I once heard someone say there are two kinds of people: those who are sick and those who become sick.
The reality is, we will all die and our loved ones will all die. In most cases, even if we know the diagnosis that might be the cause of our own death, the details are blessedly unknown. There are doctors, treatments, scans, blood work, symptoms, side effects, hopefully remissions, maybe even trials — and of course, wishing, hoping and probably praying. There are experts to consult and decisions to be made, none of it easy.
One of the decisions that 20% of Americans have during these trying times is the option for mentally capable, terminally ill adults (with non-COVID-related diseases) to obtain medical aid in dying: prescription medication they can decide to take to peacefully end their suffering if it becomes unbearable. It is available in Oregon, Washington, Montana, Vermont, California, Colorado, Washington, D.C., Hawaii, New Jersey and most recently, Maine. Most states base their medical aid-in-dying legislation, like Maryland’s End of Life Option Act, on Oregon’s law, the first and oldest such law in the nation, which has been in effect since 1997. The patient must have a terminal diagnosis from their doctor. The diagnosis must be confirmed by a second physician, the patient must be of sound mind and able to self-ingest the medication.
Additionally, the patient must be at least 18 years of age and a resident of the state. Any physician, pharmacist or facility that objects to this law need not participate. Added to the Maryland legislation, one of the meetings with the doctor must have some time in private so that the patient can be questioned about coercion. The cause of death that is listed on the death certificate is the underlying cause of the illness because this information is important to help public health officials prioritize research spending on deadly diseases.
The End of Life Option Act was originally introduced in the Maryland Legislature in 2015. In 2019, it was passed in the House but was one vote short in the Senate. The following year, as a result of a compressed session due to COVID, it didn’t come to the floor for a vote.
The use of medical aid in dying is sometimes referred to as “assisted suicide,” particularly by opponents who want to criminalize and stigmatize it. Let’s clear that up. Suicide is done in private, often violently, leaving shock and pain within a family, and is a symptom of mental illness for a physically healthy person who is tired of living. Medical aid in dying is for people who don’t want to die but are dying anyway and are tired of pain, futile debilitating treatments and suffering intolerably. It requires doctors willing to offer this option to a terminally ill patient who requests it, and it enables the person to die at home with their loving family members by their bedside. A peaceful death is the last bit of autonomy in a hopeless medical situation.
A 2019 Public Policy Polling survey shows 66 percent of Maryland voters said, “Maryland should allow mentally capable adults, who are dying of a terminal illness with no hope of recovery, to have the legal option to request a medication to bring about their own death.” Gallup polls show similar strong support across most demographic groups and Gallup found that support has nearly doubled since first asking the question in 1947.
A November 2020 Medscape poll shows 55% of physicians nationwide support medical aid in dying. Many state medical associations are supporting this option at the end of life, including MedChi (The Maryland State Medical Society ), which found strong support among physicians statewide for medical aid in dying and changed its position to neutral.
Not surprisingly, much of the objection during the legislative session comes from the Catholic Church, although a 2016 LifeWay survey showed support from 70% of Catholics questioned. It’s interesting that when asked, responses are often different from church theology.
The surprise to me was that the Baltimore Jewish Council has, for the last five years, taken a negative legislative position on the bill. They state, “While we understand that this is a personal issue for many people in Maryland, on significant life-impacting principles that are deeply rooted in Jewish heritage, doctrine and tradition, the BJC is directed by our Jewish spiritual leadership.”
Let me make it clear. While I have been discussing this topic with various members of the BJC leadership (both past and present), I never had any expectation that it would be supportive of this type of bill. I was hoping to get a letter stating that “since this is a personal issue and the make-up of the Baltimore Jewish Community has divergent opinions, the BJC will take a neutral position.”
The other possibility would be for the BJC to take no position like Jewish advocacy groups in Washington, Los Angeles, Sacramento, San Francisco, D.C., and Colorado — places where medical aid in dying is authorized.
The BJC claims to represent all of organized Jewish Baltimore and I’m not sure that all (or many) of us are represented. I know that I’ve been a member of the community since 1986 and feel they oppose a law that people may want — the last chance at personal autonomy. This law isn’t a priority, until it’s a priority.
In 2015, when he signed the California End of Life Option Act into law, then- Governor Jerry Brown of California, a former Catholic seminarian, wrote, “In the end, I was left to reflect on what I would want in the face of my own death. I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.”
Norma Cohen is a Mount Washington resident and member of Baltimore Hebrew Congregation.
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