"Death with Dignity" by Julie Jason
Originally published: August 4, 2023 (distributed by Andrews McMeel Syndication)
From time to time, lawyers, accountants and financial professionals serve clients who are terminally ill. The question of end-of-life care can lead to a discussion of “death with dignity,” the concept that terminally ill people have the right to make their own end-of-life decisions, including legally taking medication that can hasten death.
While this is a controversial and difficult subject to bring up, there is reason to do so. Some states provide special laws that offer guidance to physicians. My home state (Connecticut) considered such a law in the last General Assembly session.
Before we go any further, death with dignity is different from advance directives such as a living will or a durable power of attorney for health care, which are “legal documents that provide instructions for medical care and only go into effect if you cannot communicate your own wishes,” according to the National Institute on Aging website (tinyurl.com/yn4k4378).
Instead, this is something one might consider when terminally ill but still able to make decisions.
Nine states (California, Colorado, Hawaii, Maine, New Jersey, New Mexico, Oregon, Vermont and Washington) and the District of Columbia have death with dignity laws in place, according to the Deathwithdignity.org website.
A 10th state, Montana, has a version through a state Supreme Court ruling in 2009 to the effect that nothing in state law prohibited a physician from honoring a terminally ill patient’s request for medication that could hasten the patient’s death (tinyurl.com/2c4hhczk).
Oregon was the first state to have such a law. Adopted in 1994, the law became effective in 1997, after a circuit court overturned an injunction against its implementation.
Since the law took effect in Oregon, 3,712 people received prescriptions for lethal doses of medications, and 2,454 people died from ingesting the medications, according to the Oregon Death with Dignity Act 2022 Data Summary (tinyurl.com/46r5d9n5).
In Oregon, there are several requirements for death with dignity, which are outlined in the Oregon Health Authority’s Frequent Asked Questions section (tinyurl.com/ymyw47ak). They include:
-- The patient must be at least 18 years of age, be capable of making and communicating health care decisions for him- or herself and be diagnosed with a terminal illness that will lead to death within six months.
-- The patient must follow specific criteria to receive a prescription for the medication for ending life.
-- A physician’s participation is voluntary. Physicians are not required to provide prescriptions to patients.
-- A physician is not required to be present when the patient takes lethal medication. A physician can be present but cannot administer the medication.
Is medical aid in dying the same as euthanasia? “Euthanasia is illegal in every state in the U.S.,” according to the Oregon Health Authority’s FAQs, which adds that with euthanasia, “a doctor typically administers a lethal dosage of medication to the patient. In (Oregon’s Death with Dignity Act), a physician prescribes a lethal dose of medication to a patient, but the patient -- not the doctor -- administers the medication.”
In my home state of Connecticut, a bill titled “An Act Concerning Aid in Dying for Terminally Ill Patients” remained in the General Assembly’s Committee on Judiciary when the legislative session ended on June 7 (tinyurl.com/54vu4r2y).
The General Assembly is not scheduled to meet again until 2024 (tinyurl.com/m3uk7ttb), but the issue likely will not be going away, considering that 75% of Connecticut voters support legislation for medical aid in dying, according to a March 2021 survey by GQR of 550 likely voters (tinyurl.com/4hbkktwc). This is consistent with national polling reported by Gallup in 2020 (tinyurl.com/y7rynd92).
On deathwithdignity.org, you can see the status of legislation for each state and find out more information and news about the topic.
Death with dignity laws are controversial, to say the least. Should such options be made available for the person who has an incurable disease? Will more states, including Connecticut, follow Oregon’s lead?
Let me know your thoughts at readers@juliejason.com.