Aid in dying bill deserved a hearing

Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

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Perhaps to show that they are ordinary humans, Minnesota legislators have put off hard talk about death and dying.

Legislation that would allow medical aid in dying (MAID) was introduced in the state House and Senate this year and then left to languish without a hearing. It is a disappointing exception to this year's burst of legislative action.

Rep. Mike Freiberg, DFL-Golden Valley, the bill's chief author in the House, told an editorial writer that he hopes for a better outcome next year. We share that hope — not necessarily that the legislation will pass, but that lawmakers and the citizens they represent will have the frank, difficult conversations that the topic demands.

Passing such legislation would put Minnesota in company with 10 other states and the District of Columbia that have enacted similar laws, beginning with Oregon's Death With Dignity Act in 1997. There is some variation among the state statutes, but they all have the same aim: to give people near death the ability to exert a measure of control over their last days. Patients suffering from a terminal illness can request a prescription that will allow them a peaceful and dignified end.

A valid concern is whether a MAID law would become a convenient solution for intractable problems — for example, vulnerable people might see it as a better alternative than living with poverty or a difficult family situation.

"There's never been any documented instance of abuse or coercion or anything like that," Freiberg said. "People want bodily autonomy."

Advocates for the practice object to calling it "assisted suicide," pointing out that patients who choose such a course are not electing to die, but rather to modify the manner of their death. And in fact, a third or more of the patients who receive the prescription never take it, suggesting that they are comforted simply by having the option should they need it.

Minnesota's proposed law would require that a patient requesting MAID be at least 18 and of sound mind. The patient must be fully informed about the range of end-of-life care options and able to self-administer the prescribed drugs. Two health care providers would have to concur that the patient has no more than six months of life remaining.

"I've gotten requests from people that say it needs to go further than that," Freiberg said. "Like if I have Alzheimer's disease, I should be able to use it, too. But that's not a concession we're willing to make at this point, because that would indicate that the person's not capable of making their own medical decisions."

Perhaps you have had the experience of watching a loved one endure a difficult death. You may even have been asked to help end that loved one's suffering. If so, you may be able to understand the appeal of granting some control to the person asking for it.

But you might also have had such an experience and yet be troubled by the stories of how such practices have played out in Canada or Europe. In Canada, a law that allowed dying people the means to hasten their death was expanded to make such means available to people who were ill but not dying. A further move to broaden the law to include people with mental illness has been postponed until next March.

In the Netherlands, doctors euthanize thousands of people every year. In certain circumstances, doctors may perform euthanasia on children if they are found to be in unbearable pain with no hope of improvement.

Supporters of MAID in Minnesota should offer credible assurances that a change in state law would not result in a cascading erosion of eligibility criteria. The bar for such assurances must be high. And any such law would need to take careful account of the possibility that some people might feel financial or emotional pressure to die before they are ready, in order to spare their families the expense or burden of caring for them.

It is a vexing topic, full of questions that touch on faith, personal agency, humane treatment, medical ethics and individual liberty. Sooner or later, all of us will have a stake in it.