California Senate Health Committee Approves SB 128 – End of Life Option Act

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Image: California Senate Health Committee hearing on SB 128

“Some years ago, my precious brother Jeff died a death I would not wish on anyone. Yesterday my spirits were lifted.

At the Senate Health Committee Hearing on SB 128 – California End of Life Option Act, I was privileged to witness the powerful testimony of families who, like my own, had to stand like giants in a moment after they were just ordinary people. Those brave people who provided testimony in support of SB 128 spoke for their loved ones. And they stood for us all.

It was a landmark day in California as the Senate Health Committee approved SB 128. This is one of several hurdles the bill faces, but California is poised to catch up to Oregon in this push for greater choice in how we meet end of life challenges.”

This first-hand account from the California Senate Health Committee Hearing on SB 128 – California End of Life Option Act comes from our supporter Kate P., a Sacramento, California, resident.

It was, indeed, an emotional hearing. Along with hundreds of others in attendance, I was moved by the powerful personal testimonies. These stories highlighted what we know from the Oregon experience: Death with Dignity as one of several end of life options provides peace of mind and control for the terminally ill while safeguarding against coercion for those who are vulnerable. SB 128 would allow patients who are mentally competent and have fewer than six months to live, as determined by two physicians, to obtain prescriptions for medication to end their lives in a humane and peaceful manner, while protecting the vulnerable with strict guidelines and procedures.

Yesterday afternoon the California Senate Health Committee approved the proposed Senate Bill 128 – California End of Life Option Act. I was pleased to be instrumental in working with both bill sponsors, State Senators Lois Wolk and William Monning, to craft the law.

You can help to make this bill become law:

  • Thank the bill sponsors. Call, email, or send a letter to SB 128 sponsors, Senators Monning – D-Carmel, and Wolk – D-Davis, in appreciation of their leadership on the issue.
  • Thank the Senators voting Aye. The bill moved out of this committee by a vote of 6 to 2 along party lines. Contact Senators Hernandez (D-LA/West Covina, Committee Chair), Hall (D-LA/South Bay), Mitchell (D-Culver City), and Roth (D-Riverside), particularly if you are in their district, to express your appreciation for their courageous vote.
  • Share your story. Heartfelt personal stories were a crucial part of the testimony in favor of the End of Life Option Act. Let us know how you got involved in the Death with Dignity movement or why you support California’s proposed legislation by completing this simple form.
  • Make a contribution. We remain very optimistic the law will pass, but for that to happen we need your support. It is thanks to you that we are able to do our work in promoting Death with Dignity laws in California and elsewhere. Your gift will go a long way in promoting SB 128 as it moves along through the legislative process. You can make the difference. Thank you.

The End of Life Option Act will next get a hearing in the Judiciary Committee on April 7. We’ll be there again, continuing to work with the bill sponsors to promote the bill’s passage.

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In Support of Maryland Death with Dignity Act

The Health and Government Operations and Judiciary Committees of the Maryland House of Delegates held a joint hearing today about HB1021 – Richard E. Israel and Roger “Pip” Moyer Death with Dignity Act. Our executive director, Peg Sandeen, attended the hearing and for an hour and a half testified in support of the proposed bill and answered questions from the committee (the witness panel also included the current Delegate Shane Pendergrass, the primary sponsor of the bill, Stephen H. Sachs, a former Maryland Attorney General, and McShane Glover, a close friend of Dick Israel, who is one of the two people named in the title of the bill). This is the full text of the testimony.

Testimony in Support of Maryland’s Proposed Death with Dignity Bill

I am the executive director of the Death with Dignity National Center, an organization dedicated to improving and expanding the medical options available to terminally ill patients. In addition, I am a social worker, an instructor at the Portland State University School of Social Work, and the surviving widow of a terminally ill individual who wanted desperately to control the timing and manner of his death. As an advocate and a family member profoundly impacted by an avoidable and horrible dying experience, I strongly commend the sponsors of this legislation for your leadership in bringing this important issue forward.

Advances in medical technology have led to improvements in the care of dying patients that were unimaginable even 40 years ago. But these same breakthroughs have allowed some terminally ill patients to be kept “alive” far beyond any point of natural death, leading to extensive suffering and a diminished quality of life. To address this social problem, in 1994 Oregon enacted a carefully crafted Death with Dignity law that allows a terminally ill person to receive a prescription to hasten death safely and humanely, and requires that the medication be self-administered.

Oregon Death with Dignity Act

Now in its 18th year of successful implementation, the law sets forth precisely delineated conditions under which a patient may qualify for the medication. The bill under consideration in Maryland draws upon this model and the comprehensive peer-reviewed medical literature examining Oregon’s experience with it. These provisions act as safeguards to prevent abuse and medical mistakes, and they have worked exceedingly well. The requirements include a minimum age (18), maximum prognosis (6 months), waiting periods, repeated requests, second doctor’s opinion, and a finding of mental capability, as well as mandatory discussion of hospice and all other feasible alternatives.

The Oregon Experience

Annually, the State of Oregon issues a report on usage patterns related to Death with Dignity, and I would like to share some of findings from the most recent report. In the 17 years the law has been successfully implemented only 859 Oregonians have hastened their deaths under the auspices of the law. The Death with Dignity Act in Oregon is rarely used, in 2014, 3.1/1000 deaths were attributable to physician-prescribed aid in dying.

In those same 17 years, 1, 327 individuals have received prescriptions to hasten their deaths, meaning that over time about 30% of individuals who went through all the steps to qualify chose not to hasten their deaths, but rather died from their underlying terminal illness. For them, the Death with Dignity Act provided peace of mind and a modicum of control during their final days.

The data tell us that most participants had cancer (78%) or ALS (8.3%); died at home (94.6%) and were receiving comprehensive end-of-life care through participation and enrollment with hospice (90%). Sixty percent had private insurance, and 38% had a government-funded form of medical insurance like Medicaid or Medicare. Individuals who take advantage of Death with Dignity in Oregon are not individuals without other health care options. They are insured, cared for by hospice. They tend to die at home surrounded by their loved ones.

Death with Dignity Option a Comfort to Patients and Families

Oregon has proven that the existence of the legal option of physician Death with Dignity, though it is sparingly used, is of enormous comfort to terminally ill patients and their families; moreover, it has had a positive psychological effect upon countless others as they think about what kind of end-of-life care they would want if they were to experience terminal illness.

Despite the cataclysmic predictions of its opponents, the Oregon experience has also shown that such a legal alternative can be a catalyst for medical progress, prompting other improvements that enhance the overall medical care of terminally ill patients in the state. A robust process of public education and legislative debate can be expected to spawn new and creative proposals to advance end of life care in Maryland.

The process in which you are engaged is of the utmost importance to the people of Maryland, who want and deserve the highest quality, most humane end of life care possible. I applaud your efforts and offer my personal and professional assistance as you grapple with this profound subject.”
  
Image by Jimmy Emerson, DVM.

View full post on Death with Dignity National Center

Week 12/2015 in the Death with Dignity Movement

Last week was marked by a long and emotional hearing in Connecticut on HB 7015 – An Act Providing a Medical Option of Compassionate Aid in Dying for Terminally Ill Adults. A Death with Dignity bill was introduced in Minnesota as SF 1880 – Minnesota Compassionate Care Act; Senate Bill 128 – California End of Life Option Act got US Senator Dianne Feinstein’s endorsement; and a bill criminalizing physician-assisted dying passed in the Montana House, portending the possibility of a ban.

These are the highlights of the most important developments in the movement around the United States from March 15 to March 21, 2015, with the corresponding media coverage.

California

As California geared up to this week’s Senate Committee hearing on the End of Life Option Act, the bill gained an influential supporter.

Connecticut

Connecticut’s House hearing of the HB 7015 – An Act Providing a Medical Option of Compassionate Aid in Dying for Terminally Ill Adults saw hundreds of people provide emotional testimonies.

Nevada

Nevada Senators Parks and Kieckhefer introduced Patient Self-Determination Act.

Elsewhere

Image by weirdisnothing.

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Partnering with People of Nevada on Proposed Patient Self-Determination Act

We are proud to support Nevada Senators David Parks (D-Las Vegas) and Ben Kieckhefer (R-Carson City, Washoe) and the people of Nevada in proposing a Death with Dignity law to provide a peaceful and dignified death for those suffering from terminal illnesses. Senate Bill 336, the Nevada Patient Self-Determination Act, says that, in certain narrow circumstances, mentally competent terminally ill adults who are within the final six months of their lives will be allowed to peacefully end their lives. The Act provides strict safeguards, protects against coercion, and allows eligible terminally ill patients to spend their final days and moments at peace, surrounded by their family members and loved ones.

The Oregon Experience

“Twenty years ago last November, Oregon voters were the first to approve the Death with Dignity law after which the proposed Nevada legislation is modeled. The Oregon Death with Dignity Act has been implemented carefully and has helped to spur a national conversation about end-of-life care that will continue this year in Carson City,” said Peg Sandeen, Executive Director of the Death With Dignity National Center. “Our model legislation has been passed in Washington and Vermont, and those states are seeing the same careful implementation controlled by patients seeking to end their lives peacefully. This law has worked exactly as intended everywhere it has been adopted.”

The numerous safeguards in this law have worked well in Oregon for 18 years, in Washington for 7, and in Vermont for two. There have been no reports of coercion, failure, or misdeeds in any of these states. Far more people ask their doctor about the law than actually use it, but many find comfort knowing the law is available if their symptoms cannot be controlled. The legislation proposed by Senators Parks and Kieckhefer, together with their co-sponsors, provides peace of mind and control for the terminally ill while safeguarding against coercion for those who are vulnerable.

The Time Is Right for Nevada

“The Death with Dignity National Center is pleased to have assisted in drafting the proposed Nevada Patient Self-Determination Act. We will assist the Nevada efforts by providing our full political and strategic expertise from the successful campaigns in Oregon, Washington, and Vermont,” said Sandeen. “The time is right for Nevada to adopt this law. The Silver State has long been a leader in protecting individual rights, and it is thanks to this leadership that we are proud to join these efforts today.”

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Week 11/2015 in the Death with Dignity Movement

Maryland was in the spotlight of the Death with Dignity movement last week, with the Senate Judiciary Committee hearing drawing dozens of testimonies, including from our Executive Director, Peg Sandeen; our friend Dr. Peter Rasmussen, MD, coined an op-ed in the Baltimore Sun in support of the bill and Marylanders’ right to Death with Dignity as an end-of-life option.

The New York Times endorsed Death with Dignity as an end-of-life option for the terminally ill. Across the pond, beloved author and dying with dignity campaigner Terry Pratchett died.

These are the highlights of the most important developments in the movement around the United States from March 8 to March 14, 2015, with the corresponding media coverage.

California

California was getting ready for the March 25 Senate hearing of the End of Life Option Act.

Connecticut

Connecticut geared up to its Assembly hearing this week on the proposed physician-assisted dying bill.

Maryland

Maryland was abuzz with the House and Senate hearings on the Richard E. Israel and Roger “Pip” Moyer Death With Dignity Act.

Montana

Montana saw a rollercoaster in the House when a proposed bill outlawing physician-assisted dying first passed and eventually failed on a split vote.

Utah

Though the Utah Death with Dignity Act was tabled until next year, a discussion about the issue started in the state. A poll showed the majority of Utahns are in favor of such legislation.

Vermont

In Vermont, a bill passed in the Senate that removed the sunset provision from the state’s Death with Dignity bill, keeping safeguards intact.

Elsewhere

A couple of nice opinion pieces:

Image by Daniel Blume.

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Week 10/2015 in the Death with Dignity Movement

The most important development in the Death with Dignity movement last week was the joint hearing of the Health and Government Operations and Judiciary Committees of the Maryland House of Delegates about HB1021 – Richard E. Israel and Roger “Pip” Moyer Death with Dignity Act, where we provided a testimony. In New Hampshire, the House passed a bill establishing a committee to study end-of-life choices. And here in Oregon, a friend of our organization’s, Dr. Peter Rasmussen, appeared on OPB’s Think Out Loud program discussing Death with Dignity.

These are the highlights of the most important developments in the movement around the United States from March 1 to March 7, 2015, with the corresponding media coverage.

Maryland

The debate about the proposed Death with Dignity bill heated up in the run-up to the March 6 House Committee hearing.

New Jersey

Elsewhere

Image by [BarZaN] Qtr.

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We Testified in Support of Maryland Death with Dignity Act

The Health and Government Operations and Judiciary Committees of the Maryland House of Delegates held a joint hearing today about HB1021 – Richard E. Israel and Roger “Pip” Moyer Death with Dignity Act. Our executive director, Peg Sandeen, attended the hearing and for an hour and a half testified in support of the proposed bill and answered questions from the committee. This is the full text of the testimony.

Testimony in Support of Maryland’s Proposed Death with Dignity Bill

I am the executive director of the Death with Dignity National Center, an organization dedicated to improving and expanding the medical options available to terminally ill patients. In addition, I am a social worker, an instructor at the Portland State University School of Social Work, and the surviving widow of a terminally ill individual who wanted desperately to control the timing and manner of his death. As an advocate and a family member profoundly impacted by an avoidable and horrible dying experience, I strongly commend the sponsors of this legislation for your leadership in bringing this important issue forward.

Advances in medical technology have led to improvements in the care of dying patients that were unimaginable even 40 years ago. But these same breakthroughs have allowed some terminally ill patients to be kept “alive” far beyond any point of natural death, leading to extensive suffering and a diminished quality of life. To address this social problem, in 1994 Oregon enacted a carefully crafted Death with Dignity law that allows a terminally ill person to receive a prescription to hasten death safely and humanely, and requires that the medication be self-administered.

Oregon Death with Dignity Act

Now in its 18th year of successful implementation, the law sets forth precisely delineated conditions under which a patient may qualify for the medication. The bill under consideration in Maryland draws upon this model and the comprehensive peer-reviewed medical literature examining Oregon’s experience with it. These provisions act as safeguards to prevent abuse and medical mistakes, and they have worked exceedingly well. The requirements include a minimum age (18), maximum prognosis (6 months), waiting periods, repeated requests, second doctor’s opinion, and a finding of mental capability, as well as mandatory discussion of hospice and all other feasible alternatives.

The Oregon Experience

Annually, the State of Oregon issues a report on usage patterns related to Death with Dignity, and I would like to share some of findings from the most recent report. In the 17 years the law has been successfully implemented only 859 Oregonians have hastened their deaths under the auspices of the law. The Death with Dignity Act in Oregon is rarely used, in 2014, 3.1/1000 deaths were attributable to physician-prescribed aid in dying.

In those same 17 years, 1, 327 individuals have received prescriptions to hasten their deaths, meaning that over time about 30% of individuals who went through all the steps to qualify chose not to hasten their deaths, but rather died from their underlying terminal illness. For them, the Death with Dignity Act provided peace of mind and a modicum of control during their final days.

The data tell us that most participants had cancer (78%) or ALS (8.3%); died at home (94.6%) and were receiving comprehensive end-of-life care through participation and enrollment with hospice (90%). Sixty percent had private insurance, and 38% had a government-funded form of medical insurance like Medicaid or Medicare. Individuals who take advantage of Death with Dignity in Oregon are not individuals without other health care options. They are insured, cared for by hospice. They tend to die at home surrounded by their loved ones.

Death with Dignity Option a Comfort to Patients and Families

Oregon has proven that the existence of the legal option of physician Death with Dignity, though it is sparingly used, is of enormous comfort to terminally ill patients and their families; moreover, it has had a positive psychological effect upon countless others as they think about what kind of end-of-life care they would want if they were to experience terminal illness.

Despite the cataclysmic predictions of its opponents, the Oregon experience has also shown that such a legal alternative can be a catalyst for medical progress, prompting other improvements that enhance the overall medical care of terminally ill patients in the state. A robust process of public education and legislative debate can be expected to spawn new and creative proposals to advance end of life care in Maryland.

The process in which you are engaged is of the utmost importance to the people of Maryland, who want and deserve the highest quality, most humane end of life care possible. I applaud your efforts and offer my personal and professional assistance as you grapple with this profound subject.”
  
Image by Jimmy Emerson, DVM.

View full post on Death with Dignity National Center

Week 9/2015 in the Death with Dignity Movement

Last week Brittany Maynard’s mother, Debbie Ziegler, appeared on Dr. Oz show (video preview | summary), and husband, Dan Diaz, posted an op-ed in Time magazine. Utah saw a bill introduced. New Hampshire debated a bill establishing a committee to explore end-of-life options. Polls in Maryland and New Jersey showed strong support for bills proposed in those states. The Applied Sentience blog called Death with Dignity a top three political battle this year, as continued debates in California, Connecticut, Massachusetts, and other states demonstrate. And, the artist and Death with Dignity advocate Leonard Nimoy passed away.

These are the highlights of the most important developments in the movement around the United States from February 22 to February 28, 2015, with the corresponding media coverage.

Alaska

California

Connecticut

Maryland

New Jersey

Utah

Elsewhere

  • New Hampshire: “Bill aims to give citizens more control at end of life,” SeacoastOnline.com, 2/25/2015
  • Image by m01229.

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    Your Questions about Supreme Court of Canada’s Ruling Answered

    This guest post has been contributed by Dying with Dignity Canada.


    Supporters of Death with Dignity laws in the U.S., including Death with Dignity National Center, point to the Supreme Court of Canada’s ruling decriminalizing physician-assisted death as a catalyst for their work. The ruling decriminalized physician assisted death for a broader range of people than the laws being promoted in the U.S.: competent Canadians with a grievous and irremediable medical condition, including an illness, disease or disability, that causes enduring suffering that is intolerable to the individual. The court did not define “grievous and irremediable” but it is clear it is not limited to terminal illness. In addition, someone who has dementia but is still competent to provide informed consent would qualify, provided their suffering is, at the time of the request, intolerable to them. The remedy from the courts includes both the prescription and administration of medication, so that individuals will not be compelled to end their lives too early out of fear they will lose the capacity to do so later on.

    The Court has given lawmakers a year to write new legislation, either Federal or Provincial lawmakers can pass legislation, both can, and neither has to do so, though it is unknown which level(s) of government decide to act. The provision of healthcare is a responsibility that is shared by both federal and provincial governments. Naturally, if the federal government passes legislation on assisted dying that are within its legal jurisdiction, those laws would apply across the country. However, each province has the power to craft its own framework for assisted dying.

    Opponents of the Supreme Court ruling immediately asked for the Federal Governemnt to overturn the Supreme Court’s decision by using the notwithstanding clause in the Canadian Charter of Rights and Freedoms, essentially an override rule, to be applied in order to overturn the decision of the court, butT that drastic course of action option does not seem likely. Should neither the federal nor provincial governments pass laws applying the Court’s ruling, physician-assisted death would then be regulated by existing healthcare legislation and professional standards surrounding the practice of medicine, the same way that other end-of-life treatments are regulated.

    In any case, in a year’s time, the current legal bans on prescribing and administering medication will be invalid in circumstances set out in the decision. Physicians will be able to assist either by providing the knowledge or the means for a person to end their own life, e.g. by prescribing life-ending medication or by administering life-ending medication. The SCC decision does not compel physicians to comply with requests for assisted dying. “Nothing in this declaration would compel physicians to provide assistance in dying,” the ruling reads. However, whether a doctor will have a duty to refer such a request to another doctor or healthcare institution if they are unwilling to provide the service will likely be addressed through legislation or regulatory standards governing the conduct of physicians. Similarly, the duty to provide physician-assisted death by hospitals, hospices, and other institutions will likely be addressed in federal or provincial legislation. If it is not addressed in legislation physician assisted death will be a right, but it might not be an accessible option for all Canadians.

    To learn more about this issue, please join Dying with Dignity Canada for a Q&A webinar with our CEO, Wanda Morris, next week.

    View full post on Death with Dignity National Center

    Week 8/2015 in the Death with Dignity Movement

    Last week a bill was introduced in the New York House, a bill criminalizing physician-assisted dying failed in Montana, and debate about Death with Dignity ramped up in Maryland and Massachusetts. The Daily Beast asked whether assisted dying is “the new abortion,” and after she declared support for the issue Diane Rehm featured Death with Dignity on her program.

    These are the highlights of the most important developments in the movement around the United States from February 15 to February 21, 2015, with the corresponding media coverage.

    California

    The lively debate around the End of Life Option Act continued in the media, including on KPFA radio where our Vice President George Eighmey debated the proponents’ side.

    Maryland

    Maryland’s Death with Dignity law acquires an influential spokesperson and a human face.

    Massachusetts

    After Rep. Kafka again introduced a Death with Dignity bill, the issue is back on the table in the state where a related ballot initiative was narrowly defeated in 2012.

    Montana

    The bill criminalizing physician-assisted dying failed in the Montana House.

    New York

    A month after Rep. Rosenthal introduced New York Death with Dignity Act in the State Assembly, Senators Savino and Hoylman introduced New York End of Life Options Act in the State Senate.

    Vermont

    The sunsetting provisions of the Death with Dignity law are up for debate in the state legislature.

    Elsewhere

    Image by Zarko Drincic.

    View full post on Death with Dignity National Center