Testimony of James L. Young, Jr., Esq.
On Behalf of the Elder Law Section of the Connecticut Bar Association
IN CONDITIONAL SUPPORT OF RAISED BILL 6425
An Act Concerning Aid in Dying For Terminally Ill Patients
Public Health Committee Public Hearing
February 25, 2021
Honorable Members of the Public Health Committee:
My name is James L. Young, Jr., I reside in Mystic, Connecticut, and have practiced law in Connecticut since 1988, and prior to that in Oregon. My office is at 567 Vauxhall St. Ext, Waterford, CT 06355. I am here today on behalf of the Elder Law Section of the Connecticut Bar Association, which is comprised of nearly 500 members of the Connecticut Bar, to give conditional support in favor of Raised Bill 6425, An Act Concerning Aid in Dying for Terminally Ill Patients. The support is conditional because although we support compassionate aid in dying, we believe a few changes should be made to the proposed bill.
The proposed bill allows a terminally ill “qualified patient” to voluntarily request a prescription from their attending physician that the patient may self-administer to bring about his or her death earlier than the natural disease process would. No physician is obligated to grant the request. For such a patient who has been determined by two physicians to be in the final stage of an incurable and irreversible medical condition anticipated to produce the patient’s death within six months, this proposal promotes the individual’s autonomous and informed choice to determine how and when he or she will die and offers the opportunity to alleviate that person’s emotional and physical suffering. We believe competent adults should be free to make this deeply personal end of life decision, with the support of willing physicians.
Numerous and strict safeguards against abuse are contained in the proposed bill. They include:
- Only a “qualified patient” may obtain the prescription. A qualified patient is a person who is a competent adult, and a resident of Connecticut who has a terminal illness that will soon lead to their death, and who is acting voluntarily, and who meets the strict criteria set out in the statute.
- No patient or physician can be compelled to participate in aid in dying.
- No person, including a guardian, conservator, agent under a power of attorney or health care proxy, may act on behalf of a patient for the purpose of obtaining Aid in Dying.
- The attending physician cannot provide a prescription to any patient suffering from a psychological condition including depression that is causing impaired judgment, and must refer such a patient for counseling.
- The proposal does not permit a physician or any other person to end a patient’s life by lethal injection, mercy killing, assisting a suicide or any other active euthanasia.
- A consulting physician must examine the patient and his or her relevant medical records, confirm in writing the attending physician’s diagnosis that the patient has a terminal illness, verify that the patient is competent, is acting voluntarily and has made an informed decision to request aid in dying, and refer the patient for counseling if the physician believes the patient may be suffering from a psychological condition that is causing impaired judgment, so that the patients’ competency to request aid in dying can be determined.
Our support of aid in dying legislation is conditioned upon adequate safeguards. Exactly what such safeguards might entail is a matter to be resolved as this legislation is considered by the legislature, but our support is conditioned upon the following safeguards being incorporated into the legislation (noting the second condition is part of Raised Bill 6425:
- Care givers and heirs cannot be witnesses to the request for aid in dying by the patient;
- Two independent physicians must sign off on the terminal nature of the illness;
- Nothing in this bill shall limit the jurisdiction or authority of the Office of Protection and Advocacy for People with Disabilities (or any such other agency) to exercise its statutory powers;
- The two independent physicians referenced in #2 above must advise the patient of the availability of counseling with a psychologist, psychiatrist or licensed clinical social worker.
In 2014 the Elder Law Section of the Connecticut Bar Association conducted an extensive review of a similar proposal then under consideration in Connecticut, and other states’ laws regarding aid in dying. The proposed bill is in many ways fashioned after an Oregon law which has been in effect since 1997, where as of March 2015 (there is more current information I can provide if requested) only 59% of the 1,173 individuals who requested a prescription (81% of which had a diagnosis of cancer) actually used it. The Oregon Medical Board which oversees Oregon’s program reported (again as of March 2015) that they have found no cases of coercion, abuse, or misuse of the law, and nine independent studies have confirmed these results.
Hospice care has increased in Oregon according to the Journal of the American Medical Association reporting that “End of life care including increased use of hospice care has actually improved in Oregon since the passage of their Death with Dignity Act.” In Oregon, 98% of those requesting a prescription had health insurance.
Since the last time this legislation was considered here in Connecticut the list of States with aid in dying laws has tripled.
Compassionate Aid in Dying is now legally allowed in California, Oregon, Washington, Vermont, Colorado, the District of Columbia, Hawaii, New Jersey and Maine. Montana does not have a statute safeguarding aid in dying but its Supreme Court ruled in 2009 that nothing in its laws prohibited a physician from honoring a terminally ill, mentally competent patient’s request. We expect more and more states will adopt aid in dying legislation as time goes on.
Voices are raised by those who worry that aid in dying laws would be used to abuse the disabled. I ask that you review the attached letter from the Disability Rights Oregon organization. This letter is strong evidence that aid in dying laws have not led to abuse of the disabled in Oregon, which has had this law on its books for over twenty years. Our Section strongly advocates for the rights of the disabled and the elderly. We would not advocate for this law if we thought such would lead to abuse of the vulnerable.
Failure to adopt aid in dying laws in prior sessions has resulted in continuing suffering by those Connecticut residents who would avail themselves of the law if adopted.
Such suffering is real. It is going on now, and has gone on during the years the legislature has refused to recognize that Connecticut residents should have the same rights as exist in other States that have had these laws.
Without aid in dying legislation, terminally ill individuals who wish to end their lives before the natural disease process would do so, will in some cases continue to resort to other more dire means, often guns hidden away in the home. In such cases family members and health care professionals may be exposed to potential criminal prosecution if they are deemed to have somehow facilitated the death by gun. This has happened in Connecticut.
It is reasonable to think that in some cases these firearms might be found by minors, or others who should not be in possession of the firearm, with unintended consequences.
Abuse in end of life decision making is less likely to occur in an open and transparent system rather than one where people are forced into clandestine actions.
With the adoption of the changes requested above, the Elder Law Section of the Connecticut Bar Association urges this Committee to act favorably on the Bill.
I would be happy to try to answer any questions you may have.