Editor's note: Since being interviewed for this story, the Maine Medical Association has updated its position as neither for nor against the Death with Dignity bills.
This week Maine lawmakers will consider two similar bills that pose the same question: Should terminally ill patients have the right to end their lives?
It’s a question that’s come before the Legislature a half dozen times since 1995 and was rejected by a single vote two years ago. Supporters of the latest proposals hope this time, the scales will tip in their favor. But opponents fear the law would result in abuse and erosion of patient care.
Some of the people who support what’s called “Death with Dignity” laws are the ones who hope to use it, like 57-year-old Eva Thompson of Camden.
“Yes, I would be first in line to get the drug. I wouldn’t be in a hurry to take the drug. I’m enjoying my life,” she says.
Thompson was diagnosed with stage 4 colon cancer about four years ago. It’s not curable, she says, and her treatment options have dwindled. She doesn’t want her death to be prolonged or painful.
She says having some control over the matter would give her reassurance.
“And I think I would actually live longer and better if I had the drug, because I wouldn’t be spending all of this time worrying about, otherwise, what am I going to do? Otherwise, how is the end going to go? I waste an incredible amount of time thinking about that, and I don’t have time to waste,” Thompson says.
Peace of mind is something that 43-year-old Rebecca VanWormer wanted too. She died earlier this year from cancer that spread from her breast to her liver, spine and eventually her brain. Before her death she was a vocal advocate for Death with Dignity.
Her husband, Ken VanWormer, says she wanted her lasting memory to be when she was full of life and smiling. Instead, he says she was reduced to final days full of pain and suffering, despite hospice care.
“Whether it was a few days of suffering, or going quietly in her sleep, going quietly in her sleep was a much better option. She just didn’t have that for herself,” VanWormer says.
Democratic state Rep. Patty Hymanson wants that option to be available. She’s a co-sponsor of LD 347 and a neurologist who spent a decade as the chair of the ethics committee at Portsmouth Hospital.
“In ethics — medical ethics — we try to think of four different ideas,” she says — patient autonomy, doing what’s best for patients, avoiding harm, and justice. “The idea of this bill is to fully embrace autonomy at the same time that I feel as a physician that I am doing good. Because I am helping the person to live out their life. And I think as physicians we need to be on the side of embracing the entirety of what life means, and that also includes death.”
Hymanson says the bill includes safeguards to prevent abuse. Patients must meet with a physician twice, request medication in writing in the presence of witnesses and must administer it themselves.
But Staci Converse, an attorney with Disability Rights Maine, says she doesn’t think those safeguards are adequate. There are too many protections for physicians, she says, and virtually no state oversight.
“The worst-case scenario is that a person could end their life that was influenced through coercion or undue influence,” she says.
Though Disability Rights is not taking a position on the idea of Death with Dignity itself, the Maine Medical Association opposes it.
“The AMA code of ethics makes this unethical — an unethical act to intentionally cause the death of a patient,” says spokesman Gordon Smith.
Smith says patient autonomy is important, but, “What really matters more to us is the quality of hospice and palliative care available.”
And, says Kandyce Powell of the Maine Hospice Council, hospice and palliative care is not available in many parts of the state. Before Maine creates a policy that allows patients to hasten death, she says, it should focus on ensuring quality end-of-life care is available to everyone.
“In the bill it talks a lot about choice, and I ask people to really think about this. Choice is when you have something to choose from,” she says.
If this bill were approved, Powell’s concern is that it would further contribute to what she sees as the steady erosion in U.S. health care of prioritizing adequate time and care for patients.
“This is more about where we’re going as a society. Is this where you want to go, and is this a piece of that?” she says.
But Sarah Witte, who lost her 27-year-old son Andy to brain cancer in 2010, says her son had all the care and support possibly available. In hospice care in his final days, she says, he still couldn’t escape agonizing pain.
“And you wouldn’t let anyone you love go through that without wondering if there isn’t another way. I said to the doctor, a really warm, compassionate guy, ‘Could you give him a little more, a little bit more? Please?’ And he looked me straight in the eye and he said, ‘I can’t cross the line,’” she says.
It’s a line that, if Maine crosses, would put it in the company of six other states, plus the District of Columbia, that allow physician-assisted death.
A public hearing on the bill is scheduled for Wednesday.