In my decades of medical practice, patient autonomy has been one of my guiding principles. In patients who face terminal illness, too often, I have witnessed them withdraw, fearful of losing their autonomy and reluctant to fully utilize hospice services for fear they would not be allowed to die when they were ready. Few decisions are more important to terminally ill, mentally capable people than deciding on what terms they will leave this life.

This bill is modeled on the law enacted in 1997 in Oregon. It is a law that requires the terminal status of a patient to be certified by two independent physicians, who must also determine that the patient is not depressed and fully understands the consequences of their request to use medication to peacefully end their life. It has resulted in an increased use of hospice in Oregon so that it now ranks in the top four states for use of this method of supporting patients in their final months. In a 2015 article in the Journal of Palliative Care, it was felt that the medical aid in dying law resulted in “more open conversation and careful evaluation of end-of-life options, more appropriate palliative care training of physicians, and more efforts to reduce barriers to access to hospice care and thus increase hospice referrals.” Of the people who have pursued medical aid in dying and received medication in Oregon, only about 65% of patients used the medication. However, those who did not use the medication reported that having this medication provided them with a sense of control that was invaluable. Typically, the patients were well-educated and insured. They did not have fears of abandonment and often their families were more involved in their care, surrounding their bedside as 89% of them died at home.