Will Massachusetts become a right-to-die state in 2023?
Though polls show a growing majority of residents favor it, legislation that would give the terminally ill the option to obtain lethal drugs has never been brought to a vote in the full state House or Senate.
But now, with a potential ally in the governor-elect, and the rollback of abortion rights amplifying calls for bodily autonomy, supporters of the long-stalled proposal — which lawmakers plan to reintroduce next month — say they may finally have the momentum they need.
“Our communities support this, and I’m hopeful we can do it next year,” said state Representative James O’Day, a Worcester Democrat who’s been lead sponsor of the bill in the House. He cited a post-pandemic “groundswell” in public sentiment that people who are suffering in the final months of their lives should be allowed the choice to hasten their death.
In the meantime, the state’s highest court is weighing a case that could open the door to medical aid in dying even before lawmakers act.
State voters narrowly rejected a “death with dignity” ballot question in 2012, after an eleventh-hour push by opponents, led by the Catholic church, at services and in television ads. In the decade since then, medical aid-in-dying bills — modeled after laws in nine other states and the District of Columbia — have been filed in every legislative session.
Those hoping to advance legislation in the coming session, which starts in January, are heartened by statements by Governor-elect Maura Healey that she would support a bill under certain conditions.
“Maura supports legislative action to allow medical aid in dying, provided it includes sufficient safeguards for both patients and providers,” Karissa Hand, a spokeswoman for Healey, wrote in a statement to the Globe. “She will review any legislation that reaches her desk as Governor.”
That means backers would have a lower bar to clear than they had under Governor Charlie Baker, who signaled his opposition in the past. They’d only need a simple majority rather than a veto-proof supermajority in the Legislature.
The most recent right-to-die bill won a favorable vote in the legislature’s Joint Committee on Public Health in March. But another key panel, the Joint Committee on Healthcare Financing, failed to advance it.
House Speaker Ronald Mariano last spring said representatives in his chamber remained “very divided” on the issue. Mariano, through a spokesman, declined a request for an interview for this story. Senate President Karen Spilka similarly declined to discuss the matter. In separate statements, both promised to continue reviewing the bill in conversations with their colleagues in the upcoming session.
Proponents say the backlash against the US Supreme Court’s decision in June to overturn the constitutional right to abortion, a potent issue in last month’s midterm elections, demonstrate strong support for the right to control one’s body. They’re advancing the argument that individuals, not the government, should be allowed to decide if they want to hasten their deaths to relieve suffering from incurable illness.
“I don’t want to die writhing in pain,” said Melissa Stacy, a Boston-based regional manager for the Compassion & Choices Action Network, which campaigns for medical aid-in dying legislation in nine Northeast states. “People are more comfortable when they have the choice.”
Lawmakers who’ve sponsored legislation in Massachusetts haven’t used the abortion argument in the past. But some readily acknowledge the parallels with the right to abortion, which remains legal in the state.
The idea of government restricting the end-of-life options of people in pain “becomes dangerous,” said State Senator Joanne Comerford, a Democrat from Northampton and lead Senate sponsor of past bills.
Even before the contentious high court ruling on abortion, there were signs of momentum for medical aid in dying. A record 80 of the state’s 200 lawmakers signed on as co-sponsors of bills in the Massachusetts House and Senate in the legislative session that ended this year. And in May, in a Boston Globe/Suffolk University poll, 77 percent of respondents said they favored a right-to-die law, up from 70 percent in a 2019 poll, before COVID-19 effectively put the issue on hold for two years.
Opponents of medical aid in dying, which they term “assisted suicide,” point out that polls also showed majority support before the statewide referendum in 2012. But it was defeated by a 51 to 49 percent vote.
The opposition, including Catholic and other religious leaders along with disability rights advocates, remains intense. “The church opposes any bill that would terminate life, at the beginning or the end of life,” said Jim Driscoll, executive director of the Massachusetts Catholic Conference, the public policy arm of the state’s Catholic bishops, which supports a wider use of palliative care for patients at the end of their lives.
“Church teachings are clear that life starts at conception and ends at natural death, not death predetermined by a medical diagnosis,” he said.
While the legislation could be updated in the coming session, it is likely to be broadly similar to past bills filed in the state House and Senate. Those bills applied to terminally ill, mentally capable adults who’ve been told by doctors they have no more than six months left to live. Those adults would be permitted to request and take medicines that will let them die peacefully in their sleep if their suffering becomes unbearable.
The bills have included multiple safeguards: A six-month prognosis must be confirmed by two doctors. Attending physicians must inform patients about all end-of-life options, including hospice and pain management. And individuals must be able to administer the drugs themselves and be able to change their minds even after they’ve obtained the medicine.
Opponents say doctors are often wrong in predicting life expectancy. They also contend that pain can almost always be managed through palliative care, a point disputed by advocates who recount watching helplessly as loved ones suffered from the pain of terminal diseases.
Hanging over the debate is the pending decision by the Massachusetts Supreme Judicial Court. The court in March heard arguments in a case brought by Dr. Roger Kligler, a Falmouth physician with advanced prostate cancer who wants to be able to access lethal drugs.
“At this point, I wouldn’t qualify,” said Kligler, who’s had surgery and radiation stemming from his cancer but hasn’t been certified by doctors as having fewer than six months to live. “But I want the option.”
Kligler’s lawyers argued that because there is no state law explicitly prohibiting it, doctors should be allowed to write prescriptions for life-ending medicines at the request of patients without fear of prosecution. (The state attorney general’s office, under Healey, argued against Kligler in the SJC case; Healey has since indicated she believes medical aid in dying should be enacted through the Legislature, not the court.)
While some anticipate a ruling by the end of the year, the SJC hasn’t disclosed when it might issue its decision. Kligler’s attorney, Kevin Diaz, general counsel for Compassion & Choices, said the impact of a ruling would depend on the court’s language and how it’s framed.
But the Massachusetts case bears similarities to a 2009 case in which the Montana Supreme Court concluded that individuals who were going to die imminently with great suffering had a legal option to seek and receive their physician’s assistance to die peacefully. That, in essence, allowed medical aid in dying without state legislative action.
Legislatures have legalized the option in two New England states, Vermont and Maine. Oregon was the first state to approve it, through a 1994 ballot initiative. It’s also legal in Washington state, California, Colorado, Hawaii, New Jersey, New Mexico, and Washington, D.C.
But the practice remains relatively rare, with only 5,171 people in those states taking drugs to end their lives over the past two decades. Many more fill prescriptions for the medicines but never take them.
Robert Weisman can be reached at firstname.lastname@example.org.