N.J.'s Aid in Dying bill: Terminally ill patients say it stops suffering, critics worry about abuse
New Jersey is expected to soon become the eighth state to adopt an aid-in-dying law that allows terminally ill patients with less than six months to live to obtain lethal medications to end their life. Gov. Murphy has said he will sign the controversial bill that lawmakers passed last week.
Susan Boyce recalled how her son pushed her wheelchair close to the edge of the New Jersey Senate floor so she could listen to the votes as they were cast, one by one, on the controversial Aid in Dying bill.
She was directly behind the lawmakers and when the vote count hit 21, she burst into tears. After a seven-year struggle, the bill was approved March 25, on a busy voting afternoon in the Trenton statehouse. Once it is signed by Gov. Phil Murphy, who has promised to do so, it will become effective within four months.
“I had grown a bit nervous that something could bounce it off the schedule or someone would change their mind. ... I was so hugely relieved," said Boyce, a 55-year-old terminally ill patient with a progressive, genetic disease, known as Alpha-1 Antitrypsin Deficiency, that has left her with 29 percent lung function.
She testified at earlier hearings about her need to have peace of mind and death with dignity while some others with her ailment have “lingered breathless for months before dying.”
When Murphy, a Democrat, signs the bill, New Jersey will become the eighth state to allow terminally ill patients with a prognosis of less than six months to end their lives after a doctor prescribes a lethal drug. Murphy said shortly after the bill’s passage he would sign it because “allowing terminally ill and dying residents the dignity to make end-of-life decisions according to their own consciences is the right thing to do."
Boyce said she plans to ask her doctor to prescribe a lethal drug that she can self-administer whenever she feels the time has come. “I hesitate to say whether I would use it, but having the option out there is so relieving for me to know that I will have a path to relieve suffering,” said Boyce, a Rumson resident who uses oxygen equipment.
Emotions ran high the day the bill passed.
Dozens of patients and advocates who witnessed its passage "hugged each other; they cried, they mouthed ‘thank you’ to the lawmakers,” said Corinne Carey, campaign director of Compassion & Choices New Jersey. Oregon led the way in 1997, and New Jersey legislators first considered the bill in 2012.
Critics, however, warn that disabled and vulnerable people may now face pressure from unscrupulous family members or caretakers to terminate their lives. The Catholic Church calls the bill an affront to human life. A few Republican lawmakers urged Murphy to consider a veto.
The day of the vote, scores of patients and advocates, wearing sunny yellow Compassion & Choices T-shirts, jammed the busy hallways in the statehouse and held up signs. The measure received less attention because it came at the same time a vote on legalizing recreational marijuana was canceled.
The Aid in Dying bill does not allow mercy killing, euthanasia, or assisted suicide. Instead, terminally ill patients must get a diagnosis from two New Jersey doctors before they can get a lethal drug, often a barbiturate. The bill says they can take the medication in the presence of a loved one or others, or opt to take it alone, but they must administer it themselves.
Because of these requirements, individuals such as Patrick Mirrione, 79, of Parsippany, who was charged with “aiding suicide” on the day the bill passed, will still have to face the courts, said Assemblyman John Burzichelli, a major architect of the measure. Mirrione was arrested March 15 after his wife was found dead of a gunshot wound and he was accused of moving items at the scene and giving conflicting reports to police.
“It’s a very sad story and it’s why this option should be in place to help these people,” said Burzichelli, a Democrat from Gloucester County.
Burzichelli said he was moved by the stories of terminally ill patients who said they wanted the option of choosing whether to end their own lives to stop prolonged suffering. “There’s already aid in dying in New Jersey and in Pennsylvania through the magic of morphine. With a wink and a nod, people have gotten it,” he said. “But some people would like another choice and complete control over this.”
A Gallup poll last May found 72 percent of those surveyed in the United States supported doctor-assisted suicide, while a 2015 Rutgers Eagleton poll found 63 percent of New Jersey residents supported the state’s earlier aid-in-dying bill.
The attention around 29-year-old Brittany Maynard, who had an aggressive form of brain cancer and who decided to take a lethal drug in Oregon in 2014, also played a role in changing public opinion, pollsters said.
In the last year, 17 other states considered aid-in-dying bills. Maryland rejected the measure, while it is still pending in New York. Pennsylvania last considered a bill in 2017.
Opposition to New Jersey’s plan still runs deep.
The Diocese of Camden posted a warning on its website that said the bill would go beyond the terminally ill and affect the “handicapped, elderly, depressed, and vulnerable." The Diocese of Trenton wrote to New Jersey lawmakers and said a diagnosis of terminal illness is not always accurate and people may choose based on false information. “Physicians pledge an oath to ‘do no harm.’ Taking a life before natural death violates that vow and there is no turning back,” the February letter said.
The Medical Society of New Jersey also opposes the bill, saying it requires a “physician to participate in the termination of human life and puts physicians at odds with their professional ethical requirements.” A statement on the medical society’s website said the group historically agrees with the American Medical Association’s Code of Medical Ethics but also supports patients’ right to make health-care choices.
Larry Downs, chief executive of the society, said aid-in-dying is scheduled to be discussed at the group’s conference in May and “there could be a decision to support this kind of work, or continue to discourage physicians to be engaged, or to leave it up to the individual physicians based on circumstances.” He also said that the AMA debated the issue last year and failed to get enough votes to reaffirm the current policy or to change it. “It was a very close vote … and it’s representative of all the dialogue going on about this.”
Diane Coleman, president of Not Dead Yet, a disability-rights group based in New York, said aid-in-dying laws are troubling because “there’s nothing in the bill to protect patients from medical mistakes, coercion by families or insurance companies to die early, and nothing to prevent outright abuses, including the potential for someone like an heir or a caregiver to administer the drugs. ... No independent witness or medical person needs to be present at the death.”
Coleman, 65, suffers from a form of muscular dystrophy and said doctors told her parents she would only make it to age 12. “There’s a lot of guesswork," she said.
Burzichelli said the New Jersey bill incorporates various safeguards.
Patients must request the medication twice, verbally, over a period of 15 days, and then once in writing, and have two witnesses (including one who would not stand to inherit money from the patient). If the doctor believes a patient suffers from psychological problems or depression, he or she would have a psychiatrist or psychologist make a determination.
“Dementia and mental illness are not terminal illnesses," Burzichelli said.
Burzichelli also said Oregon health officials say only 249 patients applied for the lethal drugs last year and many chose not to use it. “The argument that people will be pressured to die has always been a red herring,” he said. “Those who are against it are not looking at the facts but are looking to strike an emotional note.”