Lawmakers in Boston will hold a hearing on Tuesday on a bill that would allow doctors to prescribe a fatal dose of medication to someone suffering from a terminal illness.
BOSTON -- Should a doctor be allowed to prescribe a fatal dose of medication to someone suffering from a terminal illness?
That question, which has led to emotional and impassioned debate in Massachusetts and nationally, will be back before Massachusetts lawmakers on Tuesday.
Three years after the state's voters narrowly defeated a ballot question that would have allowed physician-assisted suicide, the Legislature's Joint Committee on Public Health will hear public testimony on a similar "death with dignity" bill sponsored by State Rep. Louis Kafka, D-Stoughton.
Among those expected to testify is Dan Diaz, whose 29-year-old wife Brittany Maynard wrote publicly about her decision to move from California to Oregon and take her own life when facing terminal cancer.
"It's important to give people who are diagnosed in this manner and who do not want to face a very painful death the ability to choose how they die," Kafka said. "It's an individual choice that we've tried to protect from outside influence."
Kafka has filed an assisted suicide bill for three sessions, at the request of a constituent who had terminal stomach cancer and has since died. Kafka's bill, H.1991, would allow a competent adult living in Massachusetts with a terminal illness and less than six months to live to request life-ending medication. The person would need to be evaluated by an attending physician and a consulting physician and undergo an evaluation by a psychiatrist. Two witnesses would need to certify that the request was made voluntarily.
Advocates for the bill say it is a matter of individual freedom and relieving suffering.
"I think it's important that people have choice at the end of their life," said Marie Manis, Massachusetts campaign director for Compassion and Choices, which supports assisted suicide bills around the country. "People should not have to suffer needlessly."
But opponents of the bill say it would open the door for abuse - for pressure from families or caregivers or for the denial of expensive medical care. They say the state already works to prevent suicide, and that position should not change.
"We say we have suicide prevention services for young people. Why is it when people become disabled, suddenly people start thinking it might be best for us to die?" said John Kelly, founder of Second Thoughts Massachusetts, a group of disability advocates who oppose assisted suicide.
Currently, five states have legalized physician-assisted suicide - Oregon, Washington, Montana, Vermont and, as of this month, California. Another 26 state legislatures are considering bills.
The Massachusetts bill has 39 co-sponsors. When asked about the bill's chances, House Speaker Robert DeLeo, D-Winthrop, said he has not yet spoken to a lot of House members about it. He did not take a position on the bill. Senate President Stan Rosenberg, D-Amherst, said he personally would support a death with dignity bill, as long as it incorporates lessons from other states and is done correctly. Gov. Charlie Baker, a Republican, said he would start from the position of the state's voters, who opposed assisted suicide in a statewide ballot question, but the details of the bill would matter.
In 2012, Massachusetts voters, 51 percent to 49 percent, voted against allowing a doctor to prescribe fatal medication to a terminally ill patient.
Supporters of the bill cite a moral imperative to allow people to end their suffering. State Rep. John Scibak, D-South Hadley, co-sponsored the bill after hearing from people he knows and reading about high profile cases.
"It's definitely a moral issue," Scibak said. "If someone is in what has been defined and diagnosed as a terminal situation ... I think if the individual is competent to make an informed decision as to whether or not they want to die with dignity, I think they should be afforded that opportunity."
But opponents argue that there should be more focus on providing end-of-life care.
Kelly, who uses a wheelchair because of a spinal cord injury, said supporters of assisted suicide tend to be in areas that are whiter and wealthier, where people generally trust the medical system. Minorities and people with less money who are less likely to afford treatment or trust the medical system tend to oppose it. Kelly said the bill raises questions about whether someone without access to good medical care would be more likely to commit suicide.
"For someone who's insurance denied coverage for needed medical procedures, it's difficult to talk about choice," Kelly said. He added, "It's always cheaper for us to die rather than be kept alive with needed services."
Kelly noted that doctors' diagnoses of how long someone has to live can be incorrect.
Brian Shea, who has cerebral palsy and depression and has worked as a peer specialist helping other people with mental health problems, said someone suffering from a terminal illness may become depressed, which "can interfere with the clarity of your thinking and also the ability to make decisions."
Although the bill requires an exam from a counselor, Shea said there is nothing to stop "counselor shopping" or "doctor shopping," finding counselors and doctors who are more likely to give the diagnosis needed for assisted suicide.
The Massachusetts Medical Society has opposed physician-assisted suicide since 1996. In prepared testimony for Tuesday's hearing, the society says it is committed to providing doctors with the training to contribute to the comfort and dignity of terminally patients and their families. The testimony quotes the American Medical Association's Code of Medical Ethics, which calls physician-assisted suicide "fundamentally incompatible with the physician's role as healer."
