SALT LAKE CITY — The sponsor of an “end of life prescriptions” bill coming up in the Utah Legislature says it would free terminally ill patients of needless misery and severe pain. But significant opposition is expected from conservative organizations.
And don’t call it a suicide bill, says the sponsor, first-year Rep. Jen Dailey-Provost, D-Salt Lake City.
“It’s really important that we not talk about the end-of-life option as suicide,” she said. “Suicide is the tragic ending of a life that otherwise would not end in the foreseeable future.”
Her House Bill 121 is part of a “death with dignity” movement that has resulted in the legalization of end-of-life prescriptions in six states and the District of Columbia, starting with Oregon in 2002.
Dailey-Provost said the proposal reflects the goal of a society that respects life and the hope that everyone should have the most fulfilling and meaningful life possible. That includes being able to “preserve the best possible end of life they can.”
“It is a compassionate choice to hasten the end of their pain ... to hasten the unavoidable,” she said.
The bill lays out limitations and safeguards, such as provisions that require a second physician’s opinion, counseling options, and a 15-day waiting period for a prescription.
“Nothing in this chapter shall be construed to authorize a physician or any other person to end a patient’s life by lethal injection, mercy killing, or euthanasia,” the bill says. “Actions taken in accordance with this chapter do not, for any purpose, constitute suicide, assisted suicide, mercy killing, or homicide, under the law.”
The bill also protects doctors and others from civil or criminal liability or professional disciplinary actions resulting from good-faith compliance with the end-of-life prescriptions law.
“Terminal disease” is defined in the bill as “an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months.”
Four previous versions of the measure were defeated in recent years, facing heavy criticism from organizations including the Catholic Diocese of Utah, the Utah Eagle Forum and the Sutherland Institute.
The Church of Jesus Christ of Latter-day Saints unsuccessfully fought an end-of-life initiative in Colorado in 2016, with the faith’s First Presidency sending a letter urging members to vote down the ballot issue.
The church apparently has not taken a direct stand against the Utah bills, but its website offers a position statement decrying physician-assisted suicide or euthanasia.
Before the 2017 version of the bill was voted down 9-3 by a legislative committee, Stan Rasmussen of the Sutherland Institute said giving a patient a choice of getting a fatal prescription “opens the patient up to pressure” by family members.
Eagle Forum director Maryann Rasmussen warned, “We worry about teen suicide, but this bill sends a clear message that it is OK to end life if it gets too hard.”
The bill features “a legal fiction that it is not assisted suicide,” said Jean Hill of the Catholic Diocese, according to recordings of that 2017 hearing.
Assurances that patients are getting sufficient mental health care before seeking an end-of-life prescription were “sadly missing” from the bill, Hill said.
But Rep. Ray Ward, a Bountiful Republican and a family physician, voted for the 2017 bill, saying, “Patients that I work with ... to me, this is an option I believe they would want to be able to think about.”
FROM CALIFORNIA TO VERMONT
Dailey-Provost said other states’ experiences with similar laws disprove “all of the scary things people are saying are going to happen.”
In Oregon in 2017, 218 people had received prescriptions under the Death With Dignity Act and 143 had died from taking the lethal doses, according to the Oregon Health Authority.
Most patients were 65 or older (80 percent) and had cancer (77 percent). More than 83 percent were in hospice or receiving palliative care.
Colorado, Washington state, Vermont and California reported similar data regarding participants: Most were elderly and suffered from cancer. Amyotrophic Lateral Sclerosis and heart disease were the next most common conditions.
Rep. Paul Ray, R-Clearfield, said he will vote against the bill when it comes up for consideration in the House Health and Human Services Committee.
He said he’s troubled the state would endorse “getting physicians involved in helping that happen.”
Ray’s also bothered by the prescription timeline. They would be good for six months.
He said his own experiences guide him on that point.
“My dad was told he had six months to live in 1978 or ‘79 and he died in 2001,” Ray said.
Ray, 52, had a congenital heart defect. He said he was told as a child he would not live past 14. Since then he has had multiple aortic valve replacements.
“I’ve fought my whole life to stay alive,” Ray said. “To say ‘Help me die,’ I just can’t agree with that.”
Asked whether his stern support for the death penalty may be at odds with his stance on the prescription bill, Ray said no, it’s “very simple.”
“With the death penalty you have somebody who’s an absolute monster,” he said. “That’s different from somebody who’s got a fatal disease and we’re trying to help them. You have a guy taking other people’s lives and the state has an obligation to put that person to death.”
He added, “It’s like asking somebody why they’re opposed to the death penalty but they’re for abortion. I can’t wrap my head around that.”
MATTER OF AGENCY
Dailey-Provost said her bill is reserved for patients diagnosed with “an absolute certainty of death. They have their full mental faculties and are capable of making this decision rationally.”
In other states, some people never use the prescriptions, she said.
“This is a matter of agency, of having some control,” she said.
Dailey-Provost said she’s pragmatic and knows the bill faces an uphill challenge.
“But we’re never going to get there if we don’t run it and talk about it every year,” she said. “There is a need for us talking about these difficult things.”