nothing in Catholic culture wants to artificially prolong life. There was a lot of doubt in that situation, but I felt I was honoring his wishes.”

    But assisted suicide would be a different matter, Pattavina went on: “I feel like it would be so much more difficult to shorten someone’s life as opposed to keeping them comfortable while they die.”

    Roy Miller, a family doctor who works in Whitefield, has a similarly gray view on assisted death. In his own work with patients over the last 37 years, he hasn’t seen a need for the type of treatments that would be allowed under an assisted-suicide law. But he has also worked with seriously ill patients who get pneumonia and ask him not to treat it.

    “I have respected that wish,” he said. “That’s a halfway step between giving someone medicine to die, but also allowing someone to die.”

    If effort should be exerted somewhere in the health care system to help dying patients, Miller said, it should be on educating them and their families about the hospice and palliative care available to them. He expressed concern about assisted suicide being “the slippery slope situation where doctors are encouraging people to do it, particularly where it’s a treatment for depression.”

    But Miller also said his attitudes could change. “I haven’t seen a need for a big change,” he said, “but I can see both sides.”

    Aging population

    Steele, the Portland-area physician, said he understands the importance of good hospice and palliative care, but that terminally ill patients still deserve a choice in the matter.

    “In an ideal world, every patient thinking about this would have good hospice care,” he said. “They would have good family support, engaged physicians, all of which can help an individual patient not make this decision in simple desperation because they’re suffering in preventable ways. If you’re making decision because of pain control is inadequate, that’s a shame. That’s why I think it’s really ideal if you have choices … If I had to choose between great hospice care and the right to end your own life when you’re terminally ill, I would pick great hospice care, but I don’t think it should be an either-or.”

    Steele supports the bill now before lawmakers because it has protections for patients. He also said the data coming from states like Oregon suggests that many patients who are prescribed lethal drugs don’t end up using them. In the 20 years that Oregon’s law has been on the books, 64 percent of the 1,749 patients who have been prescribed lethal medications used them to die, according to state data. Last year, Oregon doctors prescribed 206 lethal medications, 133 of which were reportedly used by patients.

    California passed a similar law in 2015. Other states that have approved such laws include Washington, Colorado and Vermont. A 2009 state Supreme Court ruling in Montana determined the practice was not illegal, although there is no state law there permitting it. On the other side, a 2016 state Supreme Court decision in New Mexico upheld a lower court ruling that determined terminal patients had no state constitutional right to have a physician help them end their life.

    If the Maine bill doesn’t pass this year, Steele said, he think it’s “inevitable” it will be reconsidered in two years and eventually be passed.

    “The fastest growing population in America is the one that’s over 80, so we’re having more and more of these conversations,” he said. “More physicians are being exposed to this issue with their patients. Many of us are being exposed to this with our parents and other family members … The demographic reality will keep this front and center until it passes.”

  7. Nevada Medical Aid-in-Dying Bill Receives Senate Hearing

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    Medical aid-in-dying legislation, SB 261, was heard today by the Senate Health and Human Services Committee. Sen. David Parks (D-Las Vegas) introduced the bill.

    Medical aid in dying is an end-of-life medical practice in which a terminally ill, mentally capable individual who has a prognosis of six months or less to live requests, obtains and—if his or her suffering becomes unbearable—self-administers medication that brings about a peaceful death.

    “I have recently been diagnosed with Hodgkin’s lymphoma. Even though my prognosis looks good, it has forced me to think about the future and about others who are aren’t as fortunate and are facing an incurable terminal illness,” said Laura Packard, an Enterprise, Nevada resident and advocate for Compassion & Choices, who testified at the hearing.  “I know that if my cancer should progress and if all courses of treatments have been tried and I am in agonizing pain, I should have the right to let go, as should anyone else if they so choose. That’s why I support this bill. It’s very personal now.”

    “As every day passes, it becomes more and more critical for Nevada residents facing terminal illness to have the option of medical aid in dying,” said Ashley Cardenas, Policy & Programs Director for Compassion & Choices and former Las Vegas local.  “With 30 years of combined experience in this public policy, it is clear that the vague generalities and arguments put forward by opponents today are completely unfounded and the will of the people of Nevada must prevail.”

    If enacted, SB 261 would allow Nevada to join six other states and the District of Columbia in authorizing medical aid-in-dying legislation. Oregon, where medical aid in dying has been authorized for two decades, has been joined by Washington, Montana, Vermont, California, Colorado and Washington, DC.

  8. Time for New York to Pass Medical Aid in Dying

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    Compassion & Choices called on the New York State Legislature to do what the public wants and pass the Medical Aid in Dying Act (S.3151/A.2383). Legislators and advocates supporting medical aid in dying were joined at a Capitol news conference today by several people from across the state who have been deeply and personally affected by New York not being a state where medical aid in dying is currently legal.

    The legislation would give mentally capable, terminally ill adults with six months or fewer to live the option to get a doctor’s prescription for medication they can decide to take if their end-of-life suffering becomes unbearable so they can die peacefully in their sleep.

    “New Yorkers overwhelmingly support medical aid in dying and now the legislature needs to catch up to the public,’ said Corinne Carey, Compassion & Choices New York Campaign Director. “Lawmakers seeking reelection next year should be paying attention to what their constituents want, and they should act to make sure that New York joins six other states and the District of Columbia in authorizing medical aid in dying before Election day 2018.”

    “I want to live more than anything else. I want to see my son graduate college, I want to see him finish medical school, I want to someday hold my grandchildren,” said Rochester resident Susan Rahn, who was diagnosed with stage four breast cancer four years ago. “What I don’t want is to suffer and be in uncontrollable pain while my body shuts down for what could be weeks and I don’t want my son and my family to have to watch me go through that. Medical aid in dying is a choice I should be able to make for myself and for my family.”

    “I cared for a patient who took his own life with a shotgun to end his suffering from COPD. His violent death had a profoundly negative impact on his family, and it changed my understanding of suffering. It strongly influenced my choice to become an advocate for medical aid in dying,” said David Pratt, MD, former Schenectady County Commissioner of Public Health Services, and a palliative care provider. “New Yorkers should not have to take desperate and violent measures when pain and suffering become too much to bear. They should have access to the peaceful and sound option of medical aid in dying.”

    Lindsay Wright, wife of Youssef Cohen, a professor of politics at New York University, who died from incurable mesothelioma, said: “My husband died last year after fighting an incurable disease for four years. He wanted to die at home, surrounded by friends and family. But he knew he couldn’t have full control over his own death in New York. We moved to Oregon so that Youssef could take advantage of their aid in dying law. So many people have told me they could never do what we did – move to another state to die, far from friends and family. They want to die where they live, surrounded by people they love. My husband wanted all those things, too.

    “New Yorkers with terminal illnesses deserve to have the right to choose the kind of death they want here in New York. I urge our legislators to come together now to pass medical aid in dying legislation so that no New Yorker is forced to do what we did – leave their family and friends behind to die somewhere else. Make us all proud to be New Yorkers,” Wright said.

    Janet Green, who lost her partner of 26 years, Harry, one year ago today, May 9, 2016, said: “Harry loved life, with a passion for hunting, fishing and camping. Even after being diagnosed with brain cancer eight years ago, he continued to try do things he loved. In February 2016 he fell. Diagnostic testing revealed bone cancer. He realized his life would continue to be painful. At that point, he wanted me to shoot him. Of course, I would not.

    “Hospice came to our home and provided support for me, and pain medication for Harry. They were wonderful but it was not enough. His pain often broke through and became unbearable. He often said, ‘please help me die.’ It was agonizing to watch the man I love suffer so much. I believe terminally ill adults should have legal options that help them die without prolonged suffering, and that’s why I’m asking lawmakers to support the Medical Aid in Dying Act,” Green said.

    Former Assemblymember Janet L. Duprey (R-Clinton/Franklin/St. Lawrence Counties), said: “I am so supportive of the Medial Aid in Dying legislation, I’m returning to Albany for the first time since I retired at the end of 2016. Although I’ve always preferred to keep my personal life private, I am sharing the story about my parents’ suffering during their last days. If legislators will consider the agony of watching loved ones die slow tortuous deaths, they will realize the importance of allowing people to have the ability to choose their own destiny.”

    Medical aid in dying is authorized in Oregon, Washington, Montana, Vermont, California, Colorado and most recently, the District of Columbia.

    Senator Diane Savino (IDC-Staten Island), prime sponsor or the bill, said: “Medical aid in dying continues to gain traction at the Capitol, and here is a simple fact the opposition continues to miss. The fight won’t be won because of press releases sent out by people who haven’t even taken the time to read the bill and learn the facts. We will get this law passed because it’s the right thing to do. New Yorkers will do what they always do, let elected leaders know how they feel. And every poll that’s out there says the overwhelming majority of people in every area of the state support medical aid in dying. I am the first to say this is not a program for everyone. I don’t know what my decision would be if I were in that situation. But I do know I would want the option for me and my loved ones.”

    Assemblymember Amy Paulin (D-Westchester), prime sponsor of the bill, said: The Medical Aid in Dying Act gives a dying person relief and peace of mind at a terrifying time when they are facing unbearable suffering. It’s time for New Yorkers to have this additional end-of-life care option.”

    Assembly Health Committee Chair Richard N. Gottfried, a co-sponsor of the bill, said: “This bill is about patient autonomy and dignity. For over a hundred years, New York law has recognized that adults with mental capacity have the right to refuse life-saving treatment. Morally and legally, they should have the right to end their suffering through medication if that is their own choosing. I look forward to moving the bill forward again this session towards Assembly passage.”

    Assemblymember Billy Jones (D-Clinton/Franklin/St. Lawrence Counties), a co-sponsor of the bill, said: “I, along with countless of other individuals, have watched a loved one succumb to a slow and painful death. The Medical Aid in Dying Act offers sound peace of mind to those patients who are confronting the possibility of a prolonged and agonizing end. It is these very people who need our compassion and understanding the most, and this legislation grants them that serenity. I strongly believe that we should have the ability to choose our own fate when facing a terminal illness.”

    Donna Lieberman, executive director of the New York Civil Liberties Union, said: “Mentally capable adults who are terminally ill should not be forced to undergo an agonized, prolonged dying process. We support the New York Medical Aid in Dying Act because it provides reasonable policies – with important safeguards to protect patients – that will enable mentally capable, terminally ill adults to make their own choices when it comes to the end of their life.”

    Laurie Leonard, Executive Director, End of Life Choices New York, said: “Hospice and palliative care can ensure a peaceful, pain-free death for most people. But some have conditions even the best palliative care cannot treat successfully. It is cruel and inhumane to turn our backs on those people and say they must endure tremendous suffering before they die. Many people who have seen a loved one die a bad death want to do everything they can to spare others from suffering this way. That’s why most New Yorkers support medical aid in dying.”

    Charles King, CEO Housing Works, said: “Although an HIV diagnosis is no longer a death sentence due to advancements in medical science, there was a time where people with AIDS were suffering terribly and end of life choices were few. Some folks took their own lives in horrible and violent ways to end the suffering. We as a society cannot deny terminally ill people the ability to control the manner of their death. The Medical Aid in Dying Act allows people to make fully informed decisions and is modeled after an Oregon state law that has proven to be sound public health policy for more than 20 years. It is basic compassion and common sense that we ask the Legislature to pass this important legislation

    “There is a steady groundswell of support building for medical aid in dying in New York,” Carey said. “The Medical Society of the State of New York recently voted to authorize a survey of physicians on medical aid in dying. The New York State Public Health Association has now endorsed the legislation, as has the New York Civil Liberties Union. These organizations deliberated for several years and have now joined groups like the Statewide Senior Action Council, ACT UP-New York, Harlem United, the Rochester Breast Cancer Coalition, Mobilizing Preachers and Communities, and Housing Works in support.

    “It’s hard to talk about death and dying, but our work is to sit down with each lawmaker one-on-one to hear their questions and concerns about this legislation. New Yorkers are counting on their lawmakers to face this difficult issue with a clear understanding of what the bill would do, not clouded by misinformation or distortion,” Carey said. “We are confident that groundswell of public support will be well represented in the Legislature.”

  9. Compassion & Choices and Terminally Ill D.C. Residents Advocate for Right to Access Death with Dignity Act at D.C. Council Budget Oversight Hearing on Health

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    Compassion & Choices staff and D.C. residents testified at the D.C. Council Budget Oversight Hearing on Health to urge swift action to ensure that all steps necessary to ensure residents the option of medical aid in dying is completed.

    “Our organization, healthcare providers and most importantly the patients who desperately need this option recognize that passing a law is simply the first step in making sure that D.C. residents do not needlessly suffer at the end of life, said Matt Whitaker, National Access Campaign Director, Compassion & Choices. “Without proper implementation, the very residents who spent their last months, weeks and days advocating for themselves and those like them may not be able to access  the comfort this option provides. Any hesitation and any roadblock that arises  can and will ultimately cause unnecessary suffering to the most vulnerable among us.”

    “I support the [Death with Dignity] Act and its timely implementation … Because I cannot win this fight. The disease is terminal. When I only have a short time to live, and if I am in intolerable pain, I would like the option to take medication to have a peaceful and dignified death,” said Stella Dawson, who read the testimony of her spouse, Mary Klein, who has incurable ovarian cancer and is featured in a YouTube video about why she supports medical aid in dying.

    The Death with Dignity Act will give mentally capable, terminally ill adults with six months or fewer to live the option to request from their physicians a prescription medication which they may decide to self-administer to bring about a peaceful death. D.C. residents support medical aid in dying by a 2-1 margin, according to a July 2015 Lake Research poll. The D.C. Council overwhelmingly voted to pass the legislation by an 11-2 margin on November 15, 2016 and Mayor Muriel Bowser signed it into law on December 19, 2016.

  10. Jay Kallio – 9/11 First Responder & Hospice Volunteer – Victim of Lung Cancer, Died in Pain, Unable to Access Medical Aid in Dying in New York

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    Compassion & Choices New York today released a video featuring Jay Kallio, a 9/11 first responder who passed away on September 30, 2016 from lung cancer without being able to access medical aid in dying, legislation he passionately advocated for even prior to his own diagnosis.

    The poignant video tells the story of 60-year-old Jay, a trained paramedic and hospice volunteer who lived in New York. It also features his partner, Bonnie Marcus, who was with Jay during his final hours.

    “A first responder, trained medical professional and hospice volunteer, Jay was a New York hero. He knew first-hand the importance and benefits of great palliative and hospice care. And although as a patient he received world-class palliative care, Jay’s medical team could not control the pain and suffering he endured at the end of his life,” said Corinne Carey, New York Campaign Director for Compassion & Choices. “A strong supporter of medical aid in dying even before his illness, Jay wanted his words – as he knew his brave fight was coming to an end – to resonate with lawmakers and the public. He wanted them to understand that there are limits to even the best palliative and hospice care, and that’s why New Yorkers should have the option to avail themselves of medical aid in dying.”

    In a powerful plea to New York legislators, Jay Kallio said in the video: “I’m a strong advocate for palliative care and the quality of life it can bring to patients…but I also know that there are levels of pain it can’t control. I would like to have the legal right to end my life in a way that is merciful for me…doesn’t put my family through the horror of watching helplessly while I struggle and strain in pain as I die. I would ask you to look into your heart and try to see we who needs your mercy now to save us from a horrifying death.”

    “The image of him in all that pain is very difficult to carry and I carry it. I am the witness to that,” Bonnie Rose Marcus, Jay’s partner, said in the video. “He was an extraordinary human being. He was a warrior. He didn’t deserve to die that way and nobody does….nobody does.”

    A September 2015 poll of New Yorkers, commissioned by Compassion & Choices, found 77 percent support for allowing a terminally ill, mentally competent adult the option to request aid in dying medication.

    If enacted, the Medical Aid in Dying Act (sponsored by Sen. Diane Savino [IDC-Staten Island] and Assemblymember Amy Paulin [D-Westchester] would allow New York to join six other states and the District of Columbia in providing mentally capable, terminally ill adults with the legal right to request a prescription to bring about a peaceful death should they choose to do so. Oregon, where aid in dying has been legal for two decades, has been joined by Washington, Montana, Vermont, California, Colorado and Washington, DC.

    The video can be viewed here. More information about Compassion & Choices NY’s efforts to pass medical aid in dying is available here.  New Yorkers can voice their support for medical aid in dying with state legislators here.