2021-10-01 00:00:00 - Joint Committee on Public Health
2021-10-01 00:00:00 - Joint Committee on Public Health
(Part 1 of 3)
SHOW NON-ESSENTIAL DIALOGUE
Good
morning this committee, the joint Committee on Public Health will come to order for today's hearing again. You are warmly welcome to this remote public hearing of the committee. My name is joe Comerford, I represent the Hampshire Franklin Worcester district. I have the honour of being the Senate chair or co chair of this committee and with me today as house co chair Representative marjorie Decker from the city of Cambridge, I'm very honored to chair this committee with rep Decker Welcome to Senate committee members. Vice chair, Senator Susan Moran and senators Harriette Chandler becca Rausch Julian sear and patrick O'Connor Um Thank you to my colleagues and now I'm going to invite the House Vice chair. Mr. Vice chair brian Murray to recognize the house members over to you. Mr. Vice chair.
Thank you, madam. Chair, appreciate the introduction and look forward to the hearing on this. Very important bill. Um is I see the
participants from the house on the listing the company.
Um I see Representative Vienna Howard
Um
and I'm not sure I have an indication of any other house members but if they are here um they can certainly introduce themselves. Thank you. Thank you so much. Mr Vice chair. Do we have House members that want to make your presence known. Oh actually I see rep paul Schmidt here,
I see you waving rep Schmidt welcome. Thanks mr. Vice chair. Um So as the Vice chair said rightly, I also just want to thank everyone. This is rep. Jack Lewis I'm135 here as well. Hello rip Lewis So good to see you um.
Oh good morning representative. Very good, good morning. Um So as the vice chair said, we're going to hear testimony on a very important bill. There are two parallel bills pertaining to end153 of life options in today's hearing. Um As the sponsor of the Senate bill, I do personally believe this, this bill strengthens personal autonomy by allowing terminally ill adults to choose how they end their life. Um and I'm honored to cho file this Bill Representatives O'Day and Mahoney And so today friends, we're going to hear from people on all sides of the issue and this committee made up of really good humans, is going to listen hard and carefully to the testimony um on on every side of this issue, on the continuum, everything you say today matters to us before we proceed. Um I would like to remind everyone that muting while you're not speaking is critical to the well being of the hearing. It helps with line quality, it helps us listen. Um Sometimes we204 forget to a mute that's okay, we'll remind you but that mute button looks like a microphone somewhere on your screen. Um So thank you so much for doing that. I'm going to for my colleagues in the hearing today. Uh Chair Decker and I will happily recognize you for questions after each speaker or panel um in the case of testimony by panel, we just ask that you hold your questions until the entire panel has concluded. Um and I'll try to remember and I'm sure chair Decker will try to remember to tell you if there's a group of people going we're going to look for raised hands so using the raised hand function. But in the event that I or chair Decker mrs someone please feel free246 to a mute um and jump in so that we don't miss the opportunity to hear your question or feedback. We're concerned. Um For the attendees. Um for those testifying today, your testimony is critical to the work of this committee. Um I will respectfully ask that as266 was indicated. You limit your testimony to no more than three minutes. You will hear a beep or a chime or some other sound when your time is up. So you're going to hear that and I'm going to listen for it to and help you end your testimony. If you go beyond that time, We have more than 135 people signed up to speak. So we're going to have to hold to this time by necessity uh so that everyone has the opportunity to be heard in a reasonable amount of time with no delays. This hearing will run a minimum of eight hours today. So we're mindful of the people at the 8th. Our um and their well being. So that's the time limit and the fairness. Um Thank you so much309 to L. I. S. And our staff, public health fellows and interns helping today's hearing run. Well we're looking out for you those of you who have come to testify. Um So uh and we're taking notes and timekeeping again to make everything run like clockwork. If there is additional written testimony that you'd like the committee to consider, you're warmly welcome to submitted by email. Um There is no length um for written testimony. Uh you know so the written testimony can go on338 as long as you like. It's just your verbal testimony that is limited. Um And the instructions are on the legislature dot gov website for the Public Health committee under the hearing tab. So you'll see it about how to do it, how to submit your written testimony. The custom of this committee is to allow legislators to testify out of order. That means they we take them when they are available to speak with us. Many are chairing their own hearings. Um And so thus we offer that courtesy to our colleagues to slip in um and offer their thoughts um on this legislation when they are able I'm going to try to give people advanced notice ahead of your time to speak. So you have time to prepare. So I'm going to let388 folks know three or five people in advance where the lineup is. And again that's so that you can prepare and plan yourself and a mute yourself only when it's your turn to speak. Um So with that I'm just looking to see who is on from our legislative colleagues.
Right.
Just give me one moment. Do we have Representative O'Day here
You do madam. Chair. Good morning. Representative O'Day It is my pleasure to welcome you.429 Thank you so much for your work.
[REP O'DAY:] [HB2381] Thank you and truly my pleasure being here with all of you and thank you so much to the committee and certainly to Chairwoman Decker in yourself for bringing this really important piece of legislation forward. So early in the session, I think that really speaks volume to the recognition of the importance of this piece of legislation. Um, and if you don't mind, I would ask personal preference please if Representative Philips would be able to follow me to the microphone. Um, if that's acceptable, that would be greatly appreciated. I'm here this morning to speak on House 2381. An act relative to the end of life options right now in massachusetts, excuse me, terminally ill patients are limited to make their own health decisions. Medical aid in dying is illegal in our state and people are suffering. This bill seeks to turn that situation around Nearly 70% of Massachusetts residents support the right of terminally ill patients to choose medical aid in dying. I believe nationally that numbers around 74%. So with With polls that have been asserted here in the Commonwealth and nationally.
We range between 70 and 74% in favor of this520 type of legislation. As you all know, A similar bill was525 defeated in 20 12, I believe it was by a very, very531 close margin, 51-49% uh humbly state that I supported that piece of legislation going back some uh, 10 years ago, nine years ago. Critics of this bill, we'll tell you that it is not safe, will be used to kill off the elderly, which is grossly551 untrue this bill in its current iteration as numerous, numerous safety points contained within the language of the bill. In that the bill clearly defines what medical aid in dying is and who is a consulting physician as it relates to the terminology of being terminally ill. First of all, the bill clearly defines what medical aid in dying is and who is a consulting physician. Medical aid in dying is the medical practice587 of the consulting physician prescribing lawful medications to a competent, terminally ill patient, very peaceful death competition. A terminally ill patient, confident, competent. Excuse me. In that uh, you as a terminally ill patient needs to be deemed competent by a medical provider in order to make this decision.
So if for example, you are someone who regrettably met a terrible accident on a motorcycle or an automobile and you're incapacitated and you cannot speak and you cannot tell someone whether or not you would like to have your, your life ended medically. This does not. Um, this does not address those kinds of situations. So this, this particular piece of legislation only addresses those who have been deemed terminally650 ill by a physician. And that individual has the capacity before mental capacity to a make a written statement with, with two, um, with two individuals, two witnesses to that signing of the written statement and also be capable of making an oral statement. Who your, your physician that you want to have the, the option, the option of ending your life with medical aid. I know that there are some individuals that this particular piece of legislation um, troubles them because of some religious beliefs or affiliations. And what is great about this piece of legislation is that it's not mandating anything to anyone.
If you are of a religion, who you feel this is not for you when you are at the end of your life, you do710 not have to take this option. This is not anything that's being mandated upon anybody. But my strong feeling is if this is something that you do not support, I don't believe that your opposition to this piece of legislation should prevent me. Should I be someone who was interested in taking advantage of a piece of legislation of this nature that I should be able to as an individual here in the commonwealth of massachusetts, be able to, in my full capacity in my ability to write the statement to speak into my presiding, uh, uh, that doctor that I am not interested in in extending my life through some probably long term hardcore long term suffering. So it is for those reasons that I strongly urge this committee uh to move this bill forward. And I thank you for your time this morning and giving me the opportunity to come and speak to the committee. Thank you.
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Thank you very much for your leadership questions are bitchy.
Mhm.
I see none of793 this moment representatives, so I'm going to go on as you asked the Representative Philips then I'll call798 reparable call Senator Lovely and Senator Moran after Representative Philips
[REP PHILLIPS:] [SB1384] [HB2381] Thank you806 so much. Chair Comerford Vice chair Murray esteemed members of the committee. It's a privilege to be with you today to testify in support of House 2381 and Senate 1384 which I've worked on his House staff and now state representatives since my predecessor originally filed the bill in 2000 and eight. In the past we've heard or William visions of our future surrounding this bill, in which faceless government bureaucrats make827 life or death decisions for a broad swath of the population based solely on cost. Nothing could be further from the truth Over the last 13 years. We've worked diligently to continually tweak and revise the language of this bill so that there is no ambiguity surrounding the population that this law will affect this decision cannot be made for you. In fact we've made it extremely difficult for you to even be allowed to make this decision. And there's a number of hoops that you have to jump through before then you have to be diagnosed with a terminal illness and a six month prognosis must be confirmed by not one but two doctors.
You have to be deemed of sound mind. There has to be not one but two separate requests for this medication with a defined interval between them and the individual must be able to self administer this medication. We do not make this easy if you have a chronic condition or disability, you878 are not eligible for this. If you can't communicate the request to yourself, you are not eligible for this. And even if you are and you do request this medication, you're under absolutely no obligation to take it. In fact, nearly a third of the people who make this request in other states decide not to use it, but instead they died with the peace of897 mind knowing that they remained in control of899 their own destiny. I hope that you will agree that the time has come for the Commonwealth to903 join the 10 other states and the District of Columbia that have provided this choice to their residents. And I would strongly urge you as leaders outdated to report the bill favorably and I'm happy to take any questions that you may have. Thank you.
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Thank you. Representative very much for your testimony. Questions for the Representative.
I see none rep Philips But thank you so much for926 your assistant testimony. Thank you for your support of the bill. I'm looking now for Senator joan932 lovely, is senator lovely with us.
Okay no worries. We'll come back to the Senate available. Vice Chair Susan Moran Vice chair, are you here?
[REP SUSAN MORAN:] [SB1384] [HB2381]I am that there. Thank you so much for the opportunity and thanks to rep Decker as well. I respectfully request that House 2381 and Senate 1384 and act relative to end of life options be released from the Joint Committee on Public Health with a favorable recommendation. This bill allows a term innocently ill, mentally capable adult with a prognosis of six months or less to make the choice to request, obtain and take medication to die peacefully in their sleep if they're suffering becomes unbearable. The bill includes regulatory procedural requirements including mandatory written993 and oral requests for the medication, witnesses to the written request, confirmation capacity by a licensed1002 mental health specialist and compliance with medical documentation requirements. In addition participation in end of life options are entirely optional for physicians, health providers and pharmacists when so much is out of control. For individuals with a prognosis of so less making this choice available gives them some level of autonomy in their decisions at the end of life. This is not to say this is a decision without oversight. It is a choice that must be made with oversight by mental health specialists and voluntary participation by health care professionals. But
But it is a decision that a person may assert once they have received a prognosis that their life will be ending, allowing this choice empowers the patient to make a decision with dignity and in the time frame of their choice, the benefit is not just limited to the patient based on research conducted in states who have this choice available. The choice promoted family discussions of difficult topics surrounding death and families reporting feeling more emotionally prepared for their family members death. This is of course a difficult topic, but the commonwealth would not be the first to make this option available. Medical aid in dying as we have heard, is also available in 11 jurisdictions. We can work to grant patients the control1099 of their own decisions with the advice and consent healthcare professionals and remove ourselves from the equation. I hope to work together with you. So the commonwealth can be the1112 next to provide this auction to patients in their last six months of life, your attention and assistance. This matter is appreciated. I'll be happy to answer any questions and submit in writing. Thank you, madam. Chair.
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Vice Chair. Thank you questions or comments for the Vice chair
seeing none madam. Vice chair. Thank you. I now warmly welcome Representative Alan Silvia please. Representative I see you on.
[REP SILVA:] Thank you, Madam chairs and members of the committee. Um I come before you today in opposition of this bill. Um This is not my first time1161 before this. The Committee on Public health with regard to this. Uh this bill uh was of course called several names in the past um and I will be extremely brief. Uh There has been remarkable advances in palliative care also. Um the legalization of assisted suicide would pose unnecessary conflict for those patients with disabilities and it distorts the goals of health care professionals. Um you know the words of dignity, mercy compassion are used to disguise um the taking of one's life suicide. And I asked that this bill not be1215 moved forward to the committee and I thank you for your Felicity. Thanks
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thank you. Representative testified before the committee questions or comments for the Representative.
Mr Representative seeing none. Thank you again and we'll move on appreciate your testimony. Um I am now looking for Representative Oliveira please jake Oliveira
[REP OLIVEIRA] [SB1384] [HB2381] Good morning. Thank you. Chair Comerford Chair Decker Members of the committee. I'd like to speak in favour of House 23 81 Senate bill 13 84. I'd also like to thank the co sponsors of the legislation. Leader. O'Day Chairman. Mahoney Representative Philips and of course you madam Chair for filing this bill on the senate side and I want to also recognize former Representative cafta for carrying the ball on this legislation for many years. If there's one thing that binds us all together, it's our mortality as grim as it might sound. The one thing that we will all faces end of life. The two bills before this committee today provide options to the individuals as we face. End of life options for people with terminal illnesses.
My best friend, someone that I love in recently years lost both her father and her mother to terminal cancer and she sat there and watched them suffer in great pain as they as she as they as they face into life as someone seeing someone that you love face that suffering, giving the tools and options to the individuals to make a decision about their own health as they face. And the life is something that I think we need to give to the individuals of the commonwealth. That is why I'm proud to say that I'm a co sponsor of this bill and I hope that this committee recommends a favorable opinion of both of the bills. Thank you again, madam. Chair for the opportunity.
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Thank you. Representative questions or comments for the representative.
I'd like to make a department. Oh, I'm sorry. Um let's seek are you a member of the committee? I can't see who's speaking. Um This is Vonda Hamilton and1345 I signed up to speak today. Thank you so much. We we only take questions or comments from committee members. That's our hearing process. You'll get absolutely your time to speak. Um So thank you so much and I'm going to move on to a panel now. We have a four person panel Um So I'm going to call john Berkowitz Stanley handymen, jerome Madaro Lee and dr patty Gamberini please. This is a panel of four. Please lead off with the first person.
Is the panel available?
Yeah.
Okay. All right. I'll come back to this panel. Um man I spoke before and I couldn't hear what your response was to me. I just wanted to speak on behalf of not supporting the bill. My husband was Okay ma'am, I've muted you because we are going in order of speaking and you're absolutely get your time to speak on the hearing. Ok, I'm going to call a second panel. We'll come back to this first panel. The second panel is another four person panel john kelly. Anita Cameron, ruthie pool paul spooner is this panel available? Yes, this is really cool. I'm available. All spooner I'm1441 available. Just yeah, john kelly I'm available but Anita Cameron might need to come back later. Um That's fine. We'll accommodate. Please kick off so you each have three minutes and we will um time you based on our own timing. Thank you so much.
[JOHN KELLY:]1462 Thank you. Ah I'll lead off our panel will show some of the problems with assisted suicide laws from disabled perspective perspectives. Everyone knows that doctors make mistakes and studies show that 12-15% of people outlive the six-month hospice benefit for supposedly terminal people But this year Oregon revealed that only 4% of its program participants have lived past six months. This suggests that a substantial number up to one in 10 ended their lives prematurely because they trusted their terminal diagnosis. For someone who1502 barely escaped a terminal misdiagnosed as with their life. See the 2011 boston globe letter budget that hall no one would tolerate any other elective, so called medical practice. This deadly. The 2012 ballot question on assisted suicide shows a class and race ethnic divide, wealthier towns in favor more working class towns, both white and of colour against Brookline, 67% in favor heavily latino X. Lawrence 69% against Black and Latino X people have long opposed assisted suicide by more than 2-1 and often have a well earned mistrust of the medical system.
These laws make dominant the outlook of a professional class, obsessed with the individual achievement, autonomy and status. Thus the constant use of the word dignity over the world view of a working class that relies on a family support system, connection and reverence for elders. By undermining the value placed on old, ill and disabled people. These laws promote writing off writing off people as having too low equality of life. I would like1579 to point to the overwhelming oppression of people living with disabilities. Mainstream reactions to the death toll of COVID-19 were filled with reassurances like only old and fragile people are dying. We don't need to worry.
People like me serve as examples of better than the disabled in movies like me before you, whose life is it anyway. And the sea inside the Oregon report showed that assisted suicide is not about physical pain, it's1612 about escaping the quote unquote existential distress that some people experience Over depending on others of feeling undignified and like a burden of being incontinent as leading purveyor of assisted suicide. Lonnie shall Wilson told the Washington Post in 2016 quote, it's almost never about pain. It's about dignity and control. Shavelson should know. He is the chair of the newly formed american clinicians Academy on Medical Aid in dying. I just have one paragraph and someone paralyzed below the shoulders.
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You know, please do step, Please do send in your1653 written testimony. We're going to keep this as fair as we can and move on to the next Panelist. Thank you.
[RUTHIE POOLE:] Thank you. My name is ruthie poole and I'm the president of empower a statewide group made up of people with lived experience of mental health diagnosis, trauma and addiction as people with psychiatric disabilities. Empower members feel passionately about the rights to self determination. However, that's not what this bill is about. It's not uncommon for people with disabilities and elders who may not be physically well to feel like they're a burden on their families. Prescribing doctors in Oregon last year reported that more than half of programs,1696 suicides felt like a burden on family friends or caregivers sadly if physician assisted suicide were to become law in massachusetts, some people may be coerced1708 either subtly or more obviously by their families to agree to this. The bills have a provision requiring people requesting assisted suicide to have a counselling appointment to determine that the person is capable and not suffering from a psychiatric or psychological disorder or depression causing impaired judgment. Historically, people with psychiatric diagnosis have been subjected to all forms of legal and extra legal coercion often abetted by these same professionals. Gatekeeping professionals continue to underestimate our capabilities and block us from living our own lives based on these experiences.
We cannot trust that councillors will have our best1755 interests in mind when evaluating our motives for requesting assisted suicide at the same time, people in the midst of a severe depression can usually present as unimpaired, especially in a single meeting with an unknown counselor. Yes, those of us in empower know that depression is insidious. We know that depression does impair judgement as a therapist once told me, depression does not cause black and white thinking it causes black and black are thinking absolute hopelessness and seeing no way out are common feelings for those of us who have experienced severe depression personally, as someone who's been suicidal in the past, I can relate to the desire for a painless and easy1803 way out. However, depression is treatable and reversible suicide is not. We applaud. I applaud the joint Committee on Public health and legislators have worked to expand funding for suicide prevention efforts. Passing this bill would be a slap in1820 the face of those efforts. Suicide contagion is real and he assisted suicide program will send the message to people with mental distress, old, young, physically ill or not that suicide is a reasonable answer to life's problems. It isn't. We urge you to give this bill and ought not to pass. Thank you.1843
[PAUL SPOONER:] Good morning. My name. My name is paul spooner. Um, a number of you know me, I'm the executive director of the Metal West Center for Independent Living in Framingham. I've worked in disability rights and advocacy1866 for over 401868 years in Massachusetts, both on a state and national level and I'm here to speak in general opposition to these bills. But I want to put a personal flavor to this because I1885 think with all due respect on how very specific this bill looks at the balancing of ensuring people are fully involved in the decision making process, relying on the medical profession to intervene to determine to analyze the request equally is the issue I have a problem with. I have a disability that I acquired as a child. I was told by doctors. I would not live to B 30 years old. I'm 66 now. Where are those doctors? 10 years ago, I had massive respiratory failure. I was on a ventilator for nine days.
There were days when people didn't think I would survive well here1947 I am today testifying in front of you. I still work full time and I use oxygen 24 7. My point is is that in many cases we cannot determine a finite Day for someone who's terminally ill or severely disabled with multiple medical conditions as to when they're going to die. So I have a suggestion for this committee to consider if you're going to go forward with this bill. You need to include a provision in the bill that would allow advocates such as myself, People who work at the 10 independent living centers across the Commonwealth to provide some community options counseling to those individuals who could then learn what is available for supports such as personal care, home health aides, homemaker services to live in the community as opposed to dying. Thank you for this opportunity to speak.
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Thank you so much for your testimony. Very, very grateful to you all. The fourth person is in my correct that the fourth person is not able to join you. Not yet. Okay, very good. Will accommodate that person when they come. Um, so please do have them be in touch with the committee uh, questions or comments for the panel.
I see none at this time. Thank you so much for your service and your testimony. I'm going to call four people now. So this is sort of an on deck list and then I'll take another paddle. Um, I have melon knew it. Sorry. if I mispronounced that name, Michael King a genesis uh, Swindle hurst swindle hurst, Betsy Louise. Symons. Um, do we have melon?
Yes, you do very good. Thank you so much.
[MELYNN NUITE:] Good morning. And thank you madam. Chair woman for allowing me to speak today. I am a proponent of age 2381 S 1384. Um, I have had the great fortune to be a nurse and a2107 patient advocate for more than 30 years. Death is a part of the life cycle, a part that is2113 greatly avoided. We are overjoyed to welcome babies with love and open arms. We are very dismissive to welcoming and embracing death. The sadness is too great, but the sadness2126 is not the reason for allowing reasoned well thought out. End of life decisions. Death with dignity is you mean for God's sakes? We have a dignified death for our pets. Why don't we have it? If we have it for our pets, then why we must we let our human counterparts suffer in numerous of their states that have passed death with dignity laws. There have not been hundreds and thousands of deaths. What I have seen is such death with dignity laws have made2157 it acceptable for all health care providers to speak about death with their patients in an open, caring and loving manner. Conversely, patients broached death conversations with less fear and anxiety patients don't believe that they are letting their caregivers down by talking about death in an open fashion.
There are diseases that are sad, debilitating awful diseases, seeing the progressions of such diseases as heart wrenching those under my care and those that I advocate for are fully entitled to death with dignity or not to choose2199 death options for them. And let me be clear. Hospice and palliative care services are not equivalent to these proposed laws. Hospice services and programs are essential to end up life. But this proposed law will allow more choice, more compassion for the severely chronically diseased with short life expectancy. The 2012 defeated on the wrong side. Let us this year be on the right side as my legislators. You certainly want to be on the side of allowing death with dignity. Move forward today in passing H 2381 S 1384. Thank you,
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thank you so much for your testimony. I appreciate it. Um the list I read earlier, Michael King, Janice, swindle hurst. Um Betsy Louise Symons is still in place. We are going to now take Senator joan lovely out of turn as I explained, we do Senator, lovely. You're welcome.
[SEN LOVELY:] [SB1384] [HB2381] Thank you madam Chairwoman to you and and Chair Decker and the and the committee. Thank you for taking me out of order. I offer my support for S. 1384 and H 2381 and act relative to the end of life options filed by you madam Chair. Um these two bills are critically critically important and they would ensure that those who have been diagnosed with a terminal illness can choose to end their lives without during further2295 pain and suffering. According to a poll conducted by the Boston Globe and Suffolk University, seven out of 10 Massachusetts residents agree that terminally ill individuals should be able to end their own lives with the aid of a doctor. While this option will not be right for every person who has a terminal illness, I believe that they should have the option to end their lives in their own terms. I have met with many advocates and constituents in support of this legislation. I was particularly moved by dan Diaz, who shared his2321 wife, Britney's end of life story, Britain was diagnosed with terminal brain cancer about a year after they were married.
The couple ultimately chose to move to Oregon where2330 medical aid in dying is legal. They chose this not because Britney had given up, she hadn't Britain desperately wanted to live, but her suffering had had become so severe that she sought treatment on how to stay alive. But as she sought treatment on how to stay alive, she knew she needed the option of being able to end her life and end her suffering, which is ultimately, sadly what she did since his wife's death, Dan has worked to promote the passage of this legislation so that others who are faced with terminal illness are not forced to2360 move to another state to ensure peaceful and painless end of life medical aid in dying would give individuals with terminal illness or disabilities a full range of medical appropriate options to plan for end of life For these reasons. I respectfully request the committee's favorable consideration again. Thank you so much. And I'm happy to answer any questions.
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Thank you. Senator. Lovely questions or comments for the senator.
Okay, seeing none. Senator. Thank you so much. Yeah. All right. Friends were back to the list. I'll take Michael then Janice, then Betsy. And then on deck is a panel the massachusetts catholic conference panel and we have two individuals on that panel. Michael Hi, this is my good morning, Michael. King works with my office and he's asked me to testify in his place. He couldn't make it today. I'm signed up as well. Um, having to take his place now to keep things moving along.
Mr Beckwith. So Mr mr King is not available. That's correct. He was going to testify today. Something came up, but he and I work in the same organization has asked me to testify on his behalf. Okay, very good. So we'll take you off the best wherever you are.
[ANDREW BECKWITH:] Thank you, ma'am. I appreciate that My name is. Andrew Beckwith him the President of massachusetts Family Institute. We've been advocating for life from conception to natural death here in the commonwealth for over three decades and I do have as well. President General counsel. I have some specific concerns about the wording of the bill. We oppose it uh, in general, but I do want to point out some concerns that we believe make it in addition to just bad policy in general, particularly in light of the The COVID-19 pandemic and all the stresses on the healthcare system and the ideas of healthcare ration that come from that. This is a particularly bad time. Even be talking about this. It's somewhat shocking that we are. Um, but I want to point out some things that I think everyone really needs to think about. Even if they favor this bill. The first is In line eight when it discusses the definition of the medical care for assisted suicide, it says that the patient may choose to self administer. So2497 that's very concerning because it means that someone could take these lethal drugs home and either do it themselves2507 alone, where they they end up suffering even more. But also someone else could use those drugs in a way that is lethal and perhaps
Make them subject to abuse. That. Combined with the fact that this language again, we've been warning with this language for years on lines 14 and 15 that said that people can request this drug requests suicide through2535 individuals familiar with the2538 patients manner of communicating if those individuals are available. So if someone themselves is not able to request the drugs because they can't talk or there's some cognitive deficit other individuals can request on2550 their behalf, take the drugs home and then administer it to the sick individual. Again, especially where this involves people older2560 an age possibly with dementia very concerning for potential abuse. We've also seen that uh suicide, the idea of suicide taking one's own life is a social contagion. Um2574 there's city see report from 2010 that shows that increase overall and suicides By 49% in Oregon after the passing of assisted suicide there.
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Thank you so much for your testimony. Well, warmly welcome your written testimony. Um and appreciate you coming in. Thank you. Thank you so much. Um Okay so we're our list is now Janice Betsy and then James and M. C. Sullivan from the massachusetts, catholic conference Janice.
[JANICE SWINDLEHURST:] Good morning.2607 I want to thank you for the opportunity to testify before this committee. I am a passionate supporter for the end of life options act and I appreciate the chance to tell you why my mom died in a nursing home on January 20, 2020 after a lengthy decline of 11 years. I was my mom's advocate and executor. I oversaw her journey from her own home to assisted living Where she was first admitted to palliative care than to hospice and finally to a nursing home where she continued to decline for another 19 months. I've lost friends to cancer who also have had long and agonizing declines from illness to death. I wish the endings for my mom and my friends could have been eased if this act was law in massachusetts at the time of their illnesses and if they chose the option through my own reading and work with death with dignity, I know as grateful as I am for palliative care. It often is not enough in many instances to relieve pain and suffering. Although I assume my mother felt no pain during dying. I cannot really know.
I did watch her frantically try to clear fluids from her mouth and throat, which she was unable to do and know that she felt as if she was drowning or choking. It brings tears to my eyes to think that that that that might have made her afraid for myself and for others. I want to have the option to decide when I have had enough and no longer wish to prolong the dying process. I am confident as the act is written, that I cannot be coerced to end my life any sooner than I wish. There are so many safeguards built into the act that it makes sense for those people who want to choose this option to access it. I cannot know at this point in my life whether I would choose to end it or not. But it would give me great relief to know that I could if I wanted to and was able to make that decision. I hope that the state of massachusetts will pass this act into law and give those people who want the option the freedom to make that decision. Thank you again for your time.
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Thank you so much Janice. And I realized that I didn't invite questions for Mr Beckwith. So I'm now looking to the committee to see if you have questions or comments for either Miss Wendell hurst or Mr Beckwith.
Okay I don't see any thank you both. And we're now going to go to Betsy Louise Symons please then the catholic conference panel then jennifer Nugent, lisa Rooney and compassionate choices panel to Betsy Louise.
Do we have Betsy Louise Symons with us?
Okay. Um Okay now I'm going to ask James Driscoll and M. C. Sullivan part of the panel uh if you are available um I'm here madam. Chairman, can you hear me? Sure I can please
[JAMES DRISCOLL:] thank you. Good morning, cheers. Decker and Comerford and members of the committee. My name is James Driscoll Executive director of the2801 massachusetts. Catholic conference. The conference represents the archdiocese of boston along with the Diocese of Fall River Worcester and Springfield, thank you for the opportunity to testify in opposition to these two bills as you are aware they would allow a patient to be prescribed the lethal dose of drugs to end his or her life after meeting certain criteria as I'm sure the committee is also aware the catholic church has always strongly opposes physician assisted suicide and always upheld the dignity of human life. In fact, the church teaches that life itself is a gift from God and should be nurtured and cared for until natural death, not a death chosen because of a medical diagnosis. It is the church's view that a truly compassionate society should work to prevent suicide at all stages of life.
We like many other faiths organizations, doctors, nurses and others are called upon to comfort the sick and the dying process. Understanding it takes a huge physical and emotional toll on the family. These bills have flaws like the often misdiagnosed um to live criteria.2866 I employ the members of the committee to read the compelling essay written by Kelsey Snow, published in the boston globe just three days ago. Her husband Chris has a LS he was 37 years old when given a2880 6-12 month diagnosis. However, he just celebrated his 40th birthday. Kelsi writes the day after he turned 40 14 months after he was supposed to die, he walked onto the Fenway park pitcher's mound to throw a2895 first pitch with2896 a good hand he has left. She went on to say it's a privilege to witness a miracle unfolding every day in front of2903 your own eyes and that's what chris is a miracle. I would also like to bring to the committee's attention the positions of two prominent2910 medical organizations this past june just four months ago, the national hospice and palliative care organization came out in strong opposition stating in part as palliative care intends to neither neither hasten or postpone death. Medical aid in dying is not a palliative intervention.
In light of the under use of hospice and palliative care to alleviate suffering, lack lack of comprehensive health care for persons with serious illness, concerns of disabilities rights advocates regarding protections from coercion, longstanding racial bias and medicine disparities and health and medical care and lack of protections to show voluntary2950 participation. The organization opposes legally access accelerated death as a societal option. Finally the American College of Physicians are also opposed the position statement in the fall of 2000 17 part of the A.2966 C. P. Believe I'll leave it there madam chair because I hear my three minutes are up and I will be submitting written testimony.
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Thank you Mr Driscoll Uh These buzzers are indelicate but hopefully our fair to help us here. Um uh Mr Driscoll do we have M. C. Sullivan with you now
I'm here. Very good thank you.
[MC SULLIVAN:] Good morning madam chair and with thanks to the chairs and to the committee's I come this morning to speak in opposition to the bills being considered at this joint committee hearing. My name is M. C. Sullivan I am the Chief healthcare ethicist and Director of palliative Care for the archdiocese of boston. I am a nurse, attorney, bioethicist who has worked on3007 end of life issues for3008 more than 25 years the problems with these3011 bills are many they lie in both the language of the bills and their provisions, but also in the flawed policy that they would promote. The language of these bills purposely3019 confused the uninformed and obfuscate the objectives of their proponents, starting3024 with their titles, bills about end of life options when in fact they3028 deal exclusively with suicide and assisted suicide. Yet the terminology of suicide and assisted suicide is deliberately absent from the bills they go so far as to allow the denial of the actual cause of deaths of those who choose to avail themselves of these acts, suicide and assisted suicide by not naming them as the causes of death, instead allowing the underlying disease, which the decedent had suffered to be named as the cause of death, which is both dishonest and disingenuous on the part of these Bills, proponents who are working so hard to legalize3056 suicide thanks to the advances and treatments and serious illness.
So many diseases that were terminal almost as soon as they were diagnosed, have now become chronic illnesses that can be treated in an ongoing fashion. Over years and even decades, during which time people lead rich and meaningful lives. And thanks to the advances and palliative care treatments have been developed to deal with pain and other physically distressing symptoms, palliative care also addresses. The other reasons that the proponents3081 claim are the rationale for promoting assisted suicide and suicide advocates for these bills emphasized the loss of control and dignity while they choose to ignore. The palliative care starts with advanced care planning where the patients are in charge as the architects of their own care plans based on their own personal values, goals and objectives. That care plan then goes on to identify and address the psychosocial issues that impact patients and their families with concerns that range from impact on relationships to the financial burdens of illness.
The palliative care plan also includes the need for spiritual care and support as they deal with existential and transcendental questions. Finally, as this committee has undoubtedly heard in other meetings, we are facing a crisis of suicidality in our society and massachusetts is not immune tragically, the populations most hard hit our our young people the mixed message of social approbation of suicide. That the legalization of assisted suicide sends a frightening one, especially in a world and to a population that does not nuance the way in which they hear messages because they're used to a few dozen words tweeted or texted. I urge you to join me in my opposition to these bills. Thank you.
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Thank you so much. Appreciate your testimony, questions or comments from the committee.
Okay, seeing none again. I thank you so much for your time and I of course welcome your written comments. Mr Driscoll I know you're were cut off. Thank you. Uh, we're moving on now. So the next folks in the order, jennifer Nugent lisa Rooney. Um, and then we have a panel of kim Callanan Roger Kliger. Sorry, I'm sure I said that incorrectly and Peggy Sand Dean. So jennifer please.
Hi, can you hear me? We can.
[JENNIFER NUGENT:] Thank you. Good morning madam Chair and esteemed members of the committee, my name is jennifer Nugent. I'm a resident of Lee massachusetts. I'm a nurse and a nurse practitioner and I'm here today to express my strong support for the bill. Um, today, those of us here to support the bill are discussing the importance of planning for death, which means talking about death and suffering3217 and ethical principles like autonomy. Death is something that we, as humans can't avoid. Yet we live in a society that frequently denies that our life will end, that our heart will stop3229 beating after a3230 period of not being able to breathe any longer if we're not killed in a trauma or some sort of thing, which ends things immediately. So as a nurse and nurse practitioner, I've been with many people as they died, I've had many, many advanced care planning conversations with patients through the years. The common denominator with nearly every patient I3252 spoke with was they didn't want to suffer severely followed in a close second place by not wanting to create suffering3260 for their spouse or their Children.
Authorizing the option of medical aid in dying will help both terminally ill people and their families avoid needless suffering. So as a daughter, I recently spent the last weeks of my 75 year old mother's life caring for her around the clock as she died in hospice care upon entering hospice knowing she only had weeks or months to live given her heart and kidney failure, she thought that hospice would give her the ability to in a dignified way and her own life, her suffering became too great. She thought3296 massachusetts residents had the option here in massachusetts, and I had to tell her that we did not. Mhm. At the same time, her brother died in hospice care in California only weeks before her death. And he had that option, knowing that was was an option provided peace of mind for him to choose to experience whatever came or to peacefully die in his wife's arms with family or friends at his bedside.
My mother was most concerned about suffering, that her kidneys would completely shut down and she would be unable to excrete the fluid that builds up in your body. Her fears were real. Before this occurred, her body ultimately couldn't rid itself of the metabolites of the hospice medications to ease her pain. And she began having what's called terminal delirium and this is a condition that's caused by the chemical changes in the body leading up to death. It can be caused by frequently the medications that's one is given as well as the inability to excrete those metabolites. So it's really all these chemical changes that occur as death approaches. And she experienced disturbing visions in her final days. She saw her brother being shot over and over again in Vietnam in her mind, as though it were covering all in front of her and I will submit the rest of my testimony. Thank you. Please consider voting yes on this bill.
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Thank you so much. Uh Thank you for submitting your written testimony and that's very, very welcome. Uh So I'm going to go down the list now. We have lisa and then kim Roger and Peg high, Just 1 2nd, and then we have Vernon and Charlotte Miller. Uh so before we go on3397 to Lisa Rooney, do we have any questions um from Miss Nugent?
Okay, very good. Um I see a hand raised by Sigrid um if you could uh email in a question um were generally keeping two committee members. Um I see your hand went down emailing a question will get you right away. Okay, so we're going to go pleased to lisa Rooney.
[LISA ROONEY:] Uh Hello, my name is lisa Rooney and I come in favor of the end of life options act. Thank you for letting me speak and to tell my mother's story In January 2019 my mom was walking and had a little back pain by May 2019. She was in a wheelchair and diagnosed with a LS before this, she was a healthy 78 year old Active grandmother who was not on any medication, no obesity, diabetes and walking three miles a day. When we found out, we were all devastated. As you know, LS is a terminal illness. There isn't to cure as long as my mother lived the disease, who is only going to get worse and she would die in August 2019. She was told she most likely would die within the year. And I've heard other people say that they have lived outlived their diagnosis. Um, ALS was going through my mother very quickly. Her mind was 100% fine. My mother was an old school Italian Catholic and she didn't like to talk about these kind of issues prior to LS, I have no idea what her thoughts were on dying because all of her siblings are still alive and the oldest one is 97 still alive. Once my mother was diagnosed with ALS, knowing what a terrible disease it was it is and she was going to die from it. My job was to find someone who could help her pass up on her own terms at this point.
It wasn't about morality, ethics, or religion, it was about reality her day to day suffering and physical decline. She did not want to die at the hands of this absolutely horrendous disease and she felt the disease declining through her body each and every day and we physically saw it. I asked every professional I came into contact if she he or she would help us pass doctors, nurses, paley, it's of care hospice and the answer was always know. I even tried to get her up to Vermont and that was no. Then I found one person involved with a less who understood what we were going through and with his help we put my mother into a hospice home at the end of January 2020. The hospital3564 home was great. Everyone did their best to3567 make her comfortable and it took my mother two full weeks to pass. But if you think for one minute that not eating and drinking and being drugged up on morphine is the best way to pass on your own terms. I'm here to tell you it's not. I had to watch my mother get weaker by the day. I would ask if she wanted something to eat or drink and she would say no, she could still speak although her body was declining her mind and it was fine. Her speaking was very weak. She would say no, I can't, I'm not supposed to, sorry, I can submit this later. SHOW NON-ESSENTIAL DIALOGUE
Thank you hard to have a buzzer in the middle of personal testimony. Thank you for3610 submitting the written remarks. Um and for your testimony today. Questions for Miss Rooney.
Okay, seeing none, thank you for your testimony. We have a panel now there are three kim Callanan Roger Kliger Kliger Peg Dean is the panel ready? I'm here. I'm kim Hi kim, you're warmly welcome to lead off. Great
[KIM CALLINAN:] good morning chairs, Comerford and Decker and members of the committee. My name is kim Callanan and I leave both3644 compassion and choices3645 and the compassion and choices action network and I work across the country through3650 all of the states that have authorized medical3652 aid in dying With direct and firsthand experience of the positive benefits this law affords to terminally ill patients. I joined seven out of 10 Massachusetts residents from all demographic backgrounds and six out of 10 Massachusetts physicians in support of this legislation. The legislation that is before you is modeled after the Oregon death with Dignity Act, which was enacted nearly 25 years3678 ago. Your bill includes all of the same strict eligibility criteria and3683 core safeguards. Plus you have added additional regulatory requirements to address concerns that have come up3691 over the years, Most notably in addition to having to doctors certify that a person is eligible and has mental capacity.
You have added a mandatory mental health evaluation and you also have a3704 mandatory 15 day waiting period. We now have more than 60 years of combined experience across 10 states and Washington D.3714 C. and even without the additions that you have put into this3718 bill, we know a certainty that this bill protects vulnerable populations. Medical aid in dying has not resulted in any unintended negative consequences. Those worst3729 case scenarios and hypothetical simply have not been borne out in the data or the experience in the authorized states. However, there has been a number of tremendous positive benefits that have resulted from this legislation, including the peace of mind3745 that it gives to a dying person to know that if they're suffering becomes to great, they do have an option. It has also resulted in better conversations between doctors and patients improvements and palliative and hospice care.
Um and a host of other positive benefits like earlier and more appropriate enrollment into hospice care. Mhm. In september after having a very similar medical aid in dying Lawn effect for five years, the California Legislature reauthorized it's states end of Life option act. They had a sunset3778 provision in their bill and that reauthorization happened with three out of four lawmakers voting to pass the bill, which was significantly more than the first time the bill went through the Legislature. Lawmakers who previously opposed the bill like Dr Richard Pan, who is a doctor and he also chairs their Senate health committee, went from being an opponent to an advocate. And he noted in his testimony that he had now seen firsthand that none of his initial concerns had come to fruition and that this was a bill that his constituents wanted that had improved the experience for terminally ill americans. Thank you for the opportunity to be here and I would be happy to answer other questions about what the experiences and authorized states.
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Thank you so much And you have other members of the panel. Um so I see Roger and Peg are they with you? Yes, both are here. Okay. Super.
Um
3840 [DR3840 ROGER KLIGLER:] Chair Decker chair, Comerford and committee members. Thank you for permitting me to testify in favor of an act relative to end of life options. I thank you for passing the same bill that you're considering today during the last session. This is truly a life or death issue. I am dr Roger clegg lor from Falmouth and practiced internal medicine for over 30 years. I was in ICU attending hospice, attending, did palliative care before there was such a specialty and relief suffering with palliative sedation. This is the fourth time that I am testifying to this committee. During that time you've heard pleas regarding richard Dalton, David Folger signee tam Clare Fox and Representative chris Walsh all dead and unanimous and desiring to end their suffering when it was too much for them to bear. Larry moe and Lee marshall both terminally ill are here today to Beseech you for legislative relief to avoid the worst part of the dying process and have the peace of mind that comes with that prescription. Unfortunately the reality is that they both will die with needless suffering. I'm able to access medical aid in dying3922 here.
This bill has been extensively debated and modified in the 13 years that it has been before the legislature Since then 60 million Americans have obtained this option, but not in Massachusetts, usually a leader in health care and human rights. I have been advocating for this bill for over six years while suffering with incurable3946 cancer. While I have been3949 waiting for legislative actions, I have had three courses of radiation therapy to the commonwealth for judicial relief and work with the Mass Medical Society to change their position from opposition to neutrality. Two thirds of their members polled wanted the legislature to pass this legislation. The Boston3970 Globe and many other papers have endorsed this legislation and in poll after poll, 70% of your constituents want this and studies show this type of legislation improves end of life care for everyone, even those who do not avail themselves of this option. I humbly ask this committee for two things. The first is to expeditiously advance this bill and the second is to become fierce proponents of this option. It is long past time for the legislature to act. I implore you to do so before it is too late for Lee Larry, maybe myself and perhaps someone you know or love. Thank you. SHOW NON-ESSENTIAL DIALOGUE
Thank you very much for your testimony uh and is pegged with you.
Yes, I'm here. Very good.
[PEG SANDEEN:] Hello everyone. My name is Peg Sanden and I am the executive director of the death with dignity political fund testifying in support of the massachusetts. End of life options act. I thank the committee and chairs for your time and consideration of this bill. I want to first acknowledge Dr Kriegler, who we just heard from a well respected physician from Falmouth who has spent his career caring for others and fighting for assisted dying law to pass in the commonwealth. I have worked for the last 16 years in this movement and I have taken part in the efforts in all 10 US jurisdictions that have enacted death with dignity law is statutorily, it is so rare to have a physician who has lived this issue caring for dying patients and one who is also a patient himself facing4073 the decisions every person must face4075 when forced to make difficult decisions about death.
Today, you will hear from opponents trotting out the same tired arguments they have used since 1994 and none of which have come to pass the safeguards built into the laws before you today, ensure the patient is acting voluntarily and able to make their own health care decisions. In all of the states where this law has passed, there has never been a case where a patient has been forced into it. Indeed, it is the very reason why the medication must be self administered. You may hear today from people with disabilities who fear they will be targeted that to has never happened and really cannot with the safeguards in place in these bills, you may hear about insurance companies denying treatment and thus forcing people into medical aid in dying. That to has never happened. We believe strongly that all people should have access to health care4131 in fighting their4132 diseases. And there is language within the bill that protects patients from harm.
In my written testimony, you will see research from medical journals investigating the efficacy of the law. Their opinion is unanimous. This law provides a rarely used and of life option that provides incredible comfort for those who qualify and harms no one else. We respect the beliefs of those medical professionals who choose not to participate. For that reason, the opt out provision in the bill are clear and your own massachusetts Medical society is neutral on the issue because dying patients trump those who would not participate anyway. The needs of dying patients trump those who believe it goes against the Hippocratic oath or their religious beliefs. And finally today4181 you will hear from dying patients who are grappling with their own end of life concerns. Your vote to move this bill favorably out of committee will mean they can live their final days at peace knowing they are in control at the end of their life. We urge your support for this legislation. Thank you, SHOW NON-ESSENTIAL DIALOGUE
thank you so much to the panel4202 um for your testimony. I see two of my colleagues have questions or comments. I saw Vice chair, maran's hand and then Representative Vargas over to you. Vice chair.
[REP SUSAN MORAN:] Thank thank you Madam Chair. I'm just um I'm struck by dr Flagler's testimony in the sense that for the4226 limited amount of time that he has left and I've known Dr Klingler as a constituent4232 for many years, he's chosen to put that time into this issue and to4240 advocate for others and that just it sinks into me so much that I really wanted to to lift up that point and that's my colleague madam Chair. Thank you.
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Um Thank you madam Vice Chair. Um and I see Representative Vargas
[REP VARGUS:]thank you madam Chair and and thank you to the panel Doctor Klingler, it's good to see you again. I know we've met multiple times. Um uh and I had pertains the definition of capable. Um Could you elaborate a little bit more on who determines whether an individual is quote unquote, capable to choose medical aid in dying.
[KLIGLER:]So this is a rather routine operation when people come into the office every day, I would have to determine whether they were capable to be able to make decisions for themselves before I could do anything to them, before I could examine them, before I could take care of them before I could prescribe. So physicians do this every day. Um So what you're having is two different physicians check on capacity to make sure that the person is able to make decisions for themselves and in addition there is a mental health provider who also has to decide. So this is overkill. Have something that is rather routine in the medical profession
[CALLINAN:] and I'll just add to that, that4326 in the vast4327 majority of the other authorized states, there is not a mandatory mental health requirement that was in addition that massachusetts put in um to have that additional safety provision.
[VARGAS:] In other words there there are more safeguards in this bill than there are in other states that have already done this.
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That's right. All right, well thank you no further questions, madam Chair and thank you to the panel representative. Thank you so much. Panel, thank you for your testimony.
Okay? Um we have now vernon and maybe charlotte Miller. Uh next up on deck and then we have a panel, we have Michael um Mark dignity, Lee marshall and Lewis cohen in that panel and then we have another panel, Sandra Koharski and Elizabeth K So I'm looking4378 for vernon first4379
burning are you here?
Okay? We'll get vernon or actually I should check for charlotte Sure that are you here?
Okay, we'll certainly make space um if the Millers comeback. Um so now a panel Michael, Lee and Lewis are you available?
Lewis is available.
Lee available. Very good. Thank you for your virtual willingness to surface yourselves on these crowded screens and over to you
[LEE MARSHALL:] I guess I'll go first. Um my name is lee marshall, I I want to thank you Chair, Decker chair, Comerford and the committee members for what will be a very long day listening to testimonies Again, my name is Lee Marshall. I'm 69 years old and psychotherapist and retired registered nurse. I sit here today Bald for the third time in 10 years due to chemotherapy and radiation. I am dying of metastatic breast cancer and advocating for the option of medical aid in dying in massachusetts. I had a mastectomy followed by chemotherapy and radiation in 2011, all my follow up scans showed no tumours. Then in October 2018 I had a seizure while at work and a biopsy revealed that I had stage for metastatic breast cancer in my brain, my bones, my liver and my lungs. At that time my doctor gave me a prognosis of approximately six months to two years to live. I'm now into almost my third year as time passes and I become sicker, I grow more and more concerned about my limited end of life options.
4519 The reality is that the cancer went undetected and I am back to fighting for my life. I have had radiation to my brain and tried multiple chemo medications to slow my cancer, all of their uniquely burdensome and painful side effects. Constipation, nausea, vomiting, rashes, dry, cracked and peeling hands and feet, fatigue mouth sores, lack of appetite, weight loss, uh Cognitive changes and headaches, not to mention the every three week drive to Boston to get ivy chemotherapy infusions. I thought I would live to be into my 80s, but I probably won't see 70. It's very disheartening to me. I desperately want to live but I'm dying. There is no miracle that will rid me of my cancers. You however can make the burden lighter massachusetts medical aid in dying bill is my hope for a peaceful death. This bill is imperative for me and other terminally ill residents of massachusetts to be able to die with some control and peace of mind still intact. So if you have an ounce of empathy, you will pass this legislation. Thank you for your time.
Uh, thank you money Lee and share your story. Thanks.
It's a great deal of courage today for all people. Lee included to show your stories and the committee is exceedingly grateful. Thank you.
Um, next person on the panel,
I was Michael, I suggest you go, yes, can you see and hear me folks? We are good to go, Michael Okay,
[MICHAEL MARTIGNETTI:] my name is Michael Martin et in 1990 I was diagnosed with Friedrich's Ataxia and our muscular of in life shortening disease that will eventually incapacitate me. I have lost the ability to walk and now uses a wheelchair by purpose today is to inform you that I am one of the majority of disabled mass residents Who support the end of life option to act. In fact there was a to 13 parole insights poll Which found that 75% of people with disabilities are in favor of medical aid in dying and the recent Boston Globe Suffolk University poll which found that over 70% of vast residents are in favour today. You will. You have heard from john kelly who liked me is significantly disabled.
Mr kelly is against the end of life options act because he thinks uh that if this law is passed it will jeopardize the well being of people with disabilities, people of color and poor people john kelly know that definitely does not speak for me, nor does he speak for the overwhelming majority of disabled people. I trust that your committee will base your decision on this bill on facts and not on the unfounded fears of the minority of mass residents or of the minority of the disabled community. The fact is that I personally spoke with dr bob bob june Devers who was the executive Director of disability rights in Oregon probably for two decades. And he said quote disabilities rights or gone has never to my4781 knowledge received the mind that a person4785 with disabilities was coerced or being coerced to4792 make use of the act. My point is That we know this bill works in the 11 jurisdiction is law and that individuals and family using the law report that their last days with their loved ones were full of love and relief rather than haunting memories of unbearable pain and suffering. No disability qualifies you to use all our and I urge you to vote for it, thank you very much.
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Thank you, Michael very much. Next Panelist please.
[LEWIS COHEN MD:] Um, Chairman Chairwoman Comerford and committee members. Thank you for this opportunity to offer4845 testimony in support of H. F. 23 81. My name is dr luke Owen. I'm a professor emeritus of psychiatry at both the University of Massachusetts Bay State Medical School and Tufts University School of Medicine. I'm the author of two books for the general public that deal with the end of life issues and I'm a palliative medicine researcher today. In my capacity as an academic psychiatrists, I would like to broach to subjects for the committee, depression and suicide. You'll hear a lot from opponents to this bill who will raise the specter that assisted dying will be provided to many people who are not thinking straight because they have a depression. That's nonsense. The first thing you need to appreciate is that there is depression, a term liberally used by lay persons and major depression, which is a psychiatric disorder. The first would apply to your feelings upon learning that someone dented your car in the parking lot. The second is used if a pervasive feeling continues for several weeks, you begin losing weight, can't sleep, want to kill yourself.
And this second often runs in families often appears out of the blue without a clear precipitates if you carefully look at the diagnostic criteria for the second, the symptoms they don't count if they are caused by a physical illness. And so the bottom line is that patients who request assisted dying rarely qualify as having the psychiatric illness of depression and the doctors involved in these evaluations would almost always detect such a condition and institute treatment. The other word you'll hear repeatedly from the opponents of this bill is suicide. As someone who has evaluated about 2000 people admitted to base state after suicide attempts. I'd like to assure you that there is a world of difference between those people and individuals who seek physician assisted dying. Ironically, the best delineation of those differences is in a position statement by the American Association of Suicidology from 2017, which makes two distinctions.
The first being that in physician assisted dying, the person with a terminal illness does not necessarily want to die. He or she typically wants to live but cannot do so because of their physical disease. And by contrast, suicide is often marked by ambivalence uh typically stems from unrelenting psychological pain and despair and the person cannot enjoy life or see things may change in the future and they're angry and they're hurt again. The5009 second thing um is that in physician assisted dying, the individual who is already facing death often experiences intensified emotional bonds with their loved ones and a sense of deep and meaning as life is coming to an end. While suicide, the individual typically um feels loneliness. Thank you very much for the opportunity.
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Thank you very much to the panel um for your testimony,5036 just check to see if there are questions or comments from the committee
seeing none. Thank you for your testimony and your service. Um here is uh the next list of folks. We have a panel uh Sandra and Elizabeth. Um Then we're going to go on to reverend dr Richard Stewart, Alan Dawson and then another panel. Rabbi Elias Lieberman Dan Diaz Amanda Podenzana. Um So I'm going to look for Sandra and Elizabeth right now.
Good morning madam. Can you hear me? We can.
[SANDRA KUCHARSKI:] Thank you so much. Thank you for this opportunity. This is Sandra Kozarsky. Thank you for this opportunity to testify in opposition into this bill. I am currently registered as a nurse and a retired nurse practitioner. My nursing career has spanned 48 years, including time as a psychiatric nurse. First and foremost. Aid in dying is not an adequate substitute for quality health care at the end of life. Let me5107 address the three major issues I find especially troubling in this bill. The first is that those who request aid in dying will receive at best, only a cursory mental health evaluation by a quote mental health professional, unquote. The decision to end5126 1's life Is a complex one. The medical literature on this issue shows that those who have attempted to take their own lives by lethal means are not always convinced that ending their lives is their only option. It is more often the case that they have exhausted all of their emotional reserves. Many things must come together in a line in order to override one's deep natural instinct to survive. It is the ultimate state of burnout. In nearly all cases, a determination that a person's disease has advanced to the point of having six months or less to live.
Often comes after an exhaustive course of treatment. It is not a big leap to say that the one requesting aid in dying has likely been through a period where all of their emotional reserves are exhausted and that they are essentially suffering from emotional burnout. This bill provides no provisions5182 to assure that one has been fully educated and understands all of their options, such as stopping treatment, palliative and hospice care. Another concern is who can function as a mental health professional. Does the marriage and family counselor or someone who treats addiction qualify? They're licensed and are considered mental health professionals. Mental health professionals should be required to have some specialist training around the issues involved in dying from a terminal illness, but the required evaluation consists of the therapeutic conversation only, or generally accepted standardized depression and suicide screening5226 tools be used to rule out treatable mental health problems.
Would the documentation of such be required if a person screens in for depression, treatment for this should be required to be assured that someone is clear minded enough to make such a weighty decision. Lastly, this bill states that physicians may note the cause of death as the terminal illness and not the lethal overdose or combination of prescribed medications, asking physicians to knowingly prescribed lethal medications and falsify the cause of death on a legal document, unethical. And the state should not be a party to this for these reasons. I am opposed to the special and I will be submitting written testimony that outlines my further concerns. Thank you for this opportunity, madam Chair.
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Thank you so much Sandra. I really appreciate your testimony. Is Elizabeth here, I am here. Very good.
May I go ahead. Oh please, yes. Okay, good morning everyone.
[ELIZABETH KAY:] Um My name is Elizabeth K. And I have been a nurse for over 20 years. I am a nurse practitioner, palliative care nurse practitioner. Um I've worked in many critical care units across the country including Burn ICUs5306 for the last5307 eight years. My practice has been in hospice and palliative medicine, palliative care is typically consulted when things are not going well. Perhaps a person's cancer is not responding to treatment or they keep ending up in the hospital or they receive that terminal diagnosis difficult diagnoses like cancer dementia or LS are life changing when traditional medicine fails us as it will for all of us at some point facing our mortality is an emotionally charged time. The most common worries my patients expressed at this time is thinking they will suffer and number two that they will be a burden on their families.
This is the opportunity to get involved and offers support to these patients and families. We do this through good pain and symptom management, increasing home resources and welcoming open communication about fears and questions surrounding end of life. And when I tell my patients that I'm confident their pain and symptoms can be well managed5370 and offer education about what to anticipate. There is typically a sense of relief. People want to know what to expect and as humans, we fear what we don't understand. Listen, coming into this world is sometimes work and this can be true when we die.
But I believe that pain can be well managed to end of life because I have seen it, but also with the intention of alleviating suffering and never with the intention of hastening a person's death. So these bills and all bills that promote physician assisted suicide are completely incompatible, contrary and really the antithesis of what we in palliative care aimed to provide. I ask that you understand these legislations to be what they are legalizing suicide and that they affect the most vulnerable populations. And this includes those have those that have been given a devastating diagnosis. Please know my colleagues and I are committed to caring for5434 these patients and families through their difficult diagnosis, their problematic symptoms, their functional losses and their emotional distress. This is the way to truly promote human dignity at the end of a person's life. And I ask you to please do not vote this bill out of committee. Thank you for your time.
SHOW NON-ESSENTIAL DIALOGUE
Thank you for your testimony, questions or comments from the committee, wow, seeing none. Um we'll move on the list now. Richard Stewart then Alan Dawson, then a panel of um Rabbi Lieberman dan Diaz Amanda Lorenzana. And then another panel. This is a new panel. Matt Valliere dr joe marine, Jackie Bieber, Stephanie5483 packer. So I'm going to look now for Richard Stewart please.
You weren't there?
Okay, not seeing Richard. Um we'll get him if he comes back. Alan Dawson please.
Is Allen here. Mhm.
Okay, I'm going to look then for a panel um Rabbi Lieberman dan Diaz Amanda Lorenzana
is the panel here. This is Rabbi Lieberman. I hope you can hear me. My video has disappeared. No, you're back. I see you and hear you. Thank you Rabbi.
[RABBI ELIAS LIEBERMAN:] Thank you. Chair Decker chair. Comerford committee members, thank you for this opportunity to testify. Once again, my name is Elias Lieberman. I serve as Rabbi of Falmouth, jewish congregation on Cape Cod. A position I've heard for the past 31 years. I last offered testimony in 2019 and my commitment to this legislation has only deepened since then. The COVID-19 pandemic has brought into Sharper focus for all of us issues related to end of life decision making. I have in the past served as a hospice chaplain and I bring to this5568 moment, decades of experience as a congregational5570 rabbi serving the needs of families, as they contend with end of life issues. I've been witnessed a good deaths and bad deaths. I've seen members of my community passed from life serenely and I've watched them endure suffering that5584 none of us would wish for ourselves or anyone we love in jewish tradition of frequently her toast is la Creem a hebrew expression that means to life.5594
In truth. Mine is a faith tradition that deems precious the gift of life were granted, but mine is also a tradition that rejects the notion that there's anything inherently redemptive about suffering. The wisdom found in the book of Ecclesiastes, reminds us that there is a time to be born and a time to die. I've come5614 to believe that there is sometimes a time for an individual to make the informed decision to bring his or her suffering to an end. With compassionate support and with the protections against abuse incorporated into this legislation as a person of faith and as someone who chose a profession in which I am expected to offer guidance and support to those facing the ultimate and existential questions. I believe firmly that5640 terminally ill mentally competent adults should be afforded the right to choose to bring about a peaceful death when they're5647 suffering renders living intolerable.
I do believe that life must be infused with meaning and purpose and that when it's no longer possible for us to attain either, the compassionate alternative must be available to us. One that lies at the core of this proposed legislation. I do not presume to speak for all jews or for Judaism. Although polls consistently show strong support among jews for medical aid in dying, I do feel strongly that anyone is deeply held. Religious convictions should not preclude the exercise by others of the most fundamental of personal decisions. I do presume to offer my experience and my convictions gained over the course of my career ministering to the dying and to their loved ones. I urge you therefore to grant the precious gift of autonomy to those who suffering will be unendurable and for whom the personal choice to end their suffering at the end of their life would be the greatest of blessings. Thank you for this opportunity to testify.
SHOW NON-ESSENTIAL DIALOGUE
Thank you. Robbery. I appreciate your testimony. I just want to say that I see Alan Dawson's hand up Mr Dawson. Um I called you earlier. We'll take this panel and then we'll go right back to you. So, I have two more folks on this panel, dan and Amanda if they are with us. Yes, this is dan. I'm here. Very good dan. Can you see and hear me? I can uh, here you for sure. Um, and there I can see you. Okay,
[DAN DIAZ:] so, good morning, my name is dan Diaz and I am Brittany Maynard's husband. I'm testifying in support of this legislation, Brittany died on November 1st 2014 in Portland Oregon, Brittany utilized medical aid in dying. So yes, my wife experienced a gentle dying process only because of the option that you are debating here today. I have lived through this process. I've seen it first hand with all of the rigid safeguards and protections that are in place Britney's case. This is Brittany. Mhm Britney's case received significant media attention because we are Californians, but we had to move to organ at that time so that she could access organs. Law. When Britney died, there were only four states with this option. There are now 11. Quickly I want to thank Senator Lovely for referencing Britney's case. That means the world to me terminally ill individuals in massachusetts are currently at a significant disadvantage as it comes to end of life options.
The people of massachusetts deserve better than what Britney had to endure of leaving home. After being told you have six months to live. We found out on new year's day of 2014 that Britney had a brain tumor, she endured an eight hour brain surgery and we researched every treatment option that was available, but the tumour was growing aggressively and had we stayed in California, the brain tumor would have ended Britney's life in a brutal manner. It has already occurred this morning. So I will take5837 a second to refute the assertion by any physician,5840 any legislator or any religious official that the medical community can control a terminally ill individuals, pain and suffering in 100% of the cases. That is simply not true. That claim is irresponsible and it is reckless. I can line up dozens of physicians and hospice care nurses who will refute such an arrogant claim.
That paternalistic view of a doctor telling the patient when you've suffered enough and then hooking them up to a morphine drip as they die a terrifying death. Brittany refused to accept that. Instead, Britney had an excellent palliative care team, including Harvard trained physicians with decades of experience and the benefits that we received from hospice care was immeasurable. Those physicians did not abandon her. They worked alongside her trying to extend Britney's life as long as possible and allowing her to have a gentle dying process In Massachusetts, 71% of voters agree that determinedly individual should have5903 the option, including 64% of Catholics. Over the past 6.5 years since Britney's death, I, as a catholic, have stood up to the church's repeated attacks on Brittany's decision to have that gentle dying profit. This is not a political or a religious issue. It is a medical issue and I welcome any questions. I have been through this firsthand. Thank you so much.
SHOW NON-ESSENTIAL DIALOGUE
Thank you for taking the time to speak today. Your your story. Um, and your expertise. I'm looking for Amanda, please. Yes. Good morning. I'm here. Can you see and hear me? Okay? I can hear you.
You're warmly welcome. Thank you.
[AMANDA BAUDANZA:] Good morning. My name is Amanda bonanza. I am TJ bonanzas wife and I'm here to testify in support of S 1384. An age to 381 and act relative to5958 end of life options. In 2011, my husband TJ was diagnosed with stage four colon cancer just 28 years old at the time of his diagnosis. The disease was not terminal. In fact, his medical team was confident that with surgery, chemotherapy and radiation disease could be controlled and T. J. Was willing to try any treatment option that was available to him.5981 About a year later in 2012, TJ brought up the topic of medical aid in dying. He learned the massachusetts death with dignity initiative was going to appear in the general election ballot in our state. T. J. Told me that this legislation would be crucial to his care if his cancer ever became terminal.5998 The law would provide an end of life option for him and other terminally ill adults who have a prognosis of six months or less to live to request obtain and if suffering becomes unbearable self ingest medication that brings about a peaceful death. Yeah.
After voting in support of the ballot initiative, we were just heartened to learn it narrowly did not pass. So he6020 decided to research other states that offered this end of life6023 option. And we learned that Vermont was the closest state. T. J. Told me that if his disease ever became terminal, he wanted to move to Vermont to access medical aid in dying6033 because he did not want to suffer. But we both always remained hopeful. It would never6038 get to that point. After four6041 years of treatment, TJ's prognosis changed the disease, metastasize and his liver was failing. His prognosis was grim and we were devastated to learn that there was not enough time left for us to move to Vermont to establish residency in order to access medical aid in dying. It was too late. And the only option TJ had was to enroll in hospice.
Hospice was wonderful. The nurses were dedicated to making TJ as comfortable as possible. But as his Oregon started to fail, his pain stopped responding to palliative care, Not even the highest dose of delighted, which is four times stronger than morphine could ease his pain. As a result, TJ endured weeks of unnecessary suffering and spent his final days an excruciating unbearable pain. Yes, that is not the way my husband wanted to die.
I'm here today because I want other terminally ill, mentally capable individuals to be able to direct their care in the way T J desperately wanted, but was unable to. So much has changed since DJs death now and now 10 states in Washington, D. C. have authorized this legislation Further. Over seven and 10 people believe that terminally ill patients like my husband should have an option to6127 avoid the last worst part of the dying process? I strongly urge you to quickly and favorably move this bill out of committee so that others don't have to needlessly suffer the way my husband did. Thank you for listening to my testimony. SHOW NON-ESSENTIAL DIALOGUE
6144 Thank6144 you for sharing your testimony. Um And as6147 with everyone who is testifying today has lost a loved one on behalf of the committee. We're really sorry for your losses. Uh,
thank you questions from the committee for this panel.
Okay, I see none. Thank you for your testifying your testimony today. All three of you. I'm going to go back now to get Mr Dawson. Alan Dawson. Um who wasn't available earlier.
Mr Dawson. Are you available?
Oh,
your hand up earlier.
6191 T6191 thank tight.
Mr Dyson. I see that you're a mute. Um so you we can we can hear you6202 if you'd like to offer test testimony.
6210 Okay.6210 Mr Dawson is unavailable. We'll get them um when he's available. Um So let me tell you what's up now. We have a panel coming up Matt joe, Jackie Stephanie. Uh And then after the panel, we are going to Sigrid Vonda and then another panel. Uh Larry moe it. David grew be eric. Um So I'm looking for this panel. Matt joe, Jackie Stephanie, I am here. This is Jackie very good Jackie. Um Do you know if your other panelists are here. Matt value is also here.
Thanks Brandt Welcome. Thanks. Before you start. I just want to address. We have representative. Kay khan who has joined representative. Are you here to testify? Uh No, I was actually going to ask or just make a comment. I figure out how to get in after you were asking for comments. So I just wanted, I'm happy to say something now or later. Whatever please please please make a comment and then we'll go to the panel.
[REP KHAN:] Okay well thank you and thank you really uh to everyone who has testified this morning. Uh a very difficult time to be listening to all of this. I just wanted to mention that as a legislator and a member of this committee. I'm also a nurse. I'm a psychiatric nurse people specialist and I really want to thank all of the nurses and doctors who have spoken about how how how they care for people in hospitals or you know, end of life situations. But I think that it's great that you can how to care for your patients. But I think that the one thing that is missing from my perspective is the the right to choose to uh to end once live out the suffering has heard about this morning. So I just want to make6348 that comment because a nurse, I really support the legislation and again, I do want to say thank you to everyone who has spoken this morning on this difficult subject.
SHOW NON-ESSENTIAL DIALOGUE
Thank you so much rep Khan Thank you for being your service on the committee, your service in the world and for testifying and offering your thoughts this morning. Um so we're going to go to the panel. I see that Anita Cameron has a hand up Anita, we're going to have to find out how to help you offline. Um and you can email me directly at joo dot commer forward. Ceo EMAS and mary er f as in frank o R D as in david joe dot Comerford at M A Senate dot gov. Um and we will help answer any questions you might have. Um so again, I'm going to go back to the panel with my apologies for the interruption. Um Matt joe, Jackie and Stephanie um you are warmly welcome. Thanks so6413 much joe. I
[MATT VALLIERE:] I'll lead off. My name is Matt Valliere currently serve as an on call firefighters and first responders Northern Western county in uh senator comfort district in fact assisted suicide. Public policy is dangerous and discriminatory against people with disabilities and people of color. If one thing has been made clear in the last year and a half instead even here in massachusetts disparities in health care, pervasive and deadly. These bills are supposed to be about autonomy and alleviating pain at the end of life. But with all the health care inequities and barriers to access. Isn't it obvious that making ever cheap suicide quote medical treatment would put undue financial and societal pressure on people of economic disadvantage to opt for hasten death? Are not they faced with too few options and a system stacked against them. As it is true, health care autonomy, autonomy would mean that everyone has equal access to the gold standard. It would mean that black people are not be prioritized for kidney transplants at MGH, which was only just discovered last year, I had friends with disabilities avoiding a hospital visit during the pandemic concern that their own personal ventilator might be stolen and re allocated to somebody else deemed to have a better chance of survival.
That kind of discriminatory. Reallocation is championed in an article published right here in the new England Journal of Medicine. We already have a two tiered health care system assisted suicide laws only exist s exacerbate the problem by giving insurance and medicine a free pass on liability for helping some of their patients died by suicide while they automatically initiate the standard of care for suicide prevention care and services to everyone else who expresses a desire to harm or kill themselves. This results in death to the devalued group, with the financial emotional existential distress, not only navigating an increasingly complex health care system rife with disparities and roadblocks to access, but also the reality of one's own mortality. Are you telling me that you're putting suicide pills on the table won't add a single ounce of pressure to people with life threatening illness and disability. How do you honestly call it? In addition to autonomy. When some people feel like they have no other choice. Further, inadequate physical pain. Control of fear of it is not even in6545 the top five reasons people are requesting assisted suicide in legal states.
The top reasons are all related to newfound disabilities, like losing control of bodily6553 functions. And to me, the most tragic feelings of being a burden on family, friends and caregivers. What the hell Dystopia are we living in Where we're going to give very sick people lethal drugs to kill themselves because they're worried about being a burden on their family before we unequivocally guarantee home care and Medicare and Medicaid, whatever it is, it's not autonomy. I have been, I've treated dying people living in squalor who make repeat. 911 calls, many of whom either don't know what hospices or afraid someone will just come in and kill them. But the gold standard of hospice care can and should alleviate both the physical pain they endure and the disability related concerns or what some people6593 would rather die than endure. Hospices mantra to neither prevent nor hasten death. I'll cut off there. But my I have written testimony that also submit senator comfort and the rest of the committee for your review and I'll turn it over to Jackie.
Thank you so much. Matt, appreciate your testimony,
Jackie.
[JACKIE BIEBER:] Good morning, Good morning name is Jack Igiebor? My daughter Sean ended her life by suicide on May 22, Few life events are devastating as losing a child made even more traumatic when the death is self inflicted. What makes her death especially painful is that her suicide was accomplished using a drug cocktail, published and promoted by proponents of assisted suicide. Societal efforts to downplay suicide add another layer of encouragement to people like Sean who became an unfortunate victim. It needs to stop Shawn's path to suicide. Didn't happen overnight. An intelligent child who wanted to be a scientist, she suffered from severe depression and social anxiety for6661 many years. Her promising potential career took a nose dive when she dropped out of college and took jobs that fed her depression and anxiety jobs where she felt stupid and couldn't talk to people. Ongoing treatment for a condition met with little success.
She appeared to be getting better, but in late March, in April of 2019,6679 her condition declined. She spent hours in her bedroom and without my ever suspecting it began visiting websites that talked about suicide, where she was an active participant in the chat room, although the website features numerous statements that it does not sanction or encourage suicide, the chat room tells a different story. Sean learned how to order sodium nitrate S. N on the site and other drugs that led to her death. One of the resources listed is the peaceful pill handbook, which advocates for assisted suicide and euthanasia and that is the means that she chose the resource title is enticing for those with mental pain as they seek some semblance6720 of peace. At 11 o'clock A. M. On May 22nd sean was actively talking to website6726 participants when she took the drugs. They told her good luck and encouraged her when she said she was terrified at 4:30 p.m.
I went into her bedroom and she was dead. Powerful and well funded groups promoted a promote assisted suicide, which they say is for terminally ill patients who are suffering. But participants on the suicide website find it persuasive to link mental suffering to physical suffering and logically conclude that a peaceful death should be available to both as a society and for the sake of my daughter Sean and others like her. Our message should be consistent and of one voice suicide should not be promoted for anyone who has terminal or mental illness and the means to accomplish it should not be so public. It impacts far too many and accelerates the growing suicide rate. Thank you for the opportunity to testify.
SHOW NON-ESSENTIAL DIALOGUE
Thank you for sharing your story and for testifying you have others on the panel.
Um, so I'm looking for joe or Stephanie.
So yes, I'm here now. Oh great. Just getting thinks
Stephanie, are you, is this new and mhm Yes. Can you hear me? Perfect. Yeah please please by
wonderful
[STEPHANIE PACKER:] thank you for having me. Uh My name is Stephanie Pecker And I'm a California, mother of four. In 2012, I was diagnosed6824 with scleroderma And they gave me three years to live. As you can see. I have outlived that prognosis quite a bit and I'm relieved that I'm here in a live to care for all four of my kids. Um Shortly after California passed a law to legalize assisted suicide, my doctors prescribed an expensive new treatment that would extend my life. When I asked my insurance company about coverage originally I was approved and after the law was passed, I was later denied. I asked the insurance company if they would cover the new assisted suicide drugs under the law and they told me that I would qualify and that I would be covered for A co pay as a mere $1.20.
I was stunned. That much cheaper lethal drugs would be available to me rather than treatment that would save my life. Fortunately, I did eventually receive the coverage for the treatment that I saw it to reinforce California's interest in saving money by legalizing assisted suicide. The fiscal note attached to the proposed California law predicted that potential minor cost savings and medical based on the medic health program choosing to cover this end of life option. And what that means is that California was predicting that they would save money by covering these lethal drugs instead of actual treatments for patients.
My um my health journey has not been easy. I've been in and out of hospice For the past five years and Always with predictions of living six months or less every time I qualified for releasable drugs. And I live in fear that the next time I get another prognosis that it gets sicker treatment is going to end up being denied in favor of lethal drugs. Mhm. My four kids need me and as long as I can bear the treatment6996 I want to live, please don't place mothers and other people in massachusetts in the position that I7003 find myself in Vote against. s. In H 2381 Please. And thank you for your time.
SHOW NON-ESSENTIAL DIALOGUE
Thank you for your testimony. Thank you to the panel. Um I don't believe that joe is here, is that correct? So Senator Comerford I he had to get called into clinic at the last minute but he should try to should be trying to log on later. So if you have time for him later in the queue, that would be wonderful. Absolutely. We'll catch everybody who comes. Who's been signed up today. Who7039 comes later? If you can just let know to notify us when he's on. I will do that. Thanks. So uh questions for the panel comments.
Seeing none. I'll thank you so much for your time and your testimony. Um Ok we have I'm going to go through a list now. We have sigrid Next Vonda, then a panel with Larry David and eric and then another panel. Um So I'm adding this to the list. Um Pamela daily Ellen Lee brian shea john Robinson Um So that's the next list on deck. Sigrid are you here? I'm here. Can you hear me? We can. Thank you so much.
[SIGRID SCHMALZER:] Thank you so much for this opportunity to share my experience. In 2015 I had to help my father and his life. He was suffering miserably from an untreatable neurological illness and the doctors could7101 not give him any information on when nature would take its course. He was very clear that he wanted to get out as quickly as possible. And there was no question in my mind of my ethical and filial duty to help him escape his suffering and have the dignified death that he expected. But he didn't live in a place with end of life options. So it felt to me to figure out what his limited choices were. It was a horrible and scary thing for me to have to do on top of losing my7127 father. I did not want to orchestrate my father's death and I worried about the legal implications of helping him die without legal physician assisted end of life. The options were really unclear to me. I actually even briefly thought about trying to get him street drugs, but I had two small Children7144 and I didn't want to risk going to jail And that was a scary option for all kinds of other reasons as well.
Obviously I looked up freezing to death. It was january, It was bitterly cold year. So I thought7156 maybe we could give him some alcohol and sit with him outside until he froze. But he found that idea too horrible, which I think everybody can understand. The only other thing I could find was for him to simply stop eating and drinking. And he did decide that he could manage that his primary care physician declared him terminally ill so that we could get7175 hospice care. And that was the only support that the physician could give us. The hospice7180 nurses were able to supply morphine and I think that did help. But we were worried about giving him nightmares if we gave them too much. And I think we ended up giving him too little. But honestly, I still don't even know because I don't have that kind of knowledge and I still worry that the six days he spent getting progressively more dehydrated may have been tortured for him. He was7201 agitated for the first several days and he forgot what was happening a few times and asked for water.
My mother had to remind him what he was trying to do. And thankfully he was able to remember and demonstrate his resolve. Still, it's a horrible thing to be asked for water from a dying relative and to have to remind him that he has chosen to abstain. It would have made an enormous difference to have the assistance of a doctor with the right knowledge and medications. The right medications would have allowed my father to depart far more quickly and with far less anguish and working with a doctor backed by the law would have lifted a terrible burden from my shoulders and from my mother's, I'm also convinced that the involvement of a physician would have increased, not decreased the certainty that my father's decision was his own. And uh, the results of his own choice and not of the kinds of pressures that opponents of this bill have feared. So I ask you to support this bill and again, I'm really grateful for the chance to share my experience. SHOW NON-ESSENTIAL DIALOGUE
Great thank you for sharing your story and I'm so7268 sorry for your loss.
Questions from the committee comments,
seeing none. Thank you7278 cigarette. And we're going to move on now to Vonda. And are you here
looking for Vonda?
Okay. I don't see Vonda, I don't believe and is here. We will come back if she has time later we
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