New Jersey has failed dying Americans
The following op-ed appeared in the New Jersey Record on January 14, 2018:
With November’s elections behind us, the New Jersey’s new governor, Phil Murphy, and the Legislature are in a unique position to take on a pressing issue crucial to the residents of New Jersey – improving end-of-life care and expanding options.
Despite people’s widespread desire to die at home, research shows Garden State residents spend more days in the hospital during the last six months of life than residents in every state except New York. New Jersey also lags behind many other states in its hospice usage rates, and it has higher incidence of hospice misuse than many states.
Since 2012, New Jersey has been debating – but has not enacted – a public policy solution that history shows can improve these trends: the Aid in Dying for the Terminally Ill Act. This bill would allow a mentally capable, terminally ill adult with six months or fewer to live the option to request a prescription for medication they can take to die peacefully in their sleep if their suffering becomes unbearable.
While America’s healthcare leaders remain focused on improving end-of-life care through provider-focused policy and programmatic changes, evidence from the past two decades suggests that the most effective way to transform the end-of-life experience is through a consumer-empowerment approach: the authorization of medical aid in dying to be exact.
A look at Oregon, the first state to authorize medical aid in dying in 1997, explains why. By law, doctors are required to counsel patients on all available end-of-life care options, including hospice and palliative care, before writing a medical aid-in-dying prescription. In the end, dying patients often choose other end-of-life care options, such as hospice or palliative care.
The Oregon law also is credited with contributing to more open conversations between doctors and patients about end-of-life options, higher hospice utilization, lower rates of hospice misuse, and better palliative care training of physicians. These are the same benchmarks that New Jersey is falling short in. So the law not only gives dying patients autonomy, it has the potential to transform the entire end-of-life experience for all patients – even those who don’t use the law.
Passing the Aid in Dying for the Terminally Ill Act would give lawmakers in New Jersey the opportunity to pass a much needed, popular law. A 2015 Rutgers-Eagleton poll showed that New Jersey residents supported a state medical aid-in-dying bill by more than a 2-1 margin (63 percent to 29 percent).
Medical aid in dying has been safely practiced in seven jurisdictions – Oregon, Washington, Montana, Vermont, California, Colorado and Washington, D.C. – for a combined 40 years without a single case of misuse.
The law has withstood the test of time because it is carefully crafted. More than a dozen regulatory requirements protect dying patients. The practice is also entirely optional – for both the doctor and the patient. Only people who truly want to use the law actually do. The reality is we know based on data from the six states where medical aid in dying is authorized that less than 1 percent of people will choose to use the law, but merely knowing the law exists brings peace of mind to many more.
As a New Jersey native, I urge state lawmakers to respect the wishes of their dying constituents – even if they differ from their own – and pass the Aid in Dying for the Terminally Ill Act. Actively dying residents of New Jersey don’t have the luxury of continued deliberation. Through passage of this legislation, they will gain autonomy, peace of mind and improved end-of-life care.
Kim Callinan was raised in Oradell. She currently is the chief program officer for Compassion & Choices, the largest national organization devoted exclusively to patient-driven end-of-life care.