What is Medical Aid-In-Dying?
Medical Aid-in-Dying (also known as Death with Dignity) occurs when a mentally capable person diagnosed as terminally ill, requests and receives a prescription to be taken if his/her suffering becomes so unbearable that it prevents what we all aspire to--a painless, peaceful death. It is already legal for a person to decline life-sustaining measures; it is legal for a physician to put a dying patient into palliative sedation; and it is legal for a physician to prescribe pain medication, even if there is a good chance it may collaterally hasten death. Medical aid-in-dying is thus just an additional end-of-life option.
Medical aid-in-dying is NOT "assisted suicide"-- a terminally ill person is not favoring death over life; death is imminent because of an incurable, irreversible illness. By contrast, those who commit suicide may have years, if not decades, to live, but choose not to; those who use medical aid-in-dying have at best a few months to live, but wish they could live much longer. Euthanasia remains prohibited under Medical Aid-in-Dying legislation; the individual must be able to self-administer the medication.
What does the data show?
- Americans support medical aid-in-dying: Gallup (68% support in 2015) and Harris (74% in 2014). State surveys show support across a variety of demographic groups.
- Physicians support (54% to 31%) medical aid-in-dying as an end-of-life option.
- Twenty years of data from Oregon show that medical aid-in-dying has not been abused AND in fact has resulted in greater knowledge and usage of palliative, end-of-life and hospice care. Nine out of ten Oregonians who use medical aid-in-dying die under hospice care (vs. 45% of all Americans) and 90% die at home (vs. 30% of all Americans).
- While some institutions, such as the Catholic Church, the AMA, and certain disability rights lobbies, oppose legislation, their constituencies by and large approve of the law.
Where is Medical Aid-In-Dying legal in the United States?
It is legal in 9 US jurisdictions: Oregon, Washington, Vermont, Montana, California, Colorado, DC, and Hawaii and as of April 2019, New Jersey; And 23 other states are considering medical aid-in-dying legislation--including North Carolina.
How does the Medical Aid-In-Dying process work?
An individual may qualify for life-ending medication only if stringent requirements are met. An individual must be:
- 18 years of age or older, mentally capable, and not suffering from mental impairment.
- Diagnosed with a terminal illness that will, within reasonable medical judgment, lead to death within 6 months (the same criterion for admittance to hospice care).
- Able to self-administer the prescribed medication.
The request for prescription process:
- The attending physician must confirm all eligibility criteria are met.
- The physician must also inform of alternatives, including palliative care, hospice and aggressive pain management.
- A second, consulting physician must confirm the diagnosis, prognosis, and mental competence. If either physician determines that the application's judgment is impaired, the applicant must undergo a psychiatric evaluation.
- The individual must make two verbal requested, separated by a 15 day-waiting period, to be followed by a written request to be witnessed two individuals.
The individual may suspend the application for medical aid-in-dying at any time and once the prescription has been filled, he/she may decide not to take the medicine.
What do the opponents say?
By and large, most opposition comes from strongly held religious views, that no one has the right to deny God His right to perform a miracle. And those with such views are free of course to refuse MAID treatment. But for those whose religious views may diverge from those of MAID opponents, it surely is their right to decide on their end of life regimen. Religiously minded opponents may equally object to the decision to “pull the plug” on life-sustaining medical machinery even though the patient is brain dead; or may fervently object to a medical decision not to pursue futile treatment. Such is their right. But in a free country not subservient to a particular religious interpretation of God’swill, only the patient at end of life has the ultimate authority to decide howto proceed.
Aren’t There Viable Alternatives to MAID?
Yes,absolutely. An individual can suspend nutrition and hydration in a process called VSED (Voluntary Stopping of Eating and Drinking). It usually takes ten days, the last few of which can be agonizing not so much for the patient, as for the surrounding loved ones watching the slow withering of the beloved. An individual can always suspend life-sustaining medicine or ask to be disconnected from life sustaining medical machinery. An individual can stockpile barbiturates or pain killers and overdose. And most gruesomely, if society refuses a peaceful, loving exit, the individual can take matters in his/her hands with a gun, or by jumping from a bridge. In every case, the alternative of a peaceful, painless death at one’s home, surrounded by loved ones, best friends,spiritual counselors, perhaps surrounded by one’s favorite music, has multiple advantages, and should be legally available.
How Can I Help?
If you live in North Carolina, immediately call your NC State Rep or NC State Senator (not your Federal Congressman in Washington, DC) and make the case for supporting the End of Life Option Act introduced by Rep Pricey Harrison and several others. You can make a donation on our web site, since we depend wholly on the generosity of people like you to fight the good fight. You can sign up to volunteer on our web site.