Minnesota fails again to give some choice to the dying

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I was deeply disappointed this legislative session, not as much for myself as for the terminally ill advocates and their loved ones who worked so hard to make medical aid in dying an option for dying Minnesotans. Given the Legislature’s deep commitment to defending bodily autonomy and privacy in medical decision-making, and with Gov. Tim Walz in full support, this should have been the year to pass the End-of-Life Options Act.

I can relate to lawmakers’ caution about medical aid in dying. As a retired palliative care physician who practiced in Washington state for almost 30 years, I originally opposed the Death with Dignity Act enacted by the voters there in 2008. I believed, then, that palliative treatments could effectively ease every person’s physical, emotional and spiritual pain. I also was worried about some of the misguided and misinformed arguments opponents repeated to scare lawmakers and voters.

Over the years, I learned I was wrong. Some individuals experienced pain and symptoms that it was beyond our capacity to alleviate. In some cases, for example, the high doses of narcotics needed to ease suffering were either inadequate or resulted in sedation to unconsciousness. Furthermore, the fears of abuse and mistreatment were unfounded. There has been no evidence of misuse or coercion in Washington or any of the other jurisdictions where medical aid in dying has been authorized.

Under Minnesota’s proposed End of Life Options Act, which is modeled after the time-tested laws in Washington and Oregon, an adult must be diagnosed with a terminal illness and have a prognosis of six months or less to live. They would have to make two oral requests, submit a written request and be fully evaluated by two clinicians who would determine eligibility, including whether the patient is capable of giving informed consent and acting of their own volition. Patients who lack mental capacity, such as those suffering with dementia, would not qualify. Any kind of coercion is strictly prohibited.

In both Washington and Oregon, medical aid in dying has been implemented in this manner for decades: sparingly and with compassion and thoughtfulness. Individuals who have chosen this option had complete agency in their decision-making, and they imminently faced terminal diseases such as cancer or ALS. Loved ones were involved, and the consensus was clear — this option brought comfort and control, leading to a peaceful dying process.

As a hospice medical director, I bore witness to several patients who opted for this path. I was honored to witness the immense compassion displayed by the doctors who provided medical aid in dying.

It also became clear that just knowing they had the option brought relief to many other terminally ill individuals.

Now I am facing my own terminal illness. Fortunately, the suffering around my death is likely to be brief and manageable with hospice care. However, as someone with death on the horizon and having seen the positive impact of this law, I believe that Minnesotans should no longer be denied the opportunity to make their own end-of-life choices.

Many heroic advocates brought this urgent need to the attention of Minnesota lawmakers in 2024, explaining the facts, sharing their stories, and bringing in experts and experienced clinicians to provide accurate, firsthand information. I am profoundly grateful to Rep. Mike Freiberg, DFL-Golden Valley, and the other bill sponsors and committee members who advanced the End-of-Life Options Act to the brink of passage in the House. They listened and responded to the majority of voters who want the freedom and privacy to make our own end of-life decisions.

The task now lies before the Minnesota Senate, which as a body failed to act this year, denying the bill even a hearing. After a decade of discussion, and with the evidence and experience from 10 states, senators must no longer capitulate to scare tactics. Advocates will be looking to leaders in the Senate to make passing the End-of-Life Options Act a priority in 2025.

Dr. Joanne Roberts, of St. Paul, served as a hospice and palliative medicine specialist in Everett, Wash., and has more than 38 years of experience in the medical field.