After two failed amendments, close to an hour and a half of discussion and a decade’s worth of effort, medical aid in dying passes in the Delaware General Assembly.
Medical aid in dying, also referred to as physician-assisted suicide, cleared its final legislative hurdle for the second time in two years on Thursday, poising Delaware to become the 12th jurisdiction in the United States to legalize end of life options.
While the legislation passed in the General Assembly last session, it was ultimately vetoed by former Gov. John Carney months later.
The bill would allow a terminally ill adult with no more than a six-month death prognosis to self-administer medication to end their life.
The medication would only be prescribed to the patient after two verbal and one written request — a guardian or surrogate healthcare decision maker cannot make the request on the adult’s behalf.
Republican State Sen. Bryant Richardson (R-Seaford) introduced two amendments to the bill, one that would require a psychiatrist or psychologist to evaluate a patient seeking end of life options.
Under the language of the bill, evaluation by a psychiatrist or a psychologist is only required if an attending or consulting physician or advanced practice registered nurse is concerned that the individual lacks decision-making capacity, which the bill's sponsor Sen. Majority Leader Bryan Townsend (D-Newark) argues is sufficient.
“To say that every single patient who would like to seek to exercise this option requires that kind of medical consultation, I think sort of misses the, not only the motivating values of this legislation, but also the reality of what individuals are going through," he said.
The other would require reporting around medical professionals’ compliance with the guidelines outlined in the bill so that any violations could be identified and addressed.
The bill language states: "the Department [of Health and Social Services] may share information collected under this section with the Division of Professional Regulation if the Department suspects that a health-care provider has failed to comply with the requirements under this chapter."
Richardson takes concern with the word "may" and looked to change that word to "shall."
"Part of our purpose here is to protect those in our society who may fall victim to some of the doctors who may be the made actors," Sen. Richardson said. "Changing just this one word in this document and making sure that this is a requirement that someone is overseeing what's taking place in regards to [the bill] is not unreasonable."
But Sen. Townsend believes the bill covers Sen. Richardson's concerns and explained the language selection is intentional.
"I think one reason 'may' is there is because these are exceptions to otherwise presumed confidentiality. I think it's far better for [the Delaware Department of Health and Social Services] to ensure, including through its regulatory process that it will take prior to this law taking effect, that any contour around that is properly considered as part of its obligations to protect the public and to understand how the rest of the laws all fit together," Sen. Townsend said.
Both of the amendments failed to garner enough support to be added to the bill.
All Republicans present took the opportunity to speak in opposition of the bill, including State Sen. Minority Whip Brain Pettyjohn (R-Georgetown).
"What's unthinkable is where this has happened in other places and what has happened. Where this has led to a financial reckoning. 'Well it's going to cost you more to treat you than to give you the pill and put you down.' 'You don't want to be a burden to us, do you? Go ahead and take the pill. Be done.' That is what's happened in other places. I don't want to see that happen in Delaware," Sen. Pettyjohn said.
While several senators, including Sen. Pettyjohn, acknowledged the guardrails the bill has in place, they expressed concern that those guardrails could be weakened over time to allow for more vulnerable populations, like persons with disabilities, to access the medication.
The legislation had a difficult time passing in the Senate last session, initially receiving an abstention from State Sen. Kyra Hoffner (D-Leipsic), four no votes from Democrats State Sen. Nicole Poore (South D-New Castle), State Sen. Spiros Mantzavinos (D-Elsemere), State Sen. Darius Brown (D-New Castle) and State Sen. Jack Walsh (D-Stanton) and no support from the six-member Republican caucus.
Sen. Hoffner's decision to abstain last year prompted the bill's sponsor Sen. Majority Leader Bryan Townsend (D-Newark) to vote no on the bill to allow him to utilize a special procedure to bring it back for consideration days later.
When the bill came back to the Senate Floor, Sen. Hoffner voted in the affirmative and the bill passed 11-10.
This year, the bill passed 11-8 with two members absent — three of the same four Democrats defected from the rest of their caucus — Sen. Brown was absent for the vote — and all Republicans present voted against the bill.
Sen. Mantzavinos, Sen. Poore and Sen. Jack Walsh all spoke in opposition of the bill again prior to its vote.
"I believe we're going to legislate into existence something that I believe will ultimately reframe how our state views those who are chronically ill, those who are aging — it's going to reframe how our state views medical treatment and those who face chronic illnesses and those who are aging, and not for the better," Sen. Mantzavinos said. "Because by injecting this option, it's going to be an option that can lead to an obligation into this medical care continuum."
"We are legislating a bill that brings a lot of emotions to the forefront. It is a personal choice whether people want to live or die. Fight or flight. So, in my district, they want to fight, so I will be voting no," Sen. Poore said.
"Assisted dying laws have expanded over time to include non-terminal conditions, psychiatric illnesses, even minors. [The bill] could be Delaware's first step towards normalizing euthanasia for vulnerable populations beyond its initial intent," Sen. Walsh added.
The two newly elected Democratic senators Dan Cruce (D-Wilmington) and Ray Seigfried (D-North Brandywine) voted yes.
The bill now heads to Gov. Matt Meyer for signature, who has previously signaled support for the legislation.
