In Support of Maryland Death with Dignity Act

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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.

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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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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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    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.

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    Week 7/2015 in the Death with Dignity Movement

    Last week a bill was introduced in Alaska and Maryland Houses. A group of patients and doctors filed a lawsuit in California seeking a right to physician-assisted dying. The right-to-die movement gained an influential advocate, NPR host Diane Rehm. And the Supreme Court of Canada’s ruling last week affirming the right to physician-assisted dying fueled the Death with Dignity debate in the U.S., including NBC News, TIME, and Washington Post.

    A friend of our organization’s, Dr. Peter Rasmussen, a retired physician in Salem, Oregon, who was one of the original plaintiffs in the Supreme Court case Gonzales v. Oregon and who is now suffering from the same type of cancer as Brittany Maynard did, published an op-ed in the New York Daily News on Sunday. In the piece he answers the question, “Should doctors ever help you die?” with a resounding, “Yes.” Our Vice President, George Eighmey, was a guest on the Senior Answer webcast out of Texas.

    These are the highlights of the most important developments in the movement around the United States from February 8 to February 15, 2015, with the corresponding media coverage.

    Alaska

    Alaska has become the 21st state this year where a Death with Dignity bill will have been debated.

    California

    While the legislators grapple with the proposed End of Life Option Act, a group of patients and physicians filed a lawsuit seeking an end to the state’s ban on physician-assisted dying.

    District of Columbia and Maryland

    While in DC Councilmember Cheh’s bill is making its rounds through the Council, 37 delegates introduced a bill in the Maryland House.

    Montana

    Whereas physician-assisted dying isn’t illegal in Montana by Supreme Court ruling, two bills are circulating in the State Legislature: a Senate bill legalizing death with dignity and a House bill criminalizing physicians’ participation in assisted suicide.

    Elsewhere

    To get the news as it comes out, Like us on Facebook or follow us on Twitter.

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    Oregon Health Authority Releases 2014 Death with Dignity Report

    Oregon Health Authority, the state agency that oversees the implementation of and compliance with the Oregon Death with Dignity Act, has just released the 2014 Annual Report.

    A total of 155 terminally-ill adult Oregonians received a prescription for medications under the provisions of the Oregon Death with Dignity Act in 2014, while 105 of them (67.7%) ingested the medications to die peacefully. This corresponds to 31 Death with Dignity Act (DWDA) deaths per 10,000 total deaths, or 0.3%.

    Other highlights from the 2014 Annual Report:

    • Of the 105 DWDA deaths during 2014, most (67.6%) were aged 65 years or older. The median age at death was 72 years. As in previous years, decedents were commonly white (95.2%) and well-educated (47.6% had a least a BA).
    • While most patients had cancer, the percent of patients with cancer in 2014 (68.6%) was lower than in previous years (79.4%), and the percent with amyotrophic lateral sclerosis (ALS) was higher (16.2% in 2014, compared to 7.2% in previous years).
    • Most (89.5%) patients died at home, and most (93.0%) were enrolled in hospice care either at the time the DWDA prescription was written or at the time of death.
    • As in previous years, the three most frequently mentioned end-of-life concerns were: loss of autonomy (91.4%), decreasing ability to participate in activities that made life enjoyable (86.7%), and loss of dignity (71.4%).
    • During 2014, no referrals were made to the Oregon Medical Board for failure to comply with DWDA requirements.

    Since 1998, the year in which the first person in Oregon took medication prescribed under the law, a total of 1,327 patients have received the prescription, of whom 859 (64.7%) ingested it and died. These figures continue to underscore not only that only a small number of people use the law but also that more than one third of those who received the medication took it, finding great comfort in merely knowing it was available to them. Oregon’s Death with Dignity Act continues to work flawlessly and to provide ease of mind and relief to Oregonians facing the end of life.

    The board members and staff of Death with Dignity National Center, as the successor of the organization that passed Oregon’s law in 1994, are proud of our accomplishments. We are honored to be able to count on your support in promoting and passing Death with Dignity laws based on the Oregon model throughout the United States.

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    Week 6/2015 in the Death with Dignity Movement

    The whirlwind of media attention to Death with Dignity continued into February. These are the highlights of press coverage of the most important developments in the movement around the United States from February 1 to February 7, 2015.

    If you only read one article, make sure it’s this overview of Death with Dignity developments written in response to the New York lawsuit (see below): “More states consider assisted-suicide laws since Brittany Maynard’s death,” The Christian Science Monitor, 2/4/2015.

    (For a good overview of the Supreme Court of Canada’s ruling that Canadian adults who are mentally competent and suffering intolerably and permanently have the right to a doctor’s help in dying, read this Globe and Mail article. And, TIME magazine has an analysis, including our take, of the impact of SCC’s ruling in the U.S.)

    California

    The buzz around California’s End of Life Option Act continues unabated.

    Colorado

    Following the introduction of a bill the previous week, a lively debate unfolded in Colorado before a House Committee heard and rejected the bill on Friday. Sixty-eight percent of Coloradans continue to favor Death with Dignity.

    If you are interested in following the Committee hearings as they unfolded on Friday, February 6 (and as they will continue in the future, if applicable), see the Twitter hashtag #coleg.

    District of Columbia and Maryland

    The D.C. Council debates a death-with-dignity bill introduced mid-January by Councilmember Cheh, while Maryland awaits the introduction of companion death-with-dignity bills in the Assembly and Senate.

    Montana

    Whereas physician-assisted dying isn’t illegal in Montana by Supreme Court ruling, two bills are circulating in the State Legislature: a Senate bill legalizing death with dignity and a House bill criminalizing physicians’ participation in assisted suicide. Media coverage has been mostly relegated to letters to the editor.

    New Mexico

    New Mexico is watching out for an appeals court ruling on the legality of physicians’ right to aid patients in hastening their deaths.

    New York

    While two Senators prepare to introduce a bill, a group of patients and physicians filed a lawsuit challenging New York’s statute banning assisted suicide.

    Wisconsin

    There’s a low-key discussion of a death-with-dignity bill in Wisconsin.

    Elsewhere

    Death with Dignity is debated even in states that do not have bills on the books or legislative docket.

    To get the news as it comes out, Like us on Facebook or follow us on Twitter.

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