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Congress, get it right for dying Americans

The following op-ed appeared on CNN.com on July 27, 2017:

If you’re a legislator trying to repeal a health care law that passed with overwhelming support from both lawmakers and their constituents, you should at least read the law and know the facts about it.

Apparently, Maryland Congressman Andy Harris, a practicing anesthesiologist, does not think this common-sense standard applies to him. On July 13, the House Appropriations Committee approved an amendment he authored that would invalidate the D.C. Death with Dignity Act, which passed in 2016 by a large majority on the DC Council after over a year of debate.
It gives mentally capable, terminally ill adults in D.C. with six months or fewer to live the option to get a doctor’s prescription for medication they can use to die peacefully in their sleep if their suffering is unbearable.

It is not, as Congressman Harris calls it, “physician-assisted suicide.” According to the provisions of the law, “Actions taken in accordance with [the Act] shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide,” and the law also spells out multiple ways in which patients, not physicians, maintain agency and control over the process at each step.

If the effort to repeal D.C.’s law succeeds, history shows it will inspire opponents of medical aid in dying to seek a nationwide ban on this end-of-life care option. They essentially tried to do it twice in the past by introducing the Lethal Drug Abuse Prevention Act of 1998 and the Pain Relief Promotion Act of 1999. Both of these bills would have prohibited physicians from prescribing classes of medication subject to the Controlled Substances Act for medical aid in dying.
Thankfully, both bills failed to become law, but as the saying goes, “What’s past is prologue.”

Earlier this year, nationally syndicated National Review columnist Wesley J. Smith urged one of the champions of a previous effort to repeal the D.C. law to introduce and pass similar legislation “to prevent federally controlled substances from being prescribed” for medical aid in dying.

If Congress passed such a federal law today, it would invalidate medical aid-in-dying laws in six states representing 18% of the nation’s population, according to 2015 Census data: California, Colorado, Montana, Oregon, Washington and Vermont, as well as legislation introduced in New York and 25 other states.

The sad truth about this effort is Congressman Harris’ statement to introduce the bill in committee is filled with inaccurate information, which anyone can verify by watching it on YouTube or by watching our fact-check video here. For example, Dr. Harris erroneously claims: “…this policy in D.C. differs from other states that have done it, which makes it an even worse policy the way it’s done here.”

In fact, the D.C. law is almost identical to the Oregon Death with Dignity Act that it is modeled after. Both laws feature more than a dozen safeguards, including to prevent depressed people from getting aid-in-dying medication. Medical aid in dying has been safely practiced in Oregon,California, Colorado, Montana, Washington and Vermont for a combined 40 years.
Harris also wrongly claimed terminally ill people are “gonna come [to Washington, D.C.] to get a lethal injection.” And that it allowed “doctors to play God.”

The truth is that ill adults who qualify for the medication do not inject it; they ingest it and die peacefully in their sleep. Rather than enabling a doctor to play God, the law takes the power away from the doctor, and puts it in the hands of the patient. In fact, the law’s text unequivocally states: “Nothing in this act may be construed to authorize a physician or any other person to end a patient’s life by lethal injection.” Furthermore, tourists to D.C. cannot use the law; only D.C. residents can, as the law’s text also makes clear.

Congressman Harris is among a minority of physicians who oppose medical aid in dying. Physicians support this end-of-life option by a nearly two-to-one margin (57% to 29%), according a Medscape survey last fall of more than 7,500 doctors from over 25 specialties. National and state medical societies are responding to this physician support by adopting supportive policies or opting not to take a position, including the Medical Society of the District of Columbia and Maryland State Medical Society.

D.C. Mayor Muriel Bowser announced the law’s going into effect on July 17 and said it would remain in effect until Congress either passes or rejects the repeal amendment.

If Congressman Harris is successful at advancing his amendment, dying D.C. residents will be deprived of the peace of mind that this law brings from knowing that they do not have to suffer needlessly at life’s end.

I hope that other members of Congress will act responsibly, read the D.C. law closely, and look at the evidence and data showing there has not been a single incidence of misuse in a combined 40 years of experience with similar laws across six states.

Furthermore, I hope Congress will respect the values and priorities of the residents of Washington, D.C. — and the
American public — both of whom support medical aid in dying by overwhelming majorities across the political and religious spectrum, according to recent polling.

Finally, members of Congress should remember this vital fact: this law is entirely optional. Only people who want to use the law, use it. Allowing this law to remain in Washington, D.C. merely means that we are allowing a person who is already going to die the option of deciding how and when they spend their final day. It is not just good policy. It is compassionate policy.


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