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Bill To Allow Medically-Assisted Death In Mass. Awakens An Old Debate

The Massachusetts Joint Committee on Public Health's endorsement of the end of life options bill
The Commonwealth of Massachusetts

A bill that would give the terminally ill the option of ending their own lives medically is making its way through the Massachusetts legislature.

The bill, titled “An Act relative to end of life options,” was recommended for acceptance by the joint committee on Public Health on June 8th.

“What this bill is essentially saying is, do people currently have the option for facing their end in the most compassionate way possible," said Democratic State Senator Adam Hinds of the Berkshire, Hampshire, Franklin and Hampden district, who supports the bill. “Honestly, I’ve been swayed by the number of people who have come to me and told me about the deeply challenging circumstances faced by loved ones who were experiencing a terminal illness diagnosis and then moving towards more and more pain and discomfort and a lack of dignity in facing their death. And so this provides options for individuals and family – but centered around the individual – to take a different path.”

Supporters of the initiative have their own name for it.

“The movement called ‘Death With Dignity’ – it’s also known as ‘Medical or Compassionate Aid in Dying’ – has been around and building for more than 30 years. For instance, Oregon is the first state that has passed a ‘Death With Dignity’ law 23 years ago," said John Berkowitz, Director of Western Massachusetts Death With Dignity. “And it basically says that if a person is terminally ill, mentally capable of making their own health care decisions at the end of life and facing great pain and suffering that just cannot be relieved by even the best services of hospice or palliative care, that they could have the option of when they qualify – they’re terminally ill, all that – to doctors they meet with, they are eligible to receive a prescription from their doctor, they go and have it filled by the pharmacy, and at a time of their choosing, they may take the medication and achieve a peaceful and painless death in their sleep rather than a continued life of days or weeks of intense suffering.”

Along with Oregon, California, Colorado, the District of Columbia, Hawaii, Maine, New Jersey, Vermont, and Washington offer the terminally ill the option of physician-assisted death through pharmaceuticals.

“Traditionally, it’s been a barbiturate – a sleeping pill that is now not prescribed as a sleeping pill," said Dr. Lewis Cohen, a professor of psychiatry at the University of Massachusetts Medical School and Tufts University School of Medicine. He’s also the author of “A Dignified Ending: Taking Control Over How We Die.”

“In some states like California, they’ve found that the pharmaceutical companies have jacked up the prices and made the barbiturates less accessible," said Cohen. "And as a result they’ve come up with some combinations of medications, including amitriptyline, which was one of the old, the previous generation of anti-depressant medications, and digoxin, which is a medication used for the heart.”

Cohen views physician-assisted death as an acknowledgement that every option should be available to those suffering from terminal illnesses.

“I’m a palliative medicine researcher, and I have tremendous respect for my colleagues who offer palliative medicine, who offer hospice, and these are important things to have," he said. "But they don’t cover it for everybody, and so this becomes something on top of those that is useful to have as an option for us.”

The bill revives a hotly contested 2012 referendum that sought to establish a “Death With Dignity” initiative through the ballot box. The measure failed, with 49% of state voters for it and 51% against it. John Kelly of the group Second Thoughts was one of its opponents, who also have their own name for the idea.

“Second Thoughts is a group of disabled people in Massachusetts who advocate against assisted suicide as a form of deadly discrimination against old, ill, and disabled people,” said Kelly.

He says that what he calls assisted suicide reinforces structural inequality.

“The reasons that are cited for people to commit suicide all have to do with negative reactions to disability, so we feel that our lives are being thrown under the bus with buzzwords like dignity, quality of life," Kelly told WAMC. "And it may be choice for the wealthier, whiter people who are pushing this, but it would become the duty for working class people and disproportionately Black and Brown people.”

In December 2019, a retired Massachusetts doctor lost a court case in which the Massachusetts Superior Court ruled that terminally ill patients do not have a constitutional right to medically assisted death.

The bill has almost 40 cosponsors in the Massachusetts Legislature.

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