After tearful press conferences from both sides of the medically assisted aid-in-dying debate in Hartford on Wednesday, the Connecticut General Assembly Public Health Committee voted to continue drafts of a bill that would legalize the practice in Connecticut.
Advocates argue that the aid-in-dying expands patient autonomy, offering the terminally ill an option to end their life with dignity and without suffering. Opponents fear that it will open the doors to misuse and lead to unnecessary death in an overburdened health care system.
Connecticut legislators have introduced aid-in-dying bills 15 times since 1995. Last session, a proposal died in limbo in the Senate Judiciary Committee after receiving a favorable vote from the Public Health Committee.
Public Health Committee Chair Sen. Saud Anwar said that the bill would allow terminally ill patients with six-month life expectancy to choose to end their life by taking a lethal medication. Two physicians must verify the patient’s prognosis. Additionally, the patient would need to be deemed of sound mind, and be able to ingest the medication on their own, among other provisions.
Medically assisted suicide is legal in Oregon, Washington, Montana, Vermont, California, Colorado, Hawaii, New Jersey, Maine, New Mexico and Washington D.C.
Tim Appleton, the senior campaign director of the Compassion and Choices Action Network, said roughly 20% of Americans have access to an aid-in-dying care option and that 75% of Connecticut residents want one.
“A patient that lives in Middletown, Connecticut, does not have the same options as the same patient might have if they lived in Middletown, New Jersey, and that’s just not right,” Appleton said. “Zip codes should not define the end of life journeys of people who are faced with the most important decision they’ll ever make in their life.”
Opponents argue that the unintended consequences of such legislation are already occurring in states where medically assisted aid-in-dying is legal.
In February 2022, Dr. Jennifer Guadiani, a Denver physician who is licensed to practice in 32 states, including Connecticut, wrote about her experiences assisting anorexia nervosa patients with obtaining lethal aid-in-dying medication in the Journal of Eating Disorders.
In the paper, Guadiani argued that terminally ill anorexia nervosa patients “deserve the same attendant care and rights as all other patients with terminal illness, up to and including medical aid in dying in jurisdictions where such care is legal.”
The revelation sparked controversy among the psychiatric community and prompted a response from the Compassion and Choices Chief Legal Advocacy Officer Kevin Díaz, who said the medical aid-in-dying law “does not and was never intended to apply to a person whose only diagnosis is anorexia nervosa.”
“Assisted suicide cannot and will not stay limited to a select population,” said Cathy Ludlum, a disabilities rights advocate and staunch opponent of medically assisted suicide.
Ludlum said the eventual elimination of safeguards and expansion of medically assisted suicide is inevitable once legislation legalizes the practice. She called the proposed bill “bad medicine, bad public policy, and bad for people.”
“Supporters often say, ‘Each person is just one bad death away from becoming a proponent.’ I say, ‘If you had to fight for preventative care, aggressive treatment, and sometimes for your life in the health care system the way we do, you would likely join us on the opposing side,’” Ludlum said. “The push for assisted suicide is not about pain, it’s about loss. It’s about fear of disability.”
Kira Philips disagrees. Her mother, Clare Marie Philips, suffered debilitating back and pelvis pain during a three-year battle with multiple myeloma, which took away her ability to stand and compacted her spine, shrinking her height by more than five inches in less than 12 months.
“On June 3rd, 2021, my mom crawled out in the early hours of the morning to our backyard shed and shot herself,” Philips said through tears. “It’s unfathomable still that she was capable of even doing something like this given who she was as a person, being a gentle and kind, compassionate soul. My dad — her husband of over 40 years — had to find her that morning. … He will have that image in his head for the rest of his life.”
Philips said that if her mother had access to aid-in-dying medication, her family would have avoided the “trauma” and “violence.”
Many other advocates spoke of watching loved ones suffer unimaginable pain before their passing.
Jill Hammerberg recalled holding her husband, Mark Fey, during his death from prostate cancer in 2012. Hammerberg said her husband made “unearthly sounds as [he] fought for breath and crawled on our bed in search of relief” on that final night.
She described the experience as a “nightmare.”
“If Mark had had access to medical aid in dying, he would’ve chosen to use it on a sunny Friday when we were all together. We would’ve been wearing our Red Sox caps singing, ‘Hey Jude,’ followed by a Guinness toast. Instead, we carry the collective burden of the indignity of his prolonged pain etched in our hearts forever,” Hammerberg said.
Opponents argue that such stories don’t demonstrate a need for medically assisted suicide but rather more training, preparation and education on the realities of home hospice and palliative care.
Ranking member of the Public Health Committee Sen. Heather Somers introduced an end-of-life care bill that would impose new training requirements for physicians, permit nurses to perform offer certain care, and expand insurance reimbursements. It would also allow patients who previously terminated hospice service to return to such care.
Sommers said she is open to negotiating to make improvements to the medically assisted suicide bill, but she does not believe she would ever vote in favor of the legislation.
She highlighted concerns over competency evaluations and the distribution of lethal medications, saying that doses should be taken in a controlled clinical environment with a clinician present and that the doctor prescribing the medication needs to have had a relationship with the patient for a substantial period of time. Sommers also said that in cases of medically-assisted suicide, the cause of death should not be written as the terminal disease.
She said that such measures would “make this bill more controlled than it is now.”
“No one wants to see their loved ones suffer. I think we can all attest to that,” Sommers said. “Rather than focusing on trying to make this terrible bill a little less terrible, let’s focus on end-of-life care in our hospital system. Let’s improve hospice, let’s improve palliative care. There’s a lot of issues there that can be fixed.”
The bill would need a public hearing in the public health committee to advance before consideration for a vote before the full House and Senate.
If you are considering suicide, or need help with mental health issues, dialing 988 will connect you with a local crisis center that provides free and confidential emotional support 24 hours a day, seven days a week.
Alison Cross can be reached at email@example.com