Connecticut has been at the forefront of patient rights and access to health care, and of evidence- and compassion-based public policy․ And so today, as we again consider legislation to allow medical aid in dying, the question is simple and obvious: should terminally ill adults be permitted to leave this life peacefully and on their own terms, under strict safeguards?
To remain true to those values, Connecticut should legalize medical aid in dying.
“Death with dignity” laws allow the right to request and receive a prescription medication that may be self-administered to hasten death and end unbearable suffering by mentally capable, terminally ill adults with a prognosis of six months or less to live․ The principle is based on end-of-life autonomy․
Connecticut would not be the first state to adopt such a law․ More than ten other U․S․ jurisdictions have adopted similar laws, including Oregon in 1997․ A number of other states, including Washington, Vermont, California, Colorado, New Jersey, Maine, Hawaii, and New Mexico have followed, and a court decision has legalized the practice in Montana․ In our region, Vermont, New Jersey, and Maine already allow it․ Connecticut does not․
Having been in effect for almost 30 years, Oregon’s Death with Dignity Act is the longest-running and most consistent program in the United States, and annual reports from the Oregon Health Authority show the huge majority of Oregonians using the law are in hospice care and have cancer․ The most cited reasons to request the medication have been loss of autonomy, inability to engage in pleasurable activities and loss of dignity, but not inadequate pain control․
There are concerns that the law places pressure on or disadvantages vulnerable groups․ Peer-reviewed Oregon data analysis has found that there is no evidence that the law has increased the risk of inequities in older adults, disabled individuals, or persons with low income․ Those who use the law tend to have insurance, some education, and an existing plan for end-of-life treatment․
These statutes are replete with safeguards․ In practice, the patient must make an oral and written request for the lethal medication from a licensed Oregon physician. Two consulting physicians must confirm the diagnosis, prognosis, and capacity of the patient to make an informed decision․ Patients should be informed of alternatives, but if either physician suspects impaired judgment, a mental health evaluation is required․ This is optional for providers․
Importantly, medical aid in dying, unlike euthanasia, requires the patient to self-administer the medication, which is always optional and ultimately up to the patient․
The Connecticut statute that grants patients the right to refuse life-sustaining treatment, file do-not-resuscitate orders, and execute advance directives implies a right to hasten death by refusing life-sustaining treatment․ Medical aid in dying simply extends the same principle of bodily autonomy to a narrow class of terminally ill adults who do not want to suffer in their last days․
Polls of the public have consistently found support for physician-assisted suicide in narrowly defined circumstances for terminally ill adults, with a 2023 Gallup poll finding 71% of Americans reporting they would vote for a law allowing physicians to assist terminally ill patients with suicide․ Opposition and support are not divided along partisan lines, and are more intensely personal․
No one would be forced to use it, and there would be no weakening of palliative and hospice care․ When the option is available, people who choose to avail themselves of hospice care in the states where the program exists have a high enrollment rate․ It just helps provide peace of mind for people who qualify and want it․
The question really comes down to one of who gets to make that decision: the terminally ill person with assistance from their physician and family, or the state․
Whatever the arguments and evidence, the answer must include compassion and the chance of control․ For a handful of members of the community at the end of their lives, it is the only way left to them to have control over what little remains, dignity when it is hardest, and reassurance that their values will rule the last days․
Connecticut can remain true to its commitment to patient rights and good public policy, by enacting medical aid in dying legislation․ Dignity at the end of life should not stop at the threshold of death. Now is the time for Connecticut residents to make their voices heard by contacting their state legislators, sharing their perspectives, and urging support for compassionate, patient-centered end of life care.
Destiny Jones lives in Groton.