The Maryland House of Delegates’ Health and Government Operations and Judiciary committees held a hearing for The End-of-Life Option Act (HB 370) on Feb. 16, where testimony was offered regarding a bill that would make it legal for physicians to prescribe a lethal dose of medication to terminally ill patients who have a prognosis of six or fewer months to live.
The bill, which died in committee during the last two legislative sessions, is sponsored by Del. Shane Pendergrass, a Democrat who represents District 13 in Howard County and is the chair of the Health and Government Operations Committee.
The Maryland Catholic Conference opposes the bill, and in a position statement wrote that the intentional use of drugs to artificially end life “violates the most basic tenet of our belief in the sacredness of life, and simultaneously poses many dangers to vulnerable populations.”
During the hearing, Jennifer Briemann, the associate director of respect for life issues at the Maryland Catholic Conference, testified in opposition of the bill and told the personal story of her mother, who was operating at less than 5 percent of kidney function, and was so ill that she could not receive a kidney donation from a deceased person. After going to several doctors who did not give her a good prognosis, one doctor mentioned the possibility of doing a living donation. Six months later, she had a new kidney, donated by Briemann.
Briemann wondered whether her mother would have chosen the option of taking the pills to end her life more quickly if this bill had been passed. She said she would like to think that her mother wouldn’t have, but, “she definitely felt she was a burden, although she was never anything close to that.”
While many proponents of the bill gave emotional accounts of their loved ones dying, for every account that people gave saying they wished the option were available while they were watching their loved one suffer, Briemann said, “There is another like me saying, ‘Thank God it was not’.”
The Catholic Church teaches that all human life has God-given dignity from conception to natural death, and it teaches that assisted suicide is a violation of human dignity and should be opposed.
Many proponents of the bill voiced respect for people who did not think the option to take lethal pills was what they would want, but asked those people not to make the choice for everyone else.
Kim Callinan, the chief program officer of Compassion and Choices, an organization lobbying for assisted suicide in legislatures across the country, said, “What we are asking for today is simply just an option.”
Del. Chris West, representing district 42B in Baltimore County, also testified in support of the bill, and said he believes the government should not force people to do things with their bodies that they do not want to do, or prevent them from doing things to their bodies that they do want to do, because “adult American citizens should be entitled to maximum autonomy and personal freedom.”
West introduced a new provision to the bill, which requires the doctor and the patient to be alone when they have the end of life conversation where the patient requests the pills, in an effort to address concerns about potential coercion. Opponents noted that while the bill requires the patient to ingest the pills by themselves, there are still no safeguards in place to prevent coercion at the time of ingestion.
Proponents of the bill, like Callinan and West, emphasized that doctors are giving patients the option to quicken their death, but once the patient receives the pills they are not required to consume them, and may keep them as an option even if they ever decide to use them.
Del. Nicholaus Kipke, representing District 31B in Anne Arundel County, voiced his concern over having unused deadly medication sitting around if people who fill the prescription decide not to use it.
Physicians testified on both sides of the bill, disagreeing over whether or not the bill violates the Hippocratic Oath. Dr. Holly Dahlman, a fellow of the American College of Physicians, which opposes the bill, argued that the physician must always act in the best interest of the patient and do no harm to them.
Dr. Ann Jackson, a doctor from Portland, Oregon, where this type of assisted suicide is legal, said she does not view the bill as legalizing the physician killing the patient, since the patients ingest the medication themselves. She says giving medication to dying patients for their own use helps them have “an easier exit at the time of their death.”
Del. Neil Parrott, representing District 2A in Washington County, raised the concern that while doctors like Jackson may feel as though they are helping the patient, the pharmacist who fills the prescription may not. While the bill does not require the pharmacist to fill the prescription, and only makes it legal for them to do so, Parrott suggested there needs to be an additional safeguard to their conscience by adding a clause that says they may not be forced to fill the prescription.
Several organizations that work to support and advocate for the rights of people with disabilities testified in opposition to the bill, citing concerns that people with disabilities would be disproportionately affected, and that the bill promotes the idea that life with less autonomy is no longer worth living.
Katie Collins-Ihrke, the executive director of Accessible Resources for Independence, said she was afraid that the bill would create a two-tiered system of suicide, where one category of people – generally those with mental health disabilities – would receive a suicide prevention packet and another – those with physical disabilities resulting from a terminal illness – would receive a prescription to assist in suicide.
While proponents of the bill stated they did not think it was necessary to require an outside mental health evaluation, since attending physicians are already trained to evaluate the mental health of patients at the end of life, Collins-Ihrke and other opponents of the bill expressed concerns that the mental health evaluation is only required to evaluate mental competency to make a decision, and there are no safeguards to prevent terminally ill patients who are suicidally depressed from getting the medication.
“We need help in living, not aid in dying,” said Collins-Ihrke.
Lori Scott voiced the opposition of the Arc of Maryland, a non-profit dedicated to the rights and quality of life for people with disabilities, and also told the story of her disabled daughter who outlived her doctor’s prognosis by more than 14 years. Scott noted that one of the top three reasons why people choose to end their life more quickly is because they feel like a burden to their family, which people with disabilities frequently do.
Sheryl Grossman, who has a rare genetic disease making her prone to various cancers, was originally expected not to live past 2, and as she aged, her doctors continued to extend her diagnosis until they eventually gave up predicting her life span. She is now 41, and testified in opposition to the bill.
“Clearly doctors didn’t know everything then, and they don’t know everything now,” she said.
She is familiar with the societal barriers and stigma that people with disabilities are confronted with every day, she said, and how their lives are often seen as less worthy, or as problems to be fixed.
Grossman recalled a doctor entering her room during treatment for her seventh cancer, and saying, “you don’t have to do this anymore.” He offered to take her off the machines and lessen pain medication, which would lead to her death. She mustered the strength she had left to tell him no and ask him to leave, and as he was leaving the doctor said, “I don’t understand why you want to live like this.”
The answer, she said, is simple, “I love my life…it is my life and I’m worthy of it.”
The bill will be heard in the Judiciary Proceedings committee in the Maryland State Senate on March 7. Those interested in receiving updates on this legislation and other issues of importance to Catholics can sign up for the Catholic Advocacy Network, which can be found at www.mdcatholic.org/JoinCAN.