Should people with terminal illness be allowed to end their own lives with the help of doctors and other medical professionals? Or would state law allowing such a practice be misused, to end the lives of vulnerable people? Would people with disabilities become targeted under such a law? More than 200 people filled hearing rooms September 11 to hear debate on the highly emotional and controversial proposal under consideration by the Minnesota House.
The hearing before the House Health and Human Services Policy Committee was informational, and went on for hours. No vote was taken. State lawmakers don’t go back into session until February 2020.
Dozens of organizations are weighing in, with some in support, others in opposition and still others offering qualified support if there are ways to prevent abuse of such a law. How to describe physician-assisted suicide is even up for debate, as shown by the stickers worn September 11. Bill foes wore “no assisted suicide” stickers. Supporters wore stickers stating, “I support end-of-life options.”
Support and opposition to the proposal among lawmakers somewhat splits along party lines. Several House DFLers support such a bill, pointing to measures in place in eight other states. Current and past Minnesota proposals are modeled against one used in Oregon for more than 20 years.
The bill likely won’t get very far in the Senate as Sen. Michelle Benson, R-Ham Lake, chair of the Senate’s Health and Human Services Finance and Policy Committee, is in opposition and instead wants state lawmakers to focus on palliative care needs. Benson called physician-assisted suicide a “dangerous policy” and said it won’t be heard in the Senate.
She is especially concerned about people who live with mental illness and about people who may see physician-assisted suicide as a less expensive option to keeping someone alive. Benson issued a statement saying that people with disabilities are “at the greatest risk of outside influence clouding their personal judgment.”
Testimony indicated sharp divisions in the medical, personal care and faith communities. One large and diverse coalition leading the charge against the bill is the Minnesota Alliance for Ethical Healthcare. The group also held a press conference to voice its objections.
“This bill sets the stage for a treacherous healthcare future in Minnesota because it could make our state a suicide tourism destination,” said Kathy Ware, nurse and advocate for people with disabilities. “The bill lacks appropriate safeguards to protect poor, elderly, disabled and vulnerable persons and puts them at greatest risk. Minnesotans don’t deserve this.”
“This is a dangerous bill that threatens to undermine quality, ethical health care in Minnesota,” said Dr. Neal Buddensiek, chief medical officer for Benedictine Health System in Shoreview. “If passed, Minnesota would be added to a small list of states that allows physicians and nonphysicians to make life and death decisions for vulnerable patients.”
The group recommends instead that policymakers focus on quality end-of-life treatment and care such as improving palliative care, expanding public education around end-of-life decision-making, creating more accommodations for people with disabilities, and ensuring healthcare access in rural areas.
Speaking at the hearing was Californian Stephanie Packer. She is terminally ill with pulmonary fibrosis as a result of diffuse scleroderma. Her home state has a law allowing assisted deaths. Packer noted that the drug costs for medications to assist with suicide are much cheaper than those she needs to stay alive, with some of her medications no longer being covered.
Packer’s message to the House committee was that insurance companies, if given the option, would not help people health and live. “So, if there are other options out there to save them money, they are good businesspeople, and they are going to do it,” she said.
But others said a physician-assisted suicide law would help people control their own destinies, end suffering and allow people to die on their own terms. Speakers discussed their own medical conditions and those of beloved family members. They described in detail how people who don’t have the right to make end-of-life decisions often struggle with painful illnesses.
St. Paul resident Marianne Turnbull has stage 4 ovarian cancer. Turnbull told the committee she wants to be able to die on her own terms. “I want to live as long as I can. I want the medical care that can ease my pain and allow me to be in relationship with my children, my family and my friends. But when the time comes, I want a good death,” she said. “I want to die at home. I want to be surrounded by people who love me.”
(A commentary by Turnbull appears on page four of this issue of Access Press.)
Some testimony in support of the bill drew on Oregon’s experience. In Oregon, 249 people obtained life-ending prescriptions under the state’s law in 2018 and 168 of those individuals died after taking the drugs, as of January of this year. Eleven of those received the drugs before 2018. Seventy-nine percent of those who were prescribed the drugs were 65 or older, according to the Oregon Health Authority, and 63 percent had cancer.
Rep. Mike Freiberg, DFL-Golden Valley, is the House’s chief sponsor of the bill. “At the end of the day this is about the patient,” he said. “This is about what patients are going through and the government not telling them what they have to do and how they should live the end of their lives.”
The current version of Minnesota’s bill would allow people to request the drugs if they have less than six months to live. Two health care providers would have to sign off on the lethal dose.
Under current Minnesota law, those who assist a suicide can face felony charges. In 2015, a jury in Dakota County found the corporation Final Exit Network guilty of helping an Apple Valley woman end her life. This fall an Eden Prairie man was found guilty of assisting his wife’s suicide in 2018, after she had lived with disabilities for most of her life.