Death with dignity to be resurrected next year

By Diane Carman

It came as no surprise to the bill sponsors when members of the House Health and Human Services Committee voted 8 to 5 Friday night against HB 1135, a measure that would have replicated Oregon’s aid in dying law in Colorado.

The sponsors had counted the votes and knew what to expect.

What came as a shock to many, however, was the outpouring of emotion during the 11-hour hearing.

More than 100 witnesses spoke, often in tears, often bringing members of the committee to tears with their stories of suffering, death and survival.

The witnesses were nearly evenly divided pro and con, and many of them on both sides of the issue arrived in wheelchairs.

“I don’t see this as a defeat,” said Rep. Lois Court, D-Denver, one of the sponsors of the bill, who admitted that committee members were thoroughly exhausted by the marathon hearing last week. “Sure, I’m disappointed, but it’s important that we started the conversation that we know Coloradans want to have.”

The advocates for aid in dying vow to bring the issue back to the legislature next year.

Dr. Charles Hackette testifies posthumously before the Colorado Legislature in a video produced before he died of ALS.

Dr. Charles Hackette testifies posthumously before the Colorado Legislature in a video produced before his death of ALS.

“We have to remind ourselves that this is an emotional issue,” said Dr. Charles Hamlin, a retired hand surgeon and board member for Compassion & Choices, a national organization advocating for aid in dying. “Because I am clear in what I think doesn’t mean others don’t have the right to think differently.”

Anita Cameron, a board member for the disability rights group Not Dead Yet, maintains that she is just as clear in her thinking about the bill.

In her testimony last week, she said aid in dying legislation is “disingenuous at best and dangerous at worst.

“I’m not against suicide,” she said. But she said she opposes physician assistance because of the risk of coercion. “Certain people with certain disabilities and illnesses will get counseling and help while others will be coerced to die by unscrupulous family members, caregivers or heirs.”

Anita Cameron

Anita Cameron

Cameron said that “doctors often make mistakes in predicting when people will die” and they should not be the “gatekeepers of people’s lives.”

As with other opponents of the bill, she emphasized that people already have the right to die by refusing treatment and nutrition.

Julie Reiskin, executive director of the Colorado Cross-Disability Coalition, told the committee that the coalition’s board voted to oppose the measure because they believe “we cannot make this safe.”

While Reiskin personally supports aid in dying, she said she has concerns about some of the provisions in the bill.

For example, the draft called for mental health evaluations in cases where there is any question of the ability of the patient to make an informed decision. “There isn’t the capacity to do that in our current system,” she said, “and that’s scary to me.”

Dr. Charles Hamlin

Dr. Charles Hamlin

Hamlin also testified at the hearing, reading a letter of support for the aid in dying legislation from the Denver Medical Society. He said he respects the concerns expressed by representatives of the disability community, “but there is not one case in this country (of a disabled person being coerced into suicide) nor will there be because of the nine hurdles in this law.”

Among the protections he cited were a requirement that two doctors examine the patient and determine that he or she is mentally competent and likely to die within six months; the patient must request the lethal medication twice; the patient must be counseled on alternative treatments; the patient may rescind the request at any time; and others.

Hamlin said there are no plans to initiate a campaign for a ballot measure on aid in dying, largely because of the cost. Two other states – Oregon and Washington – enacted aid in dying measures through the initiative process.

Instead advocates plan to intensify public education efforts.

“We plan to do a lot more outreach,” he said, particularly in smaller cities and regions outside of the Front Range. “We need to get more support for our supporters in the legislature.”

Hamlin plans to contact every hospital in the state and offer to make presentations on aid in dying to health care workers and members of the community. He said once people have a clearer understanding of the issue and the proposed law, he is confident they will support it.

“The right to orchestrate a peaceful death without governmental intervention is tremendously popular,” he said. “The decision should be personal, private, understood and respected.”

Similar so-called “death with dignity” measures are being considered in 25 states. Court said as more and more baby boomers experience the often-prolonged deaths of their parents and consider their own end-of-life decisions, aid in dying legislation likely will take on greater urgency.

“This is a movement,” said Hamlin. “It’s a tidal wave.”

While people tend to focus on what Hamlin calls “the last step” in the process, aid in dying is much more than just a prescription for a lethal dose of medications.

“It’s about having the conversation and thinking about your wishes when you reach the end,” he said. “It’s still taboo for parents to talk to their children about this.”

In Oregon, data show that nearly 40 percent of patients who go through the process and receive prescriptions for lethal drugs never use them.

“What people really want is control,” Hamlin said. “They get into the system, get a prescription, put it in a Ziploc bag in a cool dark place and then just knowing they’re in control helps them handle the pain better.

“They say, ‘My family is less depressed, they’re talking to me, my doctor seems to understand my wishes …’ It’s about autonomy.”

Yet many of the bill’s opponents see it as the first step on the path to euthanasia.

Court is not giving up. She said she plans to introduce a similar bill next year. “You don’t open a discussion like this and then just abandon it.”

After the hearing, she spoke to Julie Selsberg and promised to keep fighting for the measure. Selsberg’s father, who had ALS, refused food and water to end his suffering last spring. Before his death, a letter he’d written with his daughter’s help was published in the Denver Post. It called for death with dignity legislation to “show mercy on the terminally ill.”

Selsberg was one of Court’s constituents.

“I told Julie that her daddy would be proud of her,” Court said.

“This is only Round 1,” she added. “Something this complicated doesn’t happen fast. It’s so personal. It’s not like deciding whether to have a gas tax.”

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