Physician-assisted death bill sees path to passage

Why Should Delaware Care? 
Last year’s bill to legalize physician-assisted death came close to passing but was vetoed by former-Gov. John Carney. Now, the legislation is back on the table and has passed through the House. Supporters say it has a better chance of becoming law this time, especially with the current governor voicing his support. But others remain concerned about the bill’s ethical, medical, and legal implications.

A bill that would make it legal for doctors to prescribe terminal medications to dying people is gaining momentum and now looks likely to land on the governor’s desk.

A month after the Delaware House of Representatives narrowly passed the legislation, House Bill 140, a spokeswoman for the Delaware Senate Democrats said on Wednesday that the two newest members in the upper legislative chamber support the bill.   

Delaware’s leader of the Senate – President Pro Tempore David Sakola – had previously told Spotlight Delaware that he also thought the bill would pass, but noted that there are “a few new faces” in the Senate.  

“It’s going to be close, obviously,” he said last week.

If the legislation becomes law, it would end a decade-long lobbying campaign by advocates – one that was thwarted last year by a governor’s veto. 

Last year’s version of the bill passed Sokola’s Senate by a one-vote margin. 

The newest members in the Senate this year are State Sens. Daniel Cruce (D-Bellefonte) and Ray Seigfried (D-Claymont). 

Both were elected to the state legislature during February special elections to replace Congresswoman Sarah McBride and Lt. Gov. Kyle Evans Gay. McBride and Gay were both supporters of last year’s bill, which is also referred to by advocates as medical aid in dying.  

In response to Sokola’s comments about his newest Senate colleagues, Spotlight Delaware asked Sarah Fulton, director of communications for the Delaware Senate Majority Caucus, whether Cruce and Siegfried support House Bill 140. 

In an email, she said, “Both Cruce and Seigfried will be voting yes on HB 140 when it comes before the chamber.” 

Gov. Matt Meyer has said he would sign the legislation if it makes it to his desk – a position that contrasts with his predecessor, former-Gov. John Carney, who vetoed the measure in September.

Carney, a devout Catholic who now serves as mayor of Wilmington, said then that he was “morally opposed” to the legislation. The Catholic Diocese of Wilmington has been among the staunchest opponents of the measure for years, citing its opposition to suicide.

Two months after the veto, Rep. Eric Morrison (D-Glasgow), reintroduced the measure as House Bill 140. It passed the Delaware House of Representatives by a vote of 21-17. 

Among the opposition in the House was Rep. Valarie Jones-Giltner (R-Georgetown), who said that, if passed, the regulations may become looser over time, as has occurred in other states. 

She cited states, such as Vermont and Oregon, which eliminated their resident requirement, making the medication accessible to individuals coming from other states. Additionally, states, such as Hawaii, have reduced the wait time to receive the medication. 

“It’s a slippery slope,” she said last month. 

Other opponents have expressed concerns that terminally ill people or those with disabilities could be coerced into taking medications. 

Morrison said there are safeguards in place, including the ability to refuse the medication or refer a patient to a psychiatrist, if a physician or nurse practitioner suspects coercion or questions an individual’s decision-making capacity.

The bill is now awaiting a review by the Senate Executive Committee. If approved in committee, it will proceed to the full Senate floor for a final vote. 

Senate support could grow

The bill would allow those diagnosed with a terminal illness, and given six months or less to live, an option to take medication that would end their life. 

There are six senators currently listed as additional sponsors for the bill, including President Pro Tempore David Sakola, Senate Majority Leader David Townsend, and Senate Majority Whip Elizabeth “Tizzy” Lockman. 

The last time the bill was proposed, all of the state’s Republican senators voted against it. But this time, State Sen. Eric Buckson (R-Dover), said he’s still weighing the issue and wants to hear from both sides before making a final decision.

Buckson says he’s most concerned with how the bill could evolve over time and how the law could be misused, especially concerning those with disabilities.

“I understand and respect someone who’s reached the end of life when it comes to an illness and is seeking a path forward that they can control. However, I do remain challenged with how this would impact folks who are in the disability community or in other spaces where it potentially has the capability of being misused,” he told Spotlight Delaware.

A long history

Morrison’s bill follows several versions introduced in past years by former-Rep Paul Baumbach (D-Newark). His first in 2015 started the conversation in Legislative Hall around physician-assisted death.

Morrison, who has been an advocate for the policy for eight years, first as an activist and later as a legislator, asserted that over 70% of people in Delaware support it, in reference to a 2022 public opinion poll from NüPOINT Market Research.

“I understand at a personal level why Delawareans who are terminally ill should have the choice to end their lives in a dignified manner with as little suffering as possible,” he said in a written statement to Spotlight Delaware. 

About five years ago, Morrison’s mother died of lung cancer that had also spread to her brain, he said. She was a firm believer in end-of-life options, which were not available to her during her final moments, he added.

Provisions of the bill 

The current bill would let terminally ill adults request life-ending medication that they would administer themselves. 

To be approved, health care providers would have to confirm the person’s diagnosis and prognosis and confirm that they can make informed decisions for themselves.

Mental illness or mental health conditions do not qualify as terminal illnesses under this bill.  

In her opposition, Jones-Giltner has argued that physicians’ prognoses are not always accurate, citing studies that show that doctors accurately predict a six-month prognosis less than a third of the time.

Individuals requesting the medication must be Delaware residents, and physicians approving those requests must be licensed in Delaware. 

To receive the medication, a patient must make two verbal requests at least 15 days apart, and then submit a written request to an attending physician or advanced nurse. A prescription can then be written 48 hours later. 

Morrison said that patients can also opt out of taking the medication at any time.

Doctors and hospitals are also able to opt out of the program, and those who agree to participate would not be subject to civil or criminal liability for assisting in the death. 

The Department of Health and Social Services will regulate the law if it is passed, while the Department of State will impose discipline and monitor compliance, according to Deborah Gottschalk, senior legislative attorney for the Delaware General Assembly. 

The Delaware Healthcare Association, the Medical Society of Delaware, and ChristianaCare have remained neutral on the bill. But, the Delaware Nurses Association is in support of it, according to Christopher Otto, executive director of the association. 

“We moved our position to support after listening to the patient and family stories related to end-of-life experiences and their advocacy for access to this treatment pathway,” Otto wrote in a statement to Spotlight Delaware. 

Currently, 11 states authorize physician-assisted death. No state has repealed the law, although New Jersey proposed a bill to do so but the bill never made it out of their General Assembly. 

“We feel good about [the bill] this year,” Morrison said.