The COVID-19 crisis has exposed the profound tragedy of loved ones dying alone, in a hospital or nursing home, without the care and comfort of loved ones surrounding them. This pandemic also demonstrates the fragility of life, the limits of modern medicine to relieve suffering, and has magnified the systemic racial disparities in our healthcare system, resulting in higher hospitalization and death rates for people in communities of color. We must eradicate these disparities, so everyone has equal access to the full range of end-of-life care options.
One important step towards achieving this goal is to passing Connecticut’s recently introduced medical aid-in-dying legislation (HB 6425) as an end-of-life care option for every terminally ill, mentally capable adult in Connecticut, so everyone is empowered to make end-of-life care decisions based on their unique culture, beliefs, and spiritual values.
Medical aid-in-dying laws improve end-life care overall, even for the relatively few people who use this end-of-life care option (less than 1% of annual deaths in Oregon and other authorized states), because they require physicians to advise any patient who requests medical aid in dying about every other end-of-life care option, including hospice and palliative care.
In fact, as The Los Angeles Times and The Hawai‘i Tribune-Herald have reported, medical aid-in-dying laws in California and Hawai‘i have improved care for many terminally ill people who didn’t utilize this end-of-life care option to peacefully end intolerable suffering: By spurring doctor-patient conversations about all end-of-life care options, like hospice and palliative care, and better utilization of them.
While there have been no Connecticut polls on this issue since this pandemic hit, the most recent Gallup poll on it, conducted in May 2020, when there were already more than one million confirmed cases of the virus nationwide, shows 74 percent of Americans support medical aid in dying, a six-point jump from the 68% support in Gallup’s pre-pandemic poll conducted in May 2019. The 74 percent support level includes a majority of every demographic group measured in the survey (see question QN15 on page 4).
It took California, Hawaii, and Vermont more than a decade to pass medical aid-in-dying laws, so it is irrelevant that Connecticut lawmakers have not yet passed medical aid-in-dying legislation. In addition, most bills on any new issue take years to pass until lawmakers get educated on the issue and public demand grows, as it did in the seven other jurisdictions that have authorized medical aid in dying: Oregon, Washington, Montana, Washington, D.C., New Jersey, Maine, and Colorado (where voters passed a medical aid-in-dying ballot initiative by a nearly 30-point margin).
The Journal of Medical Ethics has concluded that there is no evidence of abuse or coercion in Oregon, which has the nation’s oldest medical aid-in-dying law and is the model for other laws and the Connecticut bill: “Rates of assisted dying in Oregon… showed no evidence of heightened risk for the elderly, women, the uninsured… people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations.”
Like the Oregon law, the Connecticut bill has over a dozen safeguards to prevent misuse. Even the evilest, greediest relatives wouldn’t risk a murder conviction (a unique Connecticut bill provision) to coerce a mentally capable adult, with a prognosis of six months or less to live, to die a little sooner. In addition, a British Medical Journal study found that doctors tend to overestimate, not underestimate, how long patients will live by 500 percent.
That’s why the Connecticut State Medical Society dropped its opposition to medical aid in dying and adopted a neutral position.
Finally, there is no reason our legislature cannot hold virtual hearings on this compassionate legislation in 2021, so both supporters and opponents can testify remotely. I urge our lawmakers to pass medical aid-in-dying legislation because, God forbid, if their terminally ill constituents get COVID-19, their end-of-life suffering will be even more agonizing if they don’t have this peaceful dying option.
Dr. Gary Blick is the chief medical officer of Health Care Advocates International in Stratford.