Measure Would Create a Thorough Process to Allow Terminally Ill Patients to Choose Their End of Life Option
The New Jersey Aid in Dying for the Terminally Ill Act, sponsored by Assembly Democrats John Burzichelli, Tim Eustace and Joe Danielsen, continued advancing on Thursday, moving New Jersey one step closer to creating a process for terminally ill patients wishing for medicinal assistance to end their lives.
The bill (A-2451), which was approved by the full Assembly in October, was approved by the Senate Health, Human Services and Senior Citizens Committee by a vote of 5-3-1.
“This discussion is about revisiting a statute last looked at in 1978 that never took into account an individual’s right to control their body and their circumstances,” said Burzichelli (D-Gloucester/Salem/Cumberland). “Like society, medicine, palliative care and hospice services have changed dramatically since then. While there are many choices available right now that may be right for certain people, there is one more choice, not currently available, that deserves an honest discussion.”
The bill would require patients suffering from a terminal disease to first verbally request a prescription from their attending physician, followed by a second verbal request at least 15 days later and one request in writing signed by two witnesses. In addition, the attending physician would have to offer the patient a chance to rescind their request. A consulting physician would then be called upon to certify the original diagnosis and reaffirm the patient is capable of making a decision.
A patient must have a prognosis of six months or less to live to request and be prescribed medication under the bill.
“There are many strong opinions on this issue, but the truth is, only these patients understand what it is like to know death is approaching and have your last few months of life riddled with pain and angst,” said Eustace (D-Bergen/Passaic). “These patients have been betrayed by their bodies in the worst way. Death is inevitable, but for these patients, it is precise. Rather than waiting for the inevitable in pain and misery, this bill gives terminally ill patients the choice to meet their end on their own terms. We cannot prevent them from dying, but we can at least allow them to do it with dignity.”
“This is the humane approach,” said Danielsen (D-Somerset/Middlesex). “Permitting qualified terminally ill patients to self-administer medication to end their life in a dignified manner is something we should allow.”
The bill defines a “terminal disease” as an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, result in a patient’s death within six months.
Specifically, the bill provides that a patient may make a written request for self-administered medication in order to end their life in a humane and dignified manner if the patient:
1) is an adult resident of New Jersey;
2) is capable and has been determined by the patient’s attending physician and consulting physician to be suffering from a terminal disease; and
3) has voluntarily expressed a wish to die.
A valid request for medication under this act must be signed and dated by the patient and witnessed by at least two individuals who, in the patient’s presence, attest that, to the best of their knowledge and belief, the patient is capable and is acting voluntarily to sign the request. Only the patient would be permitted to administer the drug themselves.
At least one of the witnesses must be a person who is not:
1) a relative of the patient by blood, marriage, or adoption;
2) at the time the request is signed, entitled to any portion of the estate of the qualified patient upon the patient’s death under any will or by operation of law;
3) an owner, operator, or employee of a health care facility where the qualified patient is receiving medical treatment or is a resident; and
4) the patient’s attending physician at the time the request is signed.
“Statistics from other states that have enacted laws to provide compassionate aid in dying for terminally ill patients indicate that the great majority of patients who requested medication under the laws of those states, including more than 90 percent of patients in Oregon since 1998 and between 72 and 86 percent of patients in Washington in each year since 2009, were enrolled in hospice care at the time of death,” Burzichelli said. “This suggests that those patients had availed themselves of available treatment and comfort care options available to them at the time they requested compassionate aid in dying.”
The bill additionally requires that the patient’s attending physician, at the time the patient makes an initial oral request for medication under the bill, recommend that the patient participate in a consultation concerning additional treatment opportunities, palliative care, comfort care, hospice care, and pain control options, and provide the patient with a referral to a health care professional qualified to discuss these options.
The attending physician would be required to document the recommendation and referral in the patient’s medical record, indicate whether the patient chose to participate in the consultation and indicate whether the patient is currently receiving palliative care, comfort care, or hospice care.
Also, the bill provides that a person would not be authorized to take any action on behalf of a patient under the bill by virtue of that person’s designation as a guardian, conservator, health care representative or patient’s representative, except for communicating the patient’s health care decisions to a health care provider at the patient’s request.
And, theft of medication prescribed to a qualified terminally ill patient under the bill would constitute theft of a controlled dangerous substance, which is a crime of the third degree if the amount involved is valued at less than $75,000 or in a quantity of one kilogram or less. A crime of the third degree is punishable by imprisonment for three to five years, up to a $15,000 fine, or both.