QUESTION 2: Prescribing Medication to End Life
Do you approve of a law summarized below, on which no vote was taken by the Senate or the House of Representatives on or before May 1, 2012?
IN FAVOR: When my father was diagnosed with brain cancer, he had little time left. As his final days neared, he chose to use the Death with Dignity law in his home state of Oregon. The Massachusetts version, like those in other states, will allow mentally competent adults with no chance to survive their illness to take life-ending medication prescribed by a physician.
My dad knew he wanted to die in the comfort of his own home; competent and aware instead of detached and sedated; on his own terms instead of those of a fatal disease that had already taken too much.
My dad was already dying, but because of this law, he could say goodbye to those he loved, with dignity and grace in my mother's arms.
I urge you to vote "Yes" because, while this choice isn't for everyone, everyone has the right to this choice.
AGAINST: Question 2 restricts patients' choices and control by enabling suicide as a substitute for quality health care. Question 2 is poorly written, confusing and lacks even the most basic safeguards. Patients would not be required to see a psychiatrist before obtaining the lethal drug. Many patients with a treatable form of depression could get a life-ending prescription, rather than effective psychological care. Also, the proposal lacks any public safety oversight after the fatal drug is obtained.
Question 2 does not require a consultation for palliative care, a compassionate form of care that eliminates pain and maximizes quality of life for the terminally ill. And, eligibility is based on a six-month life expectancy. Doctors agree these estimates are often wrong. Individuals can outlive their prognosis by months or even years. Massachusetts should improve access to quality health care for terminally ill patients, not access to suicide. Vote no on Question 2.
This proposed law would allow a physician licensed in Massachusetts to prescribe medication, at a terminally ill patient's request, to end that patient's life. To qualify, a patient would have to be an adult resident who (1) is medically determined to be mentally capable of making and communicating health care decisions; (2) has been diagnosed by attending and consulting physicians as having an incurable, irreversible disease that will, within reasonable medical judgment, cause death within six months; and (3) voluntarily expresses a wish to die and has made an informed decision. The proposed law states that the patient would ingest the medicine in order to cause death in a humane and dignified manner.
The proposed law would require the patient, directly or through a person familiar with the patient's manner of communicating, to orally communicate to a physician on two occasions, 15 days apart, the patient's request for the medication. At the time of the second request, the physician would have to offer the patient an opportunity to rescind the request. The patient would also have to sign a standard form, in the presence of two witnesses, one of whom is not a relative, a beneficiary of the patient's estate, or an owner, operator, or employee of a health care facility where the patient receives treatment or lives.
The proposed law would require the attending physician to: (1) determine if the patient is qualified; (2) inform the patient of his or her medical diagnosis and prognosis, the potential risks and probable result of ingesting the medication, and the feasible alternatives, including comfort care, hospice care and pain control; (3) refer the patient to a consulting physician for a diagnosis and prognosis regarding the patient's disease, and confirmation in writing that the patient is capable, acting voluntarily, and making an informed decision; (4) refer the patient for psychiatric or psychological consultation if the physician believes the patient may have a disorder causing impaired judgment; (5) recommend that the patient notify next of kin of the patient's intention; (6) recommend that the patient have another person present when the patient ingests the medicine and to not take it in a public place; (7) inform the patient that he or she may rescind the request at any time; (8) write the prescription when the requirements of the law are met, including verifying that the patient is making an informed decision; and (9) arrange for the medicine to be dispensed directly to the patient, or the patient's agent, but not by mail or courier.
The proposed law would make it punishable by imprisonment and/or fines, for anyone to (1) coerce a patient to request medication, (2) forge a request, or (3) conceal a rescission of a request. The proposed law would not authorize ending a patient's life by lethal injection, active euthanasia, or mercy killing. The death certificate would list the underlying terminal disease as the cause of death.
Participation under the proposed law would be voluntary. An unwilling health care provider could prohibit or sanction another health care provider for participating while on the premises of, or while acting as an employee of or contractor for, the unwilling provider.
The proposed law states that no person would be civilly or criminally liable or subject to professional discipline for actions that comply with the law, including actions taken in good faith that substantially comply. It also states that it should not be interpreted to lower the applicable standard of care for any health care provider.
A person's decision to make or rescind a request could not be restricted by will or contract made on or after January 1, 2013, and could not be considered in issuing, or setting the rates for, insurance policies or annuities. Also, the proposed law would require the attending physician to report each case in which life-ending medication is dispensed to the state Department of Public Health. The Department would provide public access to statistical data compiled from the reports.
The proposed law states that if any of its parts was held invalid, the other parts would stay in effect.