As a retired board-certified emergency physician and as a son who lost his mother to cancer last November, I have a unique perspective on death.
Every day, I see medicine’s limitations to adequately control pain and suffering in the final stage of a terminal illness. Often the best doctors can do is sedate an individual into unconsciousness and watch helplessly as the disease ravages their bodies.
My mom was diagnosed with cancer in 2019. When all treatments stopped working, she enrolled in hospice. Thanks to palliative medicine and aggressive pain management, she was able to attend her grandson’s wedding. She was in pain, but able to experience joy in life and had much more she wanted to do.
But pain management had its limits, and she awoke one morning in agonizing pain and unable to get out of bed. Nothing brought relief. She lay in a dazed stupor, pleading for me to end her suffering. I am ashamed that our healthcare system prohibited her doctor from providing the option of the peaceful death she wanted.
We can change that. The bill under consideration in the Connecticut General Assembly modeled after the successful, time-tested 1994 Oregon Death with Dignity Act, contains safeguards to protect patients and physicians, while allowing terminally ill patients the freedom to opt for a peaceful death if they so choose. Decades of clinical data from nine states and Washington, D.C. that have authorized medical aid in dying demonstrate that these laws’ safeguards prevent abuse.
Medical aid in dying is a multi-step, weeks-long process with many more specific requirements than any other end-of-life care option. Two physicians must confirm that a requesting patient has a six-month prognosis and the mental capability to give informed consent. Providers are also required to discuss all end-of-life care options with the patient, including hospice and palliative care, and document those discussions. They must emphasize that requesting the medication does not obligate the patient to ingest the medication and that the patient may rescind the request at any time.
Annual medical aid-in-dying reports from Oregon and other jurisdictions have consistently shown that patients who request medical aid in dying are suffering from end-stage cancer, neurodegenerative disease, or heart or lung disease in which the prognosis of imminent death is clear. The vast majority are receiving hospice care at the time of the request. Two out of three patients decided to ingest the aid-in-dying medication, while one out of three did not, but all were comforted knowing the option was available if needed.
There is no requirement for any physician, pharmacists, or any other member of the healthcare team to participate. End-of-life medical decisions are deeply personal and ethically complex. Physicians take an oath to respect patients’ autonomy and do them no harm. While following our conscience, we should not impose our moral values on them, nor should we deny a compassionate end-of-life option because of our personal beliefs.
The time for Connecticut lawmakers to act is long overdue. Had this legislation not stalled last year, my mom might have had the peaceful death she wanted. Instead, she endured terminal suffering that, after a lifetime of caring for others, she did not deserve. The Act Concerning Aid in Dying for Terminally Ill Patients should be enacted this year. It will not cause any more people to die, but will allow far fewer to suffer.
Dr. Stuart Steinman lives in Norwalk.