State lawmakers are again considering a bill that would allow physicians to prescribe lethal medications at the request of terminally ill patients.
The proposal — referred to as medical aid in dying by supporters and assisted suicide by critics — is a perennial and emotionally charged subject of debate in the General Assembly.
In the eight years since state Rep. Paul Baumbach first introduced the proposal, some lawmakers have confronted the difficult end-of-life decisions at the heart of the bill themselves. Two weeks before a Tuesday House committee hearing, state Rep. Kevin Hensley – previously an opponent – helped his terminally ill mother secure a prescription for medication to end her life in California.
But the arguments surrounding the measure remain largely unchanged. For those with terminal illnesses like Dawn Lentz, it offers the option to avoid a prolonged and painful death.
“When it comes down to it, it must be me who will ultimately answer to my creator," she told the House Health and Human Development Committee on Tuesday. "I don’t know if I will use this option, but I do know that I have the right.”
Sue St. Laurent, another supporter of the bill with a terminal illness, says she only remains active because of a $15,000-per-month medication. If the nonprofit assistance that helps her afford the medication were to dry up, St. Laurent says she would want the option to request medication to facilitate a faster death. "I want the right to make my own decision about my life," she said.
Baumbach echoed the same reasoning, underscoring that the bill includes guardrails to prevent patients from being coerced into using the lethal medications. Those guardrails include a requirement that patients go through two waiting periods before receiving their prescription; their attending physician or nurse practitioner must also offer the patient opportunities to rescind their request. The bill would only allow people with a life expectancy of six months or less to request lethal medication.
Opponents include some disability rights groups, who argue that while Baumbach's bill explicitly prohibits requesting lethal medication "solely because of the individual's age or disability," other states that allow medical aid in dying — namely Oregon — have expanded eligibility to include some disabilities; they worry that Delaware could follow the same path.
The bill has also drawn firm opposition from the Delaware Psychiatric Society. Former Psychiatric Society President Neil Kaye argues physicians’ life expectancy estimates for terminally ill patients are too unreliable to use as the basis for life-or-death decisions.
“This bill requires physicians to inform patients of their end-of-life expectancy," he said. "We can’t do that with 50 percent accuracy — that’s like monkeys flipping quarters. How can we be asked to help a patient decide to commit suicide instead of seeking additional treatment and compassionate palliative care?”
Kaye also pointed out that Oregon has repeatedly updated the drug cocktail prescribed to people with terminal illnesses — a process he characterized as "unmonitored experiments" by physicians who aren't trained on how to quickly and painlessly facilitate death.
Other critics note that medical aid in dying generally relies on drugs produced by compound pharmacies — meaning they are not tested and approved by the FDA.
While the Delaware Psychiatric Society remains opposed to the bill, many of the state's other medical organizations — including the Delaware Association of Nurses and Delaware Healthcare Association — have changed their position on the subject. The Delaware Medical Society, for instance, shifted from opposing the bill to a policy of "active neutrality" to reflect divided opinions among its members.
Meanwhile, Delaware Association of Nurse Practitioners spokesperson Susan Conaty-Buck testified in support of the bill on Tuesday, attempting to assuage concerns that medical professionals might pressure patients to choose lethal medications over longer-term palliative care. "It's not an opportunity to rush a person to death," she said. "It's an opportunity for me to work with a patient and their family, to respect what they need and what they want."
The bill would, however, allow healthcare providers to prohibit physicians from prescribing the lethal medications on their premises. If the bill becomes law, Baumbach says he does not anticipate that any Delaware hospital system would immediately allow its physicians to offer medical aid in dying. "We fully expect hospitals to not allow this on their premises for at least five years," he said.
Once private practice physicians have time to demonstrate the safety of the procedure, Baumbach says he expects some hospital systems to come around. While Catholic hospitals cannot provide medical aid in dying in accordance with church doctrine, Delaware's largest Catholic hospital system — St. Francis Health Care — makes up a relatively small share of the state's total hospital beds and is not poised to merge with any competitors.
The bill passed out of committee with less opposition than in previous years, but no version of the bill has ever reached the House floor.
