Death with Dignity or Premature End for Elderly, Disabled, or Terminally Ill?

Lilo H. Stainton | November 7, 2016 | Health Care
NJ medical group says doctor-assisted suicide incompatible with helping patients, but supporters say the dying should have choice to avoid pain

A controversial proposal that would permit certain terminally ill patients to obtain powerful drugs to end their lives is gaining momentum in New Jersey’s Legislature, despite concerns from some opponents that the measure will lead to wider state-sanctioned suicide.

But supporters of the measure insist the proposal, debated by lawmakers for more than three years, includes more protections against misuse than any existing law in the nation; five states have approved similar measures over the past decade. Patients with six or less months to live should have a choice to end their suffering with dignity, they insist, even if others are opposed to the concept.

The legislation (S-2474) was approved Thursday by a Senate panel following hours of emotional testimony on both sides of the issue. Two weeks earlier, the measure squeaked by the Assembly with members voting based on personal ideology, not party. While in the past Gov. Chris Christie has suggested he would oppose such a plan, the bill’s sponsors said — after three years of working to advance the measure — it’s their job to raise and debate such important issues.

The bill would allow capable adults to obtain a lethal prescription from a physician who voluntarily participates in the program; it seeks to provide certain legal protection to the doctors and patients, who must be able to take the drugs on their own. Patients can outline their wishes in writing in advance, in case they are unable to communicate with the doctor when the end nears, but no one else can make the request on their behalf.

“This is really a matter of conscience. Some legislation you can wrangle and trade and negotiate with, and this is one you can’t. This is one you search your soul to decide what’s right,” testified Senate President Steve Sweeney, a lead sponsor, who called it “one of the more difficult bills” he’s ever worked on.

Sweeney (D-Gloucester) said his support stems in part from watching his sister-in-law die of lung cancer in a hospice, loaded up with morphine to help ease the pain. “She lived the end of her life in the worst way possible. Suffering, in pain, without dignity,” he said. “When you see people suffering and they have no choice in how to end it, it’s not right.”

Hospice representatives have not opposed the bill, but a representative made clear on Thursday this approach is not part of their model to provide compassionate end-of-life care. The state’s medical society has been vehement in its opposition, noting that allowing doctors to issue deadly doses is “incompatible” with their mandate to heal and protect patients. They have also pointed to potential holes in the bill, including a lack of detail about the eligible medications and the procedure for reporting any death.

Others, like Stephanie Packer, a California resident and mother of four who is struggling with end-stage lung disease, a paralyzed intestinal tract, and a condition that causes chronic pain and depression, insisted that every moment of life is precious and worth preserving — no matter how difficult. Packer has campaigned against such bills around the nation, following California’s passage of a similar law a few years ago.

“It’s understandable that some people look to suicide,” Packer told the Senate committee. “But our medical response should not be to permit them to end their lives prematurely.”

But Packer’s other concern is how laws designed to enable personal choice could bleed into other policies and possibly endanger the lives of those who have less of a voice. When she received her most recent diagnoses, Packer said her insurance company cancelled coverage for some of the potentially life-extending treatments she had received — but offered to pay for pills that could be used to end her life under California’s law. “I can’t afford to buy chemo for myself,” she said, “and insurance companies have a cheaper option.”

Over hours of heated testimony, advocates for disabled rights raised concerns that caregivers will use the law to find ways to end the lives of elderly or disabled residents who have become a burden. Other opponents said the measure contradicts other government and medical efforts to reduce suicide and goes against the Bible’s teachings.

Sheila Riley, a retired schoolteacher from Edison, talked about the fear this kind of bill can inspire in the black community — given the incidents of using African-Americans for medical experiments in the past. “We worry that racism in life will translate into discrimination in death,” she said.

But Ed Barocas, legal director for the New Jersey chapter of the American Civil Liberties Union, called it “a bit insulting and offensive” to take the “paternalistic” approach of restricting choice in the name of protecting others. “This bill goes farther than any other bill in the nation to make sure the choice is voluntary and willing,” Barocas said. “It’s not only about individual rights. It’s the right thing to do for individuals.”

Deputy Assembly Speaker John Burzichelli (D-Gloucester), the bill’s longtime champion, said it is carefully crafted to apply only to those diagnosed with terminal illnesses, which does not include disability, by two separate doctors.

“Some have suggested this is a slippery slope,” he said. “This is not a slippery slope, this is a very deep gravel road.”