2025-04-02 00:00:00 - Joint Committee on Public Health

2025-04-02 00:00:00 - Joint Committee on Public Health

SHOW NON-ESSENTIAL DIALOGUE


CHRIS FEENEY - AMERICAN HEART ASSOCIATION - HB 2391 - SB 1489 - Chairwoman Decker and members of the committee, my name is Chris Feeney. I am with the American Heart Association, and I am here to offer testimony in support of House Bill 2391 and Senate Bill 1489, bills requiring automated external defibrillators at sporting events. I just wanted to note that348 this bill has been championed by Daryl Settles and Doctor Lisa Owens who lost their 15 year old son, Preston, to sudden cardiac arrest during a basketball game in 2022.358 We've been working with the Settles family, and, unfortunately, they are out of the country this week and could not be here today. Sudden cardiac arrest is a leading cause of death but quick action can save lives. Sudden cardiac arrest victims need CPR and defibrillation within376 minutes, as survival chances drop by 7 to 10 percent each minute.382

Automated external defibrillators, or AEDs, which are simple and portable, can restore the heart's normal rhythm and our life saving tools. While AEDs are required at schools and school events, many community athletic facilities lack them. This legislation would ensure AEDs are available at all athletic fields and facilities, and that trained individuals are present to use them in emergencies. It can make a critical difference in saving lives. And while we fully support this legislation, American Heart Association414 also suggests that facilities have a plan in place to handle heart emergencies in addition to AEDs. These plans called cardiac emergency response plans or CERPs outline specific steps that should be taken during a heart emergency and can be shared with team members and displayed around the facility. CERP plans help communities and organizations create, practice, use, and review their heart emergencies plan, and they aim to lower the risk of death from cardiac arrest in any setting. I'll be happy to answer any questions. I am fairly new to this role, and my 1 year old was up all night, so I'm not sure how great my answers would be. But thank you for your consideration.

SPEAKER1 - Any questions?

REP DECKER - Well, fortunately, as the chair of the committee last session, we were able to hear and really have a lot of conversations regarding this bill. And you'll note the House actually moved this bill forward out, and, we hope to do the same this year. So thank you for, your testimony.

At this time, we're going to house, 25 56, enact relative to AEDs for athletic fields, and I invite Melissa Batit, parks and recreations professional. Oh, I believe Melissa is virtual on Teams.

Welcome, Melissa.

Melissa, are you there? We see your screen.

Okay. We're gonna move on and we will try to circle back to Melissa. For anyone who is, on teams waiting to provide virtual testimony, I will ask you, we really embrace and are excited that people across the Commonwealth are able to testify from wherever they are and they don't have to be here at the State House. We will say that, we cannot guarantee that we will circle back to you for a second time. So please be at your monitor,566 ready to testify when your name is called.

SPEAKER6 - Hello. It's it's Melissa. Can you hear

SPEAKER1 - me now?572 We can hear you, Melissa. Welcome.

SPEAKER7 - Oh, great.

SPEAKER6 - Great. Thank you. I'm not as familiar with Teams as with577 some of the other virtual platforms, so I was having a hard time finding the the mic on mute.

MELISSA BATTITE - TOWN OF LEXINGTON - HB 2390 - Good morning. My name is Melissa Termine585 Battite. I am a park and rec professional in the Commonwealth, for the last 32 plus years where I've served in two different communities. I strongly agree with access to AEDs and the importance of life saving access in our fields. I'm speaking today on behalf of the House bill 2390 brought forth by, Mr. Vaughn, who, has been a champion for park and recreation and across the the Commonwealth with our state association, Massachusetts Recreation and Park Association. I do have a few concerns with this. One is that the title refers to athletic fields, but then in the body of the context, it refers to parks, playgrounds, and then schools. I would caution that, each municipality is very different. Some park and recreation departments are very robust and have staff and have strong ability to provide these services well, while other towns and communities and cities only have one person or a part time person.

The implementation of the training, the purchasing, and the maintaining of this equipment would be a hardship for many communities, not only financially, but in terms of the staffing and the responsibility to make sure that these pieces of equipment were available, and678 always ready, and in working condition. Many of our parks and playgrounds are in areas where solar AEDs would not be an option due to the tree covering. There's not access to electricity to hardwire them and there's not staff at all of these696 facilities while they're open to the public dawn to dusk. So I would encourage700 the decision makers to please embrace some of the park and recreation professionals and706 to discuss these plans with them to see how they can be rolled out in a712 way that we can best support all of our communities equally. I'm happy to take questions. Thank718 you for, taking my comments.

SPEAKER1 - Thank you, Melissa. Thank you for your testimony and for the concerns you've raised. At this time, I'm going to, welcome, my colleagues from the senate, Senator Brownsberger, who also represents a piece of Cambridge here, senator Commerford, and my former colleague, senator Fernandez. It's welcome to see you. Good morning.

SPEAKER8 - Oh, I have to do this.

SEN COMERFORD - HB 2505 - SB 1486 - Good morning, Chair Decker, Chair Driscoll, honorable members of774 the committee. Thank you so776 much for allowing us to testify out of turn. We're here,780 as you know, to testify in support of782 an act relative to end of life options. I have offered this bill in partnership with Leader O'Day788 and Representative Phillips, who are unbelievable advocates and leaders on this issue. And794 we're grateful here to have Senator Brownsberger, Senator Fernandez, and senator Oliveira is also part of a quartet in support. This bill has 22 cosponsors in the Senate thus far, 52 cosponsors in the House. I am also, terrifically grateful, to have so many advocates statewide who will hope to speak with you today. And, of course, Chair Decker,822 you know this bill intimately, having worked on it so well.

This bill allows mentally capable patients with terminal conditions to choose a peaceful death. It also establishes rigorous safeguards for patients and physicians to follow in order to protect vulnerable people from coercion, which I know you care a lot842 about. In 2002, the844 Boston Globe editorial board wrote that846 the Massachusetts bill is one of the most cautious and comprehensive in the nation. In fact, some of the concerns we've got is that we've made it too rigorous, right? And we don't want it to be undoable for people. I should say that862 this committee, under your leadership, Chair Decker, has been instrumental in developing these safeguards after listening deeply to people across the commonwealth.

I am grateful for this committee for reporting this legislation out favorably last session for the third time. Last session, also for the first time, it was reported favorably from health care financing. I'll make just two brief points. First, as you know, public opinion is supportive. In June 2024, a poll found that two thirds of Massachusetts residents support giving terminally ill patients the legal option to end their lives with a doctor's prescription, with 67 supporting the idea, 22 remaining neutral, and only 11, somewhat strong opposition. Second, 10 states and the District Of Columbia already authorized medical aid in dying. In the 25 years since Oregon became the first state in the nation to implement medical aid in dying, there has been no evidence of924 any abuse, coercion, or bias in the implementation. So thank you chairs, thank you committee for your consideration and all the work932 you've done over many years on this934 bill.

SEN BROWNSBERGER - HB 2246 - SB 1331 - Thank you so938 much. And thank you so much for reporting this out previously, and I hope we're able942 to do so early this session. I'll944 just, I know you know this, but946 just kind of for the benefit of of others listening, just say, you know, this is a bill that952 is, the way I look at this bill is shaped by956 my father's perspective on this bill, who was a psychiatrist who spent a lot of his retirement years working in hospice. And, you know, this bill is really about people being able to live out their last days without fear of suffering. It gives them the option to break the glass and exit if the pain associated with their terminal illness becomes too extreme. Most of the time, they're not gonna exercise it, but knowing that they have that option, in his view, really allows them to endure those last days without fear. And so I think that's a big deal in those dying days. The1000 fear is not of death, the fear is of suffering,1002 and this gives them a way to1004 know I'm not gonna have to suffer, if I have a way out. So giving people a way out, that's what this is really about in my view. Thanks. Thanks so much for all your consideration.

SEN FERNANDES - HB 2246 - SB 1331 - It's great to be before this committee. Thank you for your support of this in the past. And I'll be brief, because I've testified in support of this bill on multiple occasions. And my my, dear constituent, Roger Kligler, has been a leader on this for over a decade. And1039 for his sake and for so many people's sake out there, it'd be great to be able to get this bill done. And I'm so encouraged by this committee holding this hearing so early1049 in the session. And the only other thing I'll add is, this is also just about choice, right? This is a choice that you can exercise if it's the right thing for you, and you meet the really quite stringent requirements to be able to exercise that1068 right. So if you don't support it, that's fine. If you don't want1072 it, that's fine. But don't make other people needlessly suffer at the end of their life if they have a terminal illness because of your own personal views. No one should have to go through that excruciating experience. No one should have to needlessly suffer if they don't want to. So, let's give people this right. Let's give people this choice. And I thank you for your support.

SPEAKER1 - Thank all of you for your incredible work. Are there any questions? Representative Sousa.

REP SOUSA - Thank you so much for your testimony. I just have a quick question. In other states where this provision's been adopted, has there, especially given the climate where doctors are sometimes concerned about providing medical care and being prosecuted for it, has there been any provisions in place or any discussion in protecting doctors administering1136 this kind of treatment and as far as protection from prosecution goes?

COMERFORD - Sure. There have not been any instances where medical providers, where it is legal in the state, that is the way that they are protected. So to my knowledge, there hasn't been any instance where a medical provider has been subject to penalties for engaging in1164 something like this.

SOUSA - Gotcha. And just a quick follow-up, even across,1168 I would imagine across like state lines and people traveling for this kind of treatment, but there hasn't, to our knowledge, been anything like that, correct?

COMERFORD - No.

SOUSA - Alright. Thank you.

COMERFORD - Not to my knowledge. Do you guys know? No. Good question.

DECKER - Thank you. And I think we're gonna hear a lot of testimony today, but I also if there's anything else that you would like to say, I think one of the things that we hear is that this prevents people from having to suffer. I think that's a part of it, but it's important to know that that's not the the predetermining issue that decides whether or not this is approved. There's actually a lot of regulations that actually lead up in consultation with1210 both psychiatric and medical1212 professionals with the individual. So it's1216 not just whether or not the threshold for suffering is intolerable, but there's1220 actually an incredible breadth of assessments that are done in consultation with medical providers.

COMERFORD - Completely correct, chair. They have to be mentally capable, physically able to self administer. They have to be diagnosed as terminally ill. And then there are many steps that they have to go through including a mental health evaluation, concurrence with another physician, numbers and numbers of steps. And this is to protect patients from being coerced in any way. And in fact, you will remember this, when we first were working on this bill, we looked at witnesses, right? People had to come and authorize, you know, whether or not someone was mentally capable, physically able.

And what we heard was, it wasn't about a concern regarding someone's estate being potentially sought after, it was actually the reverse of that, which was very poignant. It was people who were concerned that they would be coerced into having to do this. And so they wanted to make sure that one of the people who would come and witness their decision wouldn't be having to be physically or financially liable for their care, right? And this was a protection that we put into the bill after hearing testimony. So it's both about the financial benefit, but there is also the financial liability, potentially, of caring for someone. And it was one of many, many, many triggers in the bill that, or guardrails, that would protect people.

SPEAKER1 - Thank you, senator. I wanna thank all 3 of you for your work on this and many other issues. Nice to see you. Thank

SPEAKER10 - you, mister chair. Thank you, madam chair, so much.

SPEAKER13 - Any other question?

SPEAKER10 - Members of the committee.

SPEAKER13 - Excuse me?

Senator Dooney.

SEN DOONER - Thank you. Just quickly, is there any concern around, I don't know how else other to put this, but insurance companies potentially, I don't wanna say capitalizing on this, but having an influence on people making decisions? Has that been looked at?

BROWNSBERGER - That might cut the other way, right?

DOONER - Debatable.

BROWNSBERGER - Yeah. I mean, but you may have a better answer. I know this Jo's done so much work, Senator Comerford's done so much wonderful work to add safeguards, and I know and as well as with working with Rep Decker, so I appreciate that. But I'll let them defer to that.

DOONER - Thank you.

COMERFORD - Not to my knowledge, senator. And it's a good question. I think all good questions are welcome. But in fact, there are so many steps that prevent coercion in this bill. Again, it's known as the strongest by far, hands down bill in the nation. And again, we rub against that from the other way. We don't wanna make it so prohibitive that people can't access it, but there are, and I'm happy to provide you with this. In fact, we'll follow-up, the committee has this, but I'm happy to provide you with the steps that an individual has to make it through with so many medical providers in order to make this decision. It would be very difficult for an insurance company to force that individual to make this decision. The things is what Senator Fernandes and Senator Brownsberger also said, it's an option. It's not a mandate.

BROWNSBERGER - And just to underline it, I mean, the insurance company profits when somebody, I mean, the insurance company pays out1439 when somebody dies, so the last thing they wanna do is make somebody die. And they the1443 last thing they wanna do is accelerate it, so that it happens during the term of their insurance policy. I don't see the insurance company's interest in that.

DOONER - Yeah. I just like to look at it from both sides and make sure that, you know, that is a concern and that is on, you know, everyone's radar because they're gonna find a way to capitalize on everything.

COMERFORD - Yeah. Fair point.

FERNANDES - And the only other thing I'd add is that, this isn't novel, in any way, legislation. I mean, it's more strict than other states, but many other states have this. States who are North have this. And I've had constituents, actually look at, and actually some have exercised and and gone up to Vermont to be able to to die peacefully. And so, to my knowledge, in all the other states that have this I don't have any of these, kind of insurance issues.

BROWNSBERGER - And just to correct the record on your statement,1495 it said it's more strict in other states. What you meant, what you said was it's more strict than in other states.

FERNANDES - Thank you, Will.

BROWNSBERGER - That's why they took it down on us.

SPEAKER16 - So Thank you, Senator. It's great

SPEAKER11 - to have that

SPEAKER4 - here. Thank

SPEAKER11 - you. Yeah.

SPEAKER17 - Thank you. K.

SPEAKER1 - Thank you.

House 24 24, an act requiring automated external defibrillator devices in health clubs. This time, there's no 1 here to testify. I I have heard from, representative, Garberly who filed the bill1525 and who provided testimony to me and to the committee. So thank you. House 24 65, senate 15 40 1, enact relative to athletic training. We have a panel. I have Robert Calandrio and Jennifer Concannon. Welcome.

ROBERT COLANDREO - BRIDGEWATER STATE UNIVERSITY - HB 2465 - SB 1541 - HB 2391 - HB 2424 - HB 2556 - Chair Decker, Chair Driscoll, members of the committee, thank you for the opportunity to speak this morning in support of House 2465 Senate 1541, an act relative to athletic training. I'm Robert Colandreo, professor of health sciences at Bridgewater State and the current government affairs committee chair for the Athletic Trainers of Massachusetts. I've been licensed as an athletic trainer in the Commonwealth since 1995. The 1981, 82 legislative session saw the bill creating the Board of Allied Health Professions and Licensure for athletic trainers, occupational, and physical therapists signed into law by Governor King. Facing opposition at the time, athletic trainers compromised on language restricting our workplace and patient population. Not ideal, but Massachusetts became the fifth state in country to statutorily protect the practice of athletic training and the title of athletic trainer. We're the second to do so via licensure. We knew we could always petition the legislature for updates as our profession evolved.

Our profession has evolved greatly in 42 years but our statute language has not. Our new professionals have skills they're unable to fully utilize in clinical practice. As a result, they leave the state for better opportunities and better pay. Expanding access to athletic trainers and athletic training by removing the workplace restriction language is a much needed first step to retaining our workforce. Athletic trainers specialize in injury prevention. Public safety entities like the Fairfax County Virginia Sheriff's Office and San Antonio Fire Department hire athletic trainers. Both have saved hundreds of thousands of dollars in healthcare costs and in overtime cost savings. Companies like Boeing, Amazon, Toyota, and Turner Construction also hire athletic trainers for injury prevention and emergent care in the workplace. This bill will allow companies to bring these care models to Massachusetts and public safety entities will now be able to access our services as well.

This bill will also add athletic trainers as a provider to the high school football medical coverage law. The addition will align the current state law with the MIA's medical coverage rule. And this discrepancy is typically problematic during weekday sub varsity football games that take place at schools where only an athletic trainer tends to1697 be present. We'd also like to voice support for House 2391, 2424, and 2556. Any bill that will potentially increase access to an AED and a trained provider to allow for three minutes or less access to an AED is common sense necessity. In closing, I'd like to thank Chair Decker and Vice Kerans for your efforts during last last session. We appreciate the time your staff put into researching our issue and we look forward to working with the committee again this session for a favorable report. Thank you.

JENNIFER CONCANNON - ATOM - HB 2465 - SB 1541 - HB 2391 - HB 2424 - HB 2556 - Good morning, members of the public health committee. My name is Jennifer Concannon and I currently serve as the president for the Athletic Trainers of Massachusetts. I also own and operate a private practice athletic training facility located in Weymouth, Massachusetts. And today, I'm here to support the act relative to athletic training. As you previously heard from Bob, an act relative to athletic training will help to update the workplace restrictions for athletic trainers currently in the Commonwealth. With the removal of the restrictive language, athletic trainers will be able to assist in a critical area in need of quality healthcare, the occupational workforce. This population may frequently seek unnecessary emergency room visits and delayed care due to accessibility limitations.

According to the Bureau of Labor Statistics, private industries reported almost 3 million non fata injuries and illnesses among employees. These injuries and illnesses sustained in the workforce might account for concussions and musculoskeletal disorders. Athletic trainers1792 are specifically trained in the area of injury and illness prevention and are well suited to appropriately manage and refer patients away from entering the healthcare system via the emergency department, the most expensive access point. Athletic trainers have continued to expand upon their practice, demonstrating cost reduction, improved patient satisfaction, and accessibility in other states. Unlike our other allied healthcare colleagues, athletic training is a field based form of medical care, allowing for the prevention, triage, care, and referral when injuries occur in the place of employment.

A national survey conducted by the NETA on industrial companies who employ athletic trainers identified a reduction greater than 25% in workman's comp claims for musculoskeletal disorders. Half of the companies surveyed reported a decrease of at least 50% in work related injuries among employees. And not only are the numbers of injuries sustained in the workplace minimized through employing athletic trainers, but also the severity of injuries decreased by 25%. When injuries do occur, the presence of an athletic trainer allows employees to be progressed back into the demands of work through a return to work program, safely, and effectively. Approximately 50% of companies that provide an on-site physical rehabilitation program illustrated a 50% decrease in health care costs and savings. We look forward to working with the members of the public health committee, and we thank you for your time this morning.

SPEAKER1 - Thank you both. Are there any questions? Okay. Thank you both for your time.

K. House 24 75, senate 15 30 3, enact relative to student safety in interscholastic athletic activities. I have no 1 here today signed up to, speak on that, but I have heard from both, the senator and the representative on this bill. So thank you. At this time, we're going to move on to house 25 0 5, senate 14 86, an act to relative to end of life options. I'm going1925 to welcome before me, Elias Lieberman, retired rabbi from the Falmouth of the Jewish congregation. Rabbi, are you here?

SPEAKER18 - Okay.

SPEAKER1 - Oh, are you virtual?

Rabbi Lieberman, are you on the Teams?

K. We don't see, Rabbi Lieberman on the Teams

list here, so we will try to come back if we can. I'm going to invite,

Jim Sorrell. I have J. M. Sorrell, former executive director of Massachusetts Death with Dignity, here virtually. Are you on Teams?

SPEAKER19 - I am. Can you hear me?

SPEAKER1 - JM. Yep. Welcome.

SPEAKER19 - Let me get my camera on too. There. Thank you so much. Lucky me that I don't have to wait several hours.

J M SORRELL - CONCERNED CITIZEN - HB 2505 - SB 1486 - So thank you Senate and House chairs, and members of the Joint Committee on Public Health. I am J M Sorrell. I live in Haydenville, a village of Williamsburg in Western Massachusetts. Thank you for this hearing today and for previous years when you've moved an act relative to end of life options forward. I'm testifying to support legislation that will finally give Massachusetts residents the dignity and respect they deserve if they're near end of life and can exercise control to end tremendous suffering. For 21 years, I've been a healthcare advocate for older adults and for veterans of all ages. I've supported long term care residents and their families at end of life. After death processes where loved ones and patients endured suffering, I've been asked where did we go wrong and why didn't our mom get to be free of pain and die peacefully? Other times, dying patients and families have felt well served throughout the death process.

Each person dies differently. Some people are served well by hospice services and palliative care physicians. However, the healthcare system at large focuses on intervention even when futility and suffering ensue. This is unconscionable. Just as people have individual choices and paths throughout their lives, they also have individual needs near end of life and people deserve the respect of choice and control when they need it the most. Palliative care may not go far enough when someone wants to end profound suffering. Other states have this choice in place, including our neighbor, Vermont. This is long overdue. As you know, Senator Jo Comerford and Representative Jim O'Day have worked diligently to include tight language for the parameters to access medical aid in dying. No one can be coerced to make the choice, and the person has to have an absolute terminal illness with a short time to live, with confirmation from medical professionals that the person understands and wants the option. I have seen too many people die through increased suffering rather than an increased quality of life for the time they have. Humane choice is the least we can offer in an enlightened society. Thank you for including my testimony today and for all your good work. Thank you.

SPEAKER1 - Thank you. At this time, I'm also gonna invite, Michael Martinetti. Are you here, Michael?

Okay. May not have made it in just yet. Okay. I have in person, Molly DeHaas Walsh.

Compassion and choices.

Welcome.

MOLLY WALSH - COMPASSION & CHOICES - HB 2505 - SB 1486 - For nine years, I've been a hospice volunteer routinely visiting, making routine visits to2188 hospice patients and also on call to sit with actively dying veterans as part of No Veteran Dies Alone. I've seen that even excellent hospice care can't guarantee a peaceful death. Two stories. Ted went to Vietnam at 17 and returned home to become a teacher and raise a family. Excuse me. At 69, he was diagnosed with ALS and he was admitted to our hospice when he could no longer eat, drink or speak. He had difficulty swallowing his own saliva and he would cough and choke until his face turned purple and he was gasping for breath. He also had a condition that caused the inside of his mouth to slough off causing excruciating pain that couldn't be alleviated even with strong narcotics. Often he would sob, even wailing, and2245 the staff couldn't tell if this was from pain or an expression of total despair. Ted and his family decided to discontinue his tube feedings and he died after 14 days without fluid or nourishment.

Ron went to Vietnam at 20 and he was exposed to Agent Orange. He was a cable guy who liked trucks, country music, and most of all his dog. He was diagnosed with throat cancer at 69, and he endured radiation and chemotherapy but the tumor recurred and then spread to his lungs and bones causing severe pain. He faced the fear that the tumor in his throat would eventually block his ability to breathe and it would slowly smother him. Before that happened, he started having uncontrollable bleeding from his GI tract. His death was prolonged and difficult, complicated by severe terminal agitation related to his PTSD and uncontrolled pain despite strong narcotics. Both these men had already faced death at 17 and 20 years of age. I think they deserved a choice, some control over the way they had to face death as old men who sacrificed their2329 youth for their country. Thank you.

SPEAKER1 - Thank you. Are there any questions? K.

At this time, I would welcome Chris. I just have first name Chris who is joining us by way of teams.

SPEAKER21 - Hi. I guess, is it, are you looking for me, Chris Carrera,

SPEAKER1 - maybe? Welcome.

SPEAKER21 - Okay. Thank you.

KRIS CORREIRA - CONCERNED CITIZEN - HB 2505 - SB 1486 - My name is Kris Correira, from Charlton. I've been a physician assistant in Worcester for over 30 years. I oppose the End of Life Options Act. This is2380 the fourth time I've presented testimony to this committee. We've heard many testimonies supporting medical aid in dying. In the end, two reasons are given for legalization, suffering and autonomy. They say we need MAID for those who are suffering. We hear extreme stories about physical suffering at the very end of life, but most do not choose MAID for physical suffering, it's not a requirement. Everyone experiences significant suffering. If any kind of suffering qualifies, then anyone is a potential candidate. They say people should be able to control the timing and manner of their deaths. If autonomy is the basis for MAID, every safeguard limits autonomy. Many testimonies involve people who would not even qualify under the law. Elsewhere, safeguards have already been removed and more legal challenges aim at expanding the law.

Waiting periods, terminal illness, self ingestion, these will all be gone in due time. Hospice was not good enough. Voluntary stopping and eating drinking promoted by Compassion & Choices was not good enough. A death cocktail does not always lead to a peaceful death and significantly limits who qualifies. It will not be good enough. The arguments to expand the law are the same, suffering and autonomy. Legalization is only the beginning. Anyone assuring us the2472 law is safe is misleading us, unfamiliar with the trajectory of MAID everywhere else. Perhaps that's agreeable to the sponsor of these bills, but I doubt most constituents and poll takers would agree knowing this. Predicting death in six months is about as accurate as flipping a coin. This is why a lot of people remain on hospice beyond six months.

The disability community vigorously opposes MAID for good reasons. Studies demonstrate doctors think patients have a lower quality of life than patients do themselves. There will be more readily offered MAID than treatment. Insurance denials, unmet healthcare needs and receiving a possible erroneous terminal diagnosis are demoralizing and drives patients tragically towards MAID. We have no safeguard for this. If doctors inappropriately offer MAID, they are protected. Patients determined not to qualify by one doctor can shop for another. The bill is more about protecting the practice than making it safe. Assisted suicide cannot be made safe. Please draw the line while you still can. Thank you.

DECKER - Thank you. I just, this is a question I asked my Senate colleagues earlier. I think it's important for people to just, I encourage you to read the bill that suffering is not a reason to be granted permission, neither is just autonomy. So there's a lot of safeguards in this bill. And I just wanna make sure that this is a very sensitive issue for people who support this, people who oppose this, but that the facts of what the bill do are really important as we are guided and we deliberate on this bill today.

At this time, I would welcome Paul Goldberg who is also gonna be joining us virtually.

SPEAKER22 - Yes. Good morning. Can you see me? Hear me?

SPEAKER1 - We can hear you, Paul. Welcome. And now we can

SPEAKER4 - see you.

PAUL GOLDBERG - CONCERNED CITIZEN - HB 2505 - SB 1486 - Thank you very much for holding this session today. I'm here in support of the bills. In February 2022, my wife, Lee Marshall, and I had to move from our home in Gloucester, Massachusetts to Albuquerque, New Mexico so she could use New Mexico's Elizabeth Whitefield End of Life Options Act to peacefully end her suffering from metastatic breast cancer that had spread to her brain, bones, lungs, and liver. This move was the most painful, emotionally and physically traumatic experience of our lives and to this day, I am haunted by memories of the experience. I remain very saddened and very angry that we were forced to make this decision because the Massachusetts legislature had been unable to pass the Massachusetts End of Life Options Act.

I remember Lee being uprooted in the last month of her life in a wheelchair at the airport, unpacking in a bleak rental apartment in Albuquerque, away from everything familiar, unable to find comfort in her own bed, eat her own food, cuddle with our cat, blew up road uprooted from our home, and cherished friends because the legislators had failed to act on a bill supported by the majority of their constituents. After 42 years of marriage and developing a loving and rich community of friends, we were forced, in the last weeks of Lee's life, to be alone among strangers, lost, agitated, and very lonely. Lee herself was an RN for more than 40 years and she had worked and seen many people who suffered terribly in the dying process at the end of their lives. She supported MAID long before her diagnosis and she thought about the question for a long time.

We had many conversations. She spoke with many other people, often including multiple doctors to decide if it was right for her. The palliative care doctor, who was taking care of her, initially was against this bill. Lee spoke with her regularly throughout the course of her illness, listening to each other's point of view, discussing the reasons for and against. And in her last conversation with her doctor, before leaving for New Mexico, she asked again2748 whether after all their conversations she would prescribe MAID for her if it were legal here in2754 Massachusetts. Her doctor paused and said, yes. You have convinced me that it was right for you and I would prescribe it. Death is inevitable for all of us. When the inevitably came for Lee, she wanted to make sure she didn't suffer and linger in a debilitated, helpless, joyous state. And MAID became the only option that was consistent with her values. During her life, she worked to make medical aid in dying available in Massachusetts. And before she died, she asked me to continue to help promote passage of the bill in Massachusetts, so others won't have to suffer the same way, which is why I'm here. And thank you very much for your concern and your help in this matter.

SPEAKER1 - Thank you. At this time, I will go back to, Rabbi Lieberman, who I believe is on Teams.

ELIAS LIEBERMAN - FALMOUTH JEWISH CONGREGATION - HB 2505 - SB 1486 - Thank you so much. I am really grateful for this opportunity to offer testimony in support of an act relative to the end of life options. Fifth, such opportunity I've had to do so over the past 13 years. My name is Elias Lieberman, Rabbi Emeritus of Falmouth Jewish Congregation on Cape Cod, a position I held for 34 years until my retirement last year. I have in the past served as a volunteer hospice chaplain, and I bring to this moment decades of experience as a congregational rabbi, serving the needs of families as they have contended with end of life issues. I've been witness to good deaths and bad deaths. I've seen members of my community pass from life serenely, and I've watched them endure suffering that none of us would wish for ourselves or anyone we love.

I've had conversations with congregants in which they spoke of their desire for the option of a gentle death as provided for in this legislation. In Jewish tradition, a frequently heard toast is L'chaim, a Hebrew expression that means to life. Judaism is a faith tradition that deems precious the gift of life we're granted but it is also a tradition that rejects the notion that there is 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 have come 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 was expected to offer guidance to those facing the ultimate in existential questions, I believe firmly that terminally ill, mentally competent adults should be afforded2924 the right to choose to bring about a peaceful death when their suffering2928 renders living intolerable. I believe that life must be infused with meaning and purpose, and when it is no longer possible for us to attain either because of a suffering brought on by illness, a compassionate alternative must be available to us. I do not presume to speak for all Jews or for2948 Judaism, although polls consistently show strong support among Jews for medical aid in dying. I do feel strongly that anyone's 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 to grant the precious gift of autonomy to those whose suffering will be unendurable and for whom the option to end their suffering at the end of their life would be the greatest of blessings. Thank you.

SPEAKER1 - Thank you. At this time, I will welcome Barbara Webster from Compassionate Choices Compassionate and Choices.

SPEAKER24 - Welcome.

BARBRA WEBSTER - COMPASSION & CHOICES - HB 2505 - SB 1486 - Senator Driscoll, Representative Decker, and the others on the committee, I thank you for this opportunity to speak and tell my story of why I support this bill. I'm from Upton, and I support it in honor of my brother Chuck Webster who died early last year. My own perspective on death solidified as he agonized over his impending death from a rare and aggressive bladder cancer without the option for medical aid in dying. He and I talked many times about his wish to have the option for MAID after his experience caring for his partner who died five years ago of also a very rare and aggressive lung cancer. She only lived two and a half months after her diagnosis.

Chuck gave the best care he could give Conkey, who is a force of nature as he was, tried to give her the best care he could3069 the last two and a half months of her life, taking her to beaches on the East And West Coast Of Florida so she could see sunrises3075 and sunsets one more time. Despite initially receiving hospice care at home and his home, her pain became so unbearable that she had to be admitted to an inpatient hospice facility where she died a few days later in Chuck's arms. In Chuck's last week of life, a year ago, he, as I said, had this aggressive cancer. The hospice caregivers did the best they could to make him comfortable, but during his growing, managing his growing pain and anxiety was a challenge. Chuck's former wife, who had him in her home for the end of his life, his three daughters and their partners, my two other brothers, and I were with him that last week. We all saw how the ever increasing doses of morphine and antianxiety medications could not keep up with his breakthrough pain. It was brutal for all of us to watch.

After watching his unbearable suffering, we all agreed, including his former wife, who's Catholic, that no one should have to go through that agony, and that Chuck should have had the option for medical aid in dying. We believe that had he had this option, his last couple of months of life would have been so much richer and so much happier, but he was so scared about the pain and suffering that he anticipated that he could not enjoy the visits that he had up to the week before he died. And, actually, I have a picture of him three days before he died, and it was just so sad to have to see this knowing what he really wanted. So, to conclude, I urge your committee and other Massachusetts legislators to seize on this historic opportunity to pass this legislation to demonstrate your compassion and humanity to your constituents who might want this option for MAID. 10 other states in Washington, DC have all demonstrated the safety, autonomy, and peace this option provides to terminally ill adults. I want people in Massachusetts to be able to avoid protracted suffering in their last days and to gently die on their own terms. Thank you for your consideration.

SPEAKER1 - At this time, I'm going to welcome Sam Whiting Whiting, who is, joining us by way of teams, general counsel of Massachusetts Family Institute. Sam, welcome.

SPEAKER26 - Morning. Can you see and hear me?

SPEAKER1 - We can hear you, Sam. And now we can see you.

SAM WHITTING - MFI - HB 2505 - SB 1486 - Thank you very much. Thanks for the opportunity to testify today. As general counsel for Mass Family Institute, I'm here to speak in opposition to H 2505 and S 1486, which would legalize physician assisted suicide in Massachusetts. I first want to address one of the most misleading claims about these bills, which is that we have clear evidence that people in Massachusetts support legalizing physician assisted suicide by a wide margin. Groups with truly Orwellian names like Death with Dignity and Compassion & Choices like to point to a 2023 poll conducted by Beacon Research that supposedly showed that almost 80% of Massachusetts residents are in favor of so called medical aid and3274 dying. On its face, that sounds like pretty overwhelming support. As the old adage goes, you can barely get 80% of people to agree that the sky is blue. But if you dig a little deeper, a problem becomes apparent with this poll, and it's a big problem.

Here's what the poll actually asked people. Would you support a bill that would provide, and I quote, mentally sound terminally ill adults the option to get a prescription for medication they could decide to take to die peacefully? Of course, who wouldn't want terminally ill patients to be able to take medication that would help them die peacefully? Judging by that description, one would think these bills are about giving morphine, or anesthesia or palliative care to dying patients. But had the poll called medical aid in dying what it really is, physician assisted suicide, I think it's safe to assume the results would have been very different. For good reason, most people don't support the idea of doctors helping patients kill themselves. This type of obfuscation and misdirection is a key part of the assisted suicide lobby's playbook. It's simple. Whitewash doctor prescribed death to make it sound compassionate and empowering. Pretend like it's all about alleviating pain and we know that's not true. And most people choose assisted suicide because they feel like a burden on friends and family. Gaslight people with disabilities by claiming these bills won't devalue their lives and never admit that we're really talking about suicide.

Following the same pattern of obfuscation, the newest version of the bills would make state collected data about assisted suicide immune from the public records law. This means that if the bills passed, we may never truly know the impacts they've had on Massachusetts citizens. One has to ask, what are the proponents of these bills trying to hide? When a course is righteous, there's no need to use nice sounding euphemisms or deceptive talking points to promote it. Proponents of these bills know how unseemly it is to promote suicide, so they pretend that's not what they're doing. But I hope you can see through this ploy and I hope that you'll act to defend the sanctity of every human life by rejecting these dangerous bills. Thank you.

SPEAKER1 - Thank you. At this time, I will welcome Steve Shaheen Sheehan, Compassion and Choices.

STEVE SHEEHAN - COMPASSION & CHOICES - HB 2505 - SB 1486 - Thank you. Very emotional testimonies for sure. Again, thank you for allowing me and my colleagues to come here today. Many of us have heard sad stories about difficult end of life journeys or maybe have had a friend or a loved one who has experienced a painful death as I did during my wife's difficult battle and death from cancer. My wife was in pain and she begged me to end her life. She begged me to end her life. In her last days, she said to me several times, Steven, please, I don't wanna wake up in3441 the morning. Please. But I couldn't honor her wish because medical aid dying is not allowed here at Massachusetts. I've heard that it's not just about suffering. I've heard the minimalization of suffering at the end of life that it's expected, told to me by a physician, in fact. But I would ask anyone in this room here today, if you haven't experienced what too many of us have, do you have the courage to imagine the person you love most in the world dying a painful death and begging you to help them but you can't because the resource you need isn't allowed.

But today is no longer about my wife. Today is about any of our state's terminally ill citizens who themselves may be facing a painful death. Today is about giving voice to those who wanna decide their own end of life path and die in peace and with dignity. Are we really doing all we can for our terminally ill citizens, allowing them to suffer and die in pain and there's a resource that can end that suffering? This is a difficult but important issue. Of course, we have a right to our own convictions. Whether it's religious leaders bound by their faith, physicians bound by their Hippocratic oath, our disability community safeguarding their rights, or politicians trying to abide by their constituents' wishes. But the end of life options legislation doesn't require that we all agree.

It doesn't mean because one would refuse to access a resource like medical aid in dying that it should be denied to those who would choose to access it. It's a choice and every terminally ill citizen should have the right to make that choice. The majority of Massachusetts citizens who agree with having the right to decide how they die and they want their voices heard. This is no longer about advocacy for or opposition to the end of life options legislation. The arguments for and against have been made, and they've been heard, and they've been considered here in Massachusetts for over 12 years. Now is the time to act. As advocates, our efforts to pass this legislation won't stop. I believe the will of the people of Massachusetts to decide their3583 own end of life journey won't be deterred,3585 or their voices silenced, or their wishes go unheeded. We have the right in the state to decide how we live, we should have the right to decide how we die. I believe from our presence here today, we know it's time for this legislation to pass here in Massachusetts. And I humbly ask you, our legislative leaders, to move this bill forward and give all terminally ill citizens of Massachusetts the choice to alleviate on undue suffering and die on their own terms. Thank you.

SPEAKER13 - Thank you.

SPEAKER1 - At this time, we have on teams, Michael King from the Massachusetts Family Institute.

Michael King? K. We don't see Michael on Teams, so we're going to pivot to Gary Drimmer, who is on Teams.

Okay. I'm being told Gary may not be with us. Thomas O'Connor. Are you on Teams? Thomas Connors. Sorry.

SPEAKER27 - Hello. Hi. Can you hear me? This is Tom Connors.

SPEAKER1 - Welcome.

TOM CONNORS - CONCERNED CITIZEN - HB 2505 - SB 1486 - Hi. Thank you for hearing me. I wanted to express my concerns against this legislation that was voted down by Massachusetts voters when last put to a referendum, which health insurance companies would excitedly welcome to reduce by suicide their payout expenses. I can see in our future, they would run advertising campaigns, Boy, life sucks. Have you thought about suicide today, if this bill is passed. There's a fatal flaw in this legislation. Doctors are not an effective fake safeguard. I looked after my mother, a holocaust survivor, the last years of her life. While I experienced many good and wonderful doctors in the last years of her life, many were distracted, cold, limited in their time, limited in their ability to fully understand what she was going through. With all these limitations, how could a doctor who grew up in suburban America understand my mother whose neighbors in a small village in Ukraine, during World War 2, killed her entire family? They couldn't.

After my mother suffered a massive stroke, the doctors failed to accurately predict how long she had left to live. The nurses, however, told me not to listen to the doctors, telling me the doctors always underestimate how long the patient will live. The nurses were right. Lastly, this bill opens the door to murder. What if a person changes their mind at the eleventh hour after making a suicide decision? Would it be murder if that financially interested or narcissistic family member injects them with poison over that person's feeble but heartfelt last minute resistance? A horrific image that I want you to hold in your heads and a logical risk of this3778 proposed legislation. Thank you.3780

SPEAKER1 - Okay. At this time, in person,3784 I have welcoming, Laura Stevens.

Laura? At this time, I will welcome Steven Bartich.

STEVEN BARTICH - CONCERNED CITIZEN - HB 2505 - SB 1486 - Thank you very much for the opportunity. I'm a strong supporter of this bill. Other states, as you've heard, have had this option for decades. The fears and concerns of the disability community have not come to pass in those states, and given the guardrails established in the Massachusetts bill that you have before you, I strongly suggest that they will not happen in Massachusetts. In 1980, I watched my mother die of breast cancer. She had excellent medical care. Nonetheless, the last weeks of her life were extremely painful both physically and emotionally. She would have been a perfect candidate for medical aid in dying, but that option did not exist then. And in all candor, I doubt whether my sweet, smart and caring mother would have chosen that option.

In 2022, my wife of 53 years died. She fought through several years of pain, anguish, loss of control, and so forth. She was not terminally ill. She was a nurse and a nurse practitioner for over 30 years. She told me many times, based on her experiences with her patients at the VA, that there are a lot of things worse than dying. We even talked about going to Switzerland to take advantage of the options there regarding end of life choices for those who are not terminally ill. But before we could initiate actions to go to Switzerland, my wife had a stroke and died three days later. Also in 2022, I was diagnosed with cancer of the esophagus. A disease that is often painful and after a lengthy period of decline is usually fatal. I was lucky. I was extremely lucky. It was found early and after treatment, I'm well. Had I not been so fortunate, I certainly would have wanted the options of this bill. Whether I would have used those options, that would have been up to me. But I would have liked to have the option. There is no reason that Massachusetts residents should have to go to another state to secure these options. I urge you pass this legislation this year. Thank you.

SPEAKER1 - Thank you.

At this time, I have, Laura Stevens.

SPEAKER30 - No.

SPEAKER1 - Okay. We're looking for Donald Farley. I don't think we've seen him on Teams.

On Teams, looking for a Sigrid Schmalzer.

SPEAKER31 - Hi. Hi. Can you hear me?

SPEAKER1 - We can hear you. to me. But I would have liked to have the option. There is no reason that Massachusetts residents3947 should have to go3949 to another state to secure these options. I urge you pass this legislation this year. Thank you.

SPEAKER1 - Thank you.

At this time, I have, Laura Stevens.

SPEAKER30 - No.

SPEAKER1 - Okay. We're looking for Donald Farley. I don't think we've seen him on Teams.

On Teams, looking for a Sigrid Schmalzer.

SPEAKER31 - Hi. Hi. Can you hear me?

SPEAKER1 - We can hear you.

SIGRID SCHMALZER - CONCERNED CITIZEN - HB 2505 - SB 1486 - Thank you. Thank you so much. Thank you so much for this opportunity to share my experience. And thank you to Senator Comerford, and Senator Decker, and everyone else whose tireless efforts have made this possibility come once again. This legislation is needed not just for patients but also for their families. In 2015, I had to help my father end his life. He was suffering miserably from an untreatable neurological illness. And the doctors could 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 of4031 my ethical and filial duty to help him escape his suffering and have the dignified4035 death that he expected. But he did not live in a place with end of life4039 options, and so it fell 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 my 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. I actually even briefly thought about trying to get him some street drugs. But I had two small children I did not want to risk going to jail. And that was a scary option for all kinds of other reasons as well. I looked up freezing to death. It was January and bitterly cold. So I thought maybe we could give him some alcohol and sit with him outside until he died. He found that idea too horrible, as you can imagine. The only other thing I could offer him was for him to simply stop eating and drinking. And he decided he could manage that. His primary care physician declared him terminally ill so that we could get hospice care set up, but that was the only support that the physician could legally give us.

The hospice nurses were able to supply morphine. I think that did help. But we were worried about giving him nightmares if we gave him too much. And I think we ended up giving him too little considering that the goal was a quicker and less painful death. Honestly, I don't know because I'm not a doctor. And I still just worry, I agonize over whether those six days he spent getting progressively more dehydrated may have been torture for him. It would have made an enormous difference to have the assistance of a doctor with the right knowledge and the right 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 shoulders.

I am also certain, in response to what you're hearing from some other folks in this session, that the involvement of a physician would have increased, not decreased, the certainty that my father or anyone in his situation could make his decision without coercion and with all the necessary information. There's no way that I, with my relationship to him and, you know, wanted to be in that position. My mother now lives near me in Massachusetts and is considering her options down the road. We're wondering whether we need to establish a relationship with a doctor in Vermont that she can receive the full range of care. Shouldn't she be able to receive that kind of care here in her home state? Thank you so much.

SPEAKER1 - Thank you. At this time, I would welcome Kent Scott.

Welcome.

KENT SCOTT - CONCERNED CITIZEN - HB 2505 - SB 1486 - Well, good morning. And thank you for the opportunity to testify today in a contrarian view, in opposition to 2505 and 1486, which legalize physician assisted suicide in Massachusetts. I believe the bills disguise cruelty as compassion, where they promise a way out of unbearable suffering. In reality, they tell the most vulnerable among us, the elderly, the disability, and mentally ill, that their lives are not worth living. Not just society puts its citizens in a position where they're encouraged to kill themselves. You've all heard the data and all the information from a number of states that have bills like this. Oregon is always referenced usually because it's, a physician suicide bill has been legal for some time and they keep records about why patients choose to end their own lives. And the conventional wisdom of course is that the physician assisted suicide is a necessary compassionate choice for those in extreme pain and suffering.

Who would oppose that? Who would oppose that option, to die peacefully and with dignity? Well, pain was one of the lesser percentages of people pain is pain, but most were concerned that they'd have the fear of being a burden to their family. As a son of a remarkable man, who is currently in hospice care right now, my father who is a World War 2 veteran, yes, he's still living at 97 with 24 grandchildren, with eight great grandchildren, a loving husband of my late mother who just passed away peacefully, palliatively in hospice care, a wonderful father to me. My dad can't take care of himself now. He struggles with mobility issues. He's not in good health and his mind is failing. It requires a significant effort on my family and I to help him contently, healthy and alive, of course. And we're happy to do it because we love our dad.

But if he were able to understand the nature of his circumstances and consent to his own medical care, I do worry that he would feel like a burden to me and my family. Should he have an option to take his life? Is my father's life less valuable because he's not in his prime anymore? Should people like him who are elderly and disabled be tossed aside by society since they served their purpose and aren't useful anymore? Hard questions. Should we establish a legal regime that allows them, even encourages them to die deaths of despair? This is unconscionable to me and so many others who have loved ones in similar positions. So I ask you to reconsider and reject this counterfeit compassion of physician assisted suicide and recommend this bill not pass. Thank you, and good morning.

SPEAKER1 - Thank you.

At this time, I'm being told that Glenna McKittrick is not on Teams. Just confirming that.

Okay. I do believe we have doctor Shelley Berkowitz on Teams.

SHELLY BERKOWITZ - CONCERNED CITIZEN - HB 2505 - SB 1486 - Thank you, Chairwoman Decker, Chairman Driscoll, Senator Comerford, the members of the joint committee, and everyone here who has worked on this bill in support for this opportunity, to share my personal story and testimony in strong support of passing an act relative to end of life options. My name is Doctor Shelly Berkowitz. I'm a family practice physician with over 40 years experience. I live and work in Northampton, Massachusetts. I've cared for patients at birth. And I've also witnessed and supported many dying patients, whether at home, or in the hospital, or in a nursing home. I also sadly witnessed the painful deaths of each of my parents, Sarah and Morris Berkowitz. They were both Holocaust survivors, so their life experiences made me exquisitely sensitive to and aware of the ethical issues that can lead to the loss of human dignity, both in life and death. As a result of my experiences as a physician, a daughter, but most importantly as a human being, my journey led me from initially being against me to becoming a strong and staunch survivor of this bill for the past three to four years.

During each of my parents' terminal illnesses, my father from stomach cancer at almost 99, my mother from the sequelae of head trauma, also in her 90s, my Orthodox Jewish sisters fought to keep them alive at all costs, regardless of my parents' clearly expressed prior riches to die peacefully with dignity and without their consideration to the overt pain, suffering, and terrible quality of life that my parents then had to powerlessly endure despite the well meaning help of hospice and palliative care. This is my parents, Morris and Sarah Berkowitz when they were in love after being liberated, healthy, and the image that I would love to have retained in my mind. This is a picture of my mother, Sarah Berkowitz, in the last days of her life after she had aspirated from being essentially force fed against her will, and she couldn't combat it at the time.

I have read the entire bill. This bill has so many robust safeguards in it to preserve human dignity, which4603 I can't mention now. You all know it. So with due respect to people who suggested4607 otherwise, who have not read the bill, it rules out the presence of suicidal depression to require legal medications to be self administered with no physicians ever being required to write a position against their personal ethics. Despite ongoing scrutiny, there's been4623 no abuse of MAID4625 since4625 the 10 states and Washington DC in the 1990s. This bill needs to pass4631 so that terminally ill patients can choose the option to end their life with dignity on their own terms. Please pass this bill now. Thank you.

SPEAKER21 - Thank you. Thank you for your testimony. Next we will hear from Finn Gardner, director of policy and advocacy, autistic people of color fund. Welcome.

SPEAKER4 - Oh.

Welcome.

FINN GARDNER - AUTISTIC PEOPLE OF COLOR FUND - HB 2505 - SB 1486 - Hello. Today I will be testifying against this. To its supporters, assisted suicide is a compassionate option for people with debilitating terminal illnesses like late stage cancer. They frame their arguments in terms of bodily autonomy and self determination in the face of excruciating pain and agony. And lambaste their opponents as conservative pro lifers or heartless ghouls who want nothing more than to watch helpless people suffer. But the problem is, a lot of the reasons why people opt for assisted suicide are not the objective factors of pain or severity of illness. Instead, many worry about being a burden to their family, their friends, and their community, which is a common fear among people with disabilities.

In a study from British Columbia in Canada, researchers found that 53% of people who received assisted suicide considered loss of autonomy a factor in ending their lives, nearly as much as they did disease symptoms themselves, up to 60%. And among those eligible for assisted suicide that did not choose it, 33% were focused on their fear of future suffering, while 17% considered disease symptoms. And other research bears this out. Among assisted suicide recipients in Oregon, people rank the loss of autonomy, the loss of dignity, and the loss of control of bodily functions over pain. So all these fears are inextricably tied with disability and how it is perceived and experienced. It is not their pain alone that those who seek assisted suicide fear, but the disabled condition.

And underlying this trepidation is the idea that it is shameful and degrading to need assistance with activities of daily living, that it is burdensome, that is a reason to end one's life. And all these fears result from deeply ingrained ableism or the systemic prejudice against people with disabilities. And there4803 have been statements from the United Nations that4805 have condemned it, that have condemned assisted suicide. The UN said that it was a form of discrimination that draws strength from ableist assumptions about the inherent quality of life or worth of life of a person with a disability. And because of this, we're presented with two false choices, live with shame or die with dignity. But this isn't a choice at all. It's just capitulation to the forces of ableism. And some say that because of eligibility requirements and other safeguards exist, there's no way for the system to be abused, but the evidence says otherwise. There are places that have expanded assisted suicide to include mental health conditions. For example, in The Netherlands. And Canada recently expanded their assisted suicide laws to include mental health conditions. So I encourage you to report this unfavorably.

SPEAKER1 - Thank you. At this time, by way of teams, I wanna welcome Steve Tugas.

Steve, we were unable to hear you. Are you able to unmute4891 on your end?

We can't hear you, Steve.

We're just we're gonna give you a few seconds to see if there's a way of, unmuting on your end.

SPEAKER35 - Am I am I on now?

SPEAKER1 - We yes. Welcome. We can hear you and see you.

STEVE TOUGAS - CONCERNED CITIZEN - HB 2505 - SB 1486 - Okay. My name is Steve Tougas. I thank you distinguished legislators for the opportunity to testify against 2025 and 1486. In my early 20s I was first diagnosed with hypertension requiring medication. It was a point back then when I made the second final decision to kill myself, which doing so is the final. The second is determining where, when, how, and nobody was talking me out of it. On my way to do it, I had thought, since God is sovereign, if God didn't want me here, I wouldn't be here. And since I was, he must want me here. But am I gonna use my free will to throw my nose at him and decide I know better? No. My mom said she noticed by going there, I could point out a major side effect of the new blood pressure medication with severe depression. I stopped taking it and suddenly the bottle lifted like night and day.

I was cured of suicide for decades and so I thought, had I succeeded, I wouldn't have experienced my name on a patent nor developed software for robotic prototype performed surgery over the Internet nor performed as a lead singer in a band of thousands. I also wouldn't have been asked by mascots, national committee woman in 2016 to run committee woman in 1 Quincy. Nor received 31.5 of the vote presented the vote against the now speaker of the house in 2020. All that ended on Black Friday of 2022 as I lay there all alone in the dark on a hospital nearly half paralyzed with a stroke. I believe my life was over and pray, heavenly Father, to your hands, I commit my spirit. I've always been staunch ally against this since this suicide, but I've just been put in a situation to see the issue from the other side. If it had been legal, I would've would I have opted for assisted suicide that first night? If I didn't have faith in Christ, it would have been an extremely tempting offer, again, to wrest control from God. I chose only option available to trust. It wasn't easy.

My family in North Carolina is dealing with their disabilities, and, I was at the mercy of Fernslife State Bread Day to coast and Lonnie Brown on the Boston Broadside. I've been I was totally independent, but now I'm still in danger of being homeless. Had the option been available and I chose it during those two years, I wouldn't have been remotely completely my contract job to develop software remotely, knew the inside of veins and arteries and heart. I wouldn't have been able to continue serving on two state boards, and I wouldn't have made any progress writing my book. I think of all the people who could be cared for instead if the left didn't spend their time relentlessly trying to pass these bills and to which benefit are they really for the individual or the supposed benefit of society. All I know is that you who to spoke with these bills will be responsible for all the lives that could have been.

SPEAKER1 - Thank you. Thank you for your testimony.

SPEAKER4 - You're

SPEAKER35 - welcome. Thank you.

SPEAKER1 - At this time, I would welcome, by way of teams, Mike Mosbrucker.

Doesn't look like Mike is on teams. I'm going to invite, Matt Valeri. Are you here, Matt? Welcome.

SPEAKER4 -

MATT VALLERE - CONCERNED CITIZEN - HB 2505 - SB 1486 - Good morning. Suicidal thoughts or actions, including in older adults and people with life threatening disabilities, are a sign of extreme distress and should not be ignored. If you or someone you know needs immediate help, please call or text the National Suicide Prevention Lifeline at 988. My name is Matt Vallere. I'm a Worcester native, on call volunteer, EMS, and first responder. I'm not here to take a position on the implications of somebody taking their own life, which is legal to do with impunity here in the Commonwealth. With this public policy, however, you have to ask, could it hurt someone? Could someone be coerced? I argue that the answer is yes. There's no public policy that's gonna be perfectly able to control and protect vulnerable people.

When people hear assisted suicide, they think stage 4 metastatic cancer, and you heard some sad stories today. When you look at the underlying conditions and the data from legal states like Oregon, there are conditions that are not life threatening with treatment. Things like diabetes, HIV, anorexia, arthritis, and a hernia. My dad has diabetes. If he gets off his insulin, he qualifies for lethal drugs under this bill. There are confirmed cases of people doing this in other states that have legalized. Proponent physicians and lawyers have been overtly arguing that patients that do not have medical conditions that currently render a six month prognosis, like early stage dementia, ALS, etcetera, can legally voluntarily stop eating and drinking as a, quote, bridge, a bridge to acquire lethal drugs under assisted suicide laws, including this one. This bill would allow that.

One Oregon woman, a woman named Corrie Sontag, she started VSED in order to qualify for lethal drugs with early stage dementia. Her doctor qualified her for the drugs, gave them to her, and she died eight days later. This is a person who did not have a terminal illness. Do you have a daughter? Anybody have a daughter, a niece? I myself have daughters. This bill would allow a5274 doctor to help my daughters to kill themselves5276 with your lethal drugs if they have an eating disorder that the doctor thinks is incurable. There's no clinical evidence anywhere to show which people with anorexia might recover and might not. You're putting my girls at risk with your bill if you vote this through. There are 60 known cases of young people with eating disorders who received lethal drugs under bills just like this one.

In Colorado, they now list severe protein malnutrition, 12 cases over the course of time. California list endocrine, nutritional metabolic disease, 40 cases over time, and they have confirmed that that category includes people with anorexia. Look, my friends who have had eating disorders would have taken this and they've said so, and it will be on you if you pass this bill, if young people with anorexia and other eating disorders end up ending their lives and getting rid of decades of their lives because of it.

DECKER - Thank you. I'm going to recognize my colleague, Representative Phillips. I just wanna remind folks, I think it's really important that people read the bill. The intent to commit suicide and eating disorders do not qualify anyone in Massachusetts under the legislation that has been written.

at this time, I wanna recognize and I'm sorry. That's just a rule for anyone unless you're sitting here. At this time, I wanna recognize representative Phillips.

SPEAKER20 - Thank you.

REP PHILLIPS - HB 2505 - SB 1486 - Thank you very much, Chair Decker, Chair Driscoll, members of the committee. Thank you very much for hearing this bill so early in the session. Really grateful that you put it up. I want to address that previous point as well. As somebody who works very closely with Samaritans, in the House of Representatives, and is their champion, during budget season and things like that, I can emphatically say that this bill has nothing to do with suicide. This bill is for a very, very specific set of patients who are facing unimaginable pain at the end of their life. This is for people who know that there is no hope of recovery. This bill was first requested to my predecessor, Representative Lou Kafka that he file it, it was a constituent who was dying from stomach cancer, and who wanted to make sure that everybody else in the Commonwealth. He knew that he wasn't gonna be able to take advantage of this bill, but he wanted to make sure that everybody else had the choice and the control at the end of their life to be able to5438 make those decisions for themselves.

We have endeavored to provide that. We have also made sure that we heard from all of these, all the groups that had an objection to the bill, that had questions about the language. We tweaked it multiple times in order to make sure that if passed, this bill would be one of the most, actually the most restrictive bill in the country. We now have almost decades, or excuse me, we do have decades of data from other states that have passed this that says that this is not being abused. We know that if we brought it to Massachusetts, it would not be the slippery slope that some people claim. So, I am very, very grateful that you are looking at this bill so early in the session. We are, hopeful because the language hasn't changed, there is going to be the same result, from the joint committee, which is a favorable report. And I'm happy to answer any questions you might have.

SPEAKER1 - Thank you, representative. At this time? K. Thank you.

SPEAKER4 - Thank you,

SPEAKER34 - madam chair.

SPEAKER1 - At this time, I wanna welcome by way of Teams, Mike Mossbrucker.

Okay. Mike is not on Teams. Oh, is sorry. We did that. At this time, I will welcome, Frances Hogan by way of Teams from the Massachusetts Catholic Conference.

SPEAKER38 - Yes. Can you hear me?

Can you hear me?

SPEAKER1 - We can hear you, and we can see you. Welcome.

SPEAKER38 - Oh, excellent.

FRANCES HOGAN - MASSACHUSETTS CATHOLIC CONFERENCE - HB 2505 - SB 1486 - Thank you. Good morning, chairs Decker, and Driscoll and members of the committee. My name is Fran Hogan, and for many years, I have served as a board member of the Massachusetts Catholic Conference, which represents the Archdiocese of Boston and the diocese of Fall River, Springfield, and Worcester. I thank you for the opportunity to testify briefly on behalf of the conference in opposition to these two bills. As you are aware, the bills under consideration would allow a patient to be prescribed a lethal dose of drugs to end his or her life after meeting certain criteria. The Catholic church has always strongly opposed physician assisted suicide and continues to uphold the dignity of every single human life.

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 or other reasons. 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 faith communities, as well as a variety of organizations and doctors and nurses, are called upon to comfort the sick in the dying process, and understanding the huge physical and emotional toll on families to be compassionate and available to help both the dying person and their families in every possible way. These two bills have several flaws that others have mentioned and probably will mention. For example, the often misdiagnosed six months to live criteria or the risk of undue influence by someone who may benefit financially from the death of a vulnerable individual who feels he or she is a burden to loved ones.

Finally, however, rather than focus on the bill's flaws, I would like to bring to the committee's attention the positions of two prominent national medical organizations. The National Hospice and Palliative Care Organization came out in strong opposition to physician assisted suicide stating in part, in light of the under use of hospice and palliative care to alleviate suffering, lack of comprehensive healthcare for persons with serious illness, concerns of disabilities rights advocates regarding protections from coercion, long standing racial bias in medicine, disparities in health and medical care, and lack of protections to ensure voluntary participation, the organization opposes legally accelerated death as a societal option. In January of 23, the National Alzheimer's Association severed their ties with Compassion & Choices stating that the values of Compassion & Choices are inconsistent with those of the Association. Concluding, the Massachusetts Catholic Conference believes that the legislation should focus on ways to provide quality palliative care to the sick and dying, particularly the undeserved, disabled, poor, and minority communities. I ask this committee not to act favorable on these two bills before you and I thank you for your time.

SPEAKER1 - Thank you. At this time, I5726 by way of teams, I would welcome Jack5728 Edmondson, and we are told he is not on. Okay. At this time,5734 in person, I welcome Stephen Helfer.

SPEAKER39 - Can you hear me?

5761 I5761 guess you can.

5763 STEPHEN5763 HELFER5763 -5763 CONCERNED5763 CITIZEN5763 -5763 Thank5763 you. My name is Stephen Helfer. I live in Cambridge. I strongly oppose physician assisted suicide. Proponents say this bill is limited to persons with a terminal diagnosis, in reality, however, we all have a terminal diagnosis, so anyone eventually would and could be eligible. For 2000 years, the Hippocratic oath has enjoined physicians quote, to give no deadly medicine when asked nor suggest any such counsel, end of quote. I respectfully believe physicians who turn their backs on this ethical tradition do, neither society or their profession, a service. My brother-in-law a few years ago died from cancer after three months of extreme discomfort. My sister selflessly ministered to him. If a less burdensome, less painful, and less costly death had been held up to him in the form of physician assisted suicide, this would in fact have been tacit coercion despite the putative safeguards. I again ask you not to forward either of these bills. Thank you.

SPEAKER1 - Thank you. At this time, I welcome John Gatto by way of teams.

SPEAKER40 - Hello. Sorry. Had a little trouble there.

SPEAKER1 - Welcome.

JOHN GATTO - CONCERNED CITIZEN - HB 2505 - SB 1486 - Thanks. Thanks for having me. My name is John Gatto. I live in Rockport. I've been a social worker for a long time. I've run programs with people with AIDS, cancer, all sorts of life threatening illnesses, but really wanted to share a personal story of my husband, Art Shirk, who in 2014 was diagnosed with idiopathic pulmonary fibrosis, multiple, which basically means his lungs filled with scar tissue over the course of three years to the point where, you know, the blood no longer transfers oxygen. It's sort of like a long slow suffocation. It's a horrible disease like so many other stories you you've heard today. Art was not a fearful man. He was wildly courageous and enthusiastic. He took up the trapeze at 50. He was diagnosed with heart disease and we went hiking the Inca Trail. Fear wasn't something that ran his life. The one fear he had5945 was, at the time of his5947 diagnosis that he would have a prolonged death that was beyond any pain he should have to know. And in order to, well, actually, what I wanted to do is speak to what the absence of medical aid in dying looked like for us. Because he was scared of this needless suffering, he had friends gather helium tanks from all over the country that he stockpiled somewhere in our house.

He obtained lethal drugs from other countries. And because he feared that I could be held criminally responsible for his death, he concealed them from me, and got to a point where he said he felt like the time was coming but he would not tell me when or how it was gonna happen, to protect me. And I I mean, imagine, if you could, the idea of coming home to find your loved one under a homemade6007 helium tank dead at the kitchen table. It's not6011 a death that anybody should encounter or a loved one should have to endure. In the end, ultimately, his disease claimed his death before he had to implement either of these plans, for which I'm deeply grateful. And while it was a burden to care for him, let me just say it's a burden I would welcome every day that I have lived since his death. This is not about a way out for caregivers. And I personally believe that, you know, human dignity supersedes religious, political, social beliefs. And if we really believe in death with a life with dignity, we can't have life with dignity without death with dignity. So thank you.

SPEAKER1 - Thank you. At this time, I'd like to welcome Melissa Stacy, who's here in person.

MELISSA STACY - COMPASSION & CHOICES - HB 2505 - SB 1486 - Good morning, Chairman Driscoll, Chairwoman Decker, members of the Joint6082 Committee on Public Health. Thank you for the opportunity to testify in support of S 1486, H 2505, an act relative to end of life options. I'd like to thank the committee chairs for scheduling an early hearing on these bills this session and also for moving the bill out of committee favorably last year. My name is Melissa Stacy and I'm the regional advocacy director for Compassion and Choices Action Network here in Massachusetts. I'd like to take a minute as I begin to recognize that Doctor Roger Kligler, a subject matter expert and advocate, isn't joining us today. His health prevents him from testifying even virtually. His voice is missed and his absence underlies the urgency of our request to authorize medical aid in dying in Massachusetts.

This legislation includes strict eligibility criteria and practice requirements to ensure the highest standard of care. Individuals must be an adult resident of Massachusetts. They must be terminally ill with a six month or less to live, be capable of making an informed decision, and be able to self ingest the medication. This option is not taken lightly, and many safeguards in place ensure that the decision has not been made in haste. There is a stringent process in place that must be followed in order to be eligible to request and receive medication under this law. The legislation is optional for all involved, patients and providers alike. 11 US jurisdictions have authorized this end of life option, and the data from those states show that the process and safeguards work.

We know, from consistent polling, that Massachusetts voters overwhelmingly support terminally ill patients having this choice. Beacon Research poll from March of 23 found that 73% of Massachusetts polls, voters polled believe that medical aid in dying should be an option for terminally ill patients. And after learning about the safeguards built into the bill, that support increased to 79%. Many of us have stood by the bedside of those we love watching them suffer uncontrollably. Today is the second anniversary of my dad's death. Due to an injury in his 30s and compounded by an experimental surgery gone wrong, he was disabled and lived with pain every day. While he wouldn't have qualified for medical aid in dying at the end, he was in hospice care.

His team was incredible, loving and kind, but they couldn't get him completely comfortable. At the end, though sedated, his limbs jumped and he was grimacing in pain. Hospice and palliative care are incredible programs but they cannot control suffering for all patients all the time. Only a small percentage of Massachusetts residents will request medical aid in dying, for those that do and are eligible, having access to this option would bring peace of mind. Peace of mind that would give them the ability to focus on living their lives, living in the moment without fear for what they end may bring. Thank you for allowing me to testify and for moving the bill forward. Thank you.

SPEAKER1 - Thank you. At this time, I would welcome Myrna Maloney Flynn, president of Mass Citizens for Life to join us by way of, teams.

SPEAKER41 - Good morning. Can you6285 hear me?

SPEAKER1 - Good morning. We can hear you. Welcome.

MYRNA FLYNN - MASS CITIZENS FOR LIFE - HB 2505 - SB 1486 - Great. Thank you. Here are three truths of doctor prescribed suicide, as presented in 2022 by Fitchburg Resident Doctor Mark Rollo, a lifelong family physician. Doctor Rollo passed away suddenly a few months after sharing his remarks. It is on his behalf that I request that you keep assisted suicide out of our homes. Truth number 1, doctor prescribed suicide damages trust in doctors. A physician cannot be both healer and killer and still maintain a patient's trust. Truth number 2, doctor prescribed suicide is dangerous. Doctors make mistakes in diagnosis and prognosis. Just look at Stephen Hawking, the famous astrophysicist who discovered black holes. He was diagnosed at age 21 with Lou Gehrig's disease and was given just a few years to live. In actuality, he lived about 50 years after his initial prognosis.

Doctor prescribed suicide is a recipe for elder abuse. DPS is also dangerous because it puts a price tag on life. Required witnesses could have a variety of opportunistic interests in the patient's death. And government payers like Medicare, Medicaid, along with private insurers have significant financial incentives to approve doctor prescribed suicide because it's far cheaper than disease treatments. There are many examples of cancer patients in states like Oregon who received letters from their insurance companies or their state's health plan denying them further cancer treatment but approving inexpensive doctor prescribed suicide instead. In California, in 2016, just a week after it passed assisted suicide, a woman with four children at the age of 33 named Stephanie Packer learned that her private insurance company would no longer pay for her chemo, but with a co pay of just $1.20, Stephanie could obtain drugs to kill herself. She not only survived for more than a decade and and still testifies actually currently in various states across the nation against assisted suicide, she testified before this very legislature in opposition to DPS.

And finally, DPS is dangerous because patients can come to feel pressure from organizations like Compassion & Choices and from societal pressure as DPS becomes more accepted. Finally, it corrupts the medical profession because it is legalized fraud. Doctors are prevented from listing suicide as the cause of death on a patient's death certificate. Instead, doctors are required to lie and list the patient's underlying diagnosis as the cause of death. So once you realize, excuse me, once you legalize doctor prescribed suicide, it becomes a medical procedure and a cheap one at that. It conceals the truth, stains the medical profession, and betrays hope. It is not compassion. It is abandonment. Thank you for opposing this bill and for supporting love and pain management. And thank you for advancing excellence in patient care that is good, true, and beautiful even through life's greatest challenges.

SPEAKER1 - Great. Thank you. At this time, I'm going to welcome, by way of, no, in person, Barbara Weatherspoon.

BARBARA WITHERSPOON - CONCERNED CITIZEN - HB 2505 - SB 1486 - Good morning. So thank you to all of the board members and the co chairs, Representative Decker and Senator Driscoll. Thank you for this opportunity. It's the first time I've been here and the first time I've had an opportunity of doing this. My name is Barbara Witherspoon, and I live in Plymouth, Massachusetts. My husband, Lee, was forced to uproot his life away from my family and friends and establish residency in California where death with dignity is legal because medical aid in dying is not an option for terminally ill patients in our state. In 2014, Lee was diagnosed with with pulmonary fibrosis, a terminal illness most likely caused from his work in the steel mills as a teen. In 2018, he started having excruciating pain in his back and was also diagnosed with severe osteoporosis, severely fractured three vertebrae in one year, just coughing.

As Lee's condition worsened, we sold our home that he had built in New Hampshire and moved into our son's home in Plymouth. Lee rapidly started feeling worse. He knew that California had recently passed the end of life options act, and he knew this was his best option. Devastated to leave our family, we became California residents in 2019 and Lee enrolled into a hospice support program. By January 2020, he had lost more than 20 pounds, was very weak and in severe pain with little reprieve for medications. It was shortly after he started going through the eligibility requirements to received death with dignity approval. He was in high spirits that he now had this choice.

The week before he died, he called each of our seven children and every close friend to thank them for their love and care. On February 29, Lee had chosen two songs to dance with me, after which he laid down on our bed in my arms. He drank his medications and he died very peacefully. How I wish I could have had this experience in Massachusetts, where most of our family and friends could have been with him. I got to hold Lee for the last hour of his life, I got to tell him how much I loved him, and I got to see the complete peace in his eyes during his last moments. Don't we all want that gift? Thank you.6688

SPEAKER13 - Thank you.

SPEAKER1 - This time, I wanna welcome and see whether6698 or not Erica Garcia is on Teams.

We don't think Erica is on Teams. So I'm going to move to doctor John Barravecchio.

JOHN BARRAVECCHIO - CONCERNED CITIZEN - HB 2505 - SB 1486 - Good morning. I especially greet my senator, Mr. Driscoll. We've talked about this before. I'm a primary care physician I've been practicing in the Commonwealth since 1982 in multiple settings. Physicians are well aware of their inability to make prognostic predictions about a patient's life expectancy. Everyone has known someone who's been given a short prognosis and has nevertheless far outlived it. Individual patients may not fully fit the categories of the studies in the literature and may be falsely given of short prognosis. Indeed, the majority of hospice patients outlive the six month expectancy prognosis and may survive much longer. I will show you an article from the Patriot Ledger, Life is Beautiful, about a 100 year old woman who's writing her life story about having had a heart attack in early 90s and being placed in hospice because she was not expected to survive. She might have been induced to end her life because of a poor prognosis.

A BMJ article analyzing 25 years of Oregon Death with Dignity Act found that it was impossible to make a sound evaluation because of lack of substantive data and failure to collect data. Safeguards touted in this bill are unlikely to be maintained as evidenced by constant chipping away at similar provisions in other states once this practice is permitted. What patients most need is the commitment of the medical community and the state to offer effective palliative care with a human touch. Research indicates that requests for physician assisted suicide are unlikely to persist if compassionate supportive care is given. What is most critically needed is physician training in, support of, and expansion of consultative availability in palliative care. The AMA, the American College of Physicians, and the World Medical Association,6859 large physician organizations oppose physician assisted suicide. Rather than pass this bill under the aegis of options, I would hope that the Commonwealth would find the means to truly support the availability of better options for all our communities. I've submitted more expansive written testimony. Thank you all.

SPEAKER1 - Thank you.

This time, I'd welcome, Simon Rabgayal. And if I have not said your name correctly, please do correct me.

R a p g y a l. There's a sign. K.

Simon, are you with us on Teams?

Simon, we know that you're phoning in, so your name won't show up on Teams. We're just trying to see if you are there with us.

Okay. We will try to circle back to you, Simon. At this time, we welcome Kurt Selle.

Kurt? Okay. Eric Ruby.

ERIC RUBY - AMA - HB 2505 - SB 1486 - Chairwoman Decker, Chairman Driscoll, and committee members, thank you for this opportunity to testify in support of the end of life options act. My name is Doctor Eric Ruby. I am recently retired from practicing medicine in Taunton for more than four decades. I am a member of the American Academy of Pediatrics, the Massachusetts Medical Society, and the AMA. This is the sixth time I have given testimony in support of medical aid in dying. I am gratified to say that I've seen tremendous growth in the understanding and attitude towards end of life care by voters and my colleagues, notably increased support for medical aid in dying. 73% of Massachusetts residents support medical aid in dying. A 2017 MMS members confirmed 62% supported medical aid in dying for terminally ill patients. Nationwide surveys of US Physicians demonstrate a clear and consistent change.

From 2010 to 2020, support for medical aid in dying rose from 46 to 55%. At the same time, opposition decreased from 41 to 28%. In Massachusetts, end of life continuing medical education has become mandatory for licensure. Medical schools are integrating end of life courses7060 into standard medical education. Since December 2017, the Massachusetts Medical Society adopted a position of neutral engagement. The AMA's council on ethical and judicial affairs affirmed in its code of medical ethics that physicians who practice medical aid in dying are not violating their professional7082 ethics or standards. I quote, supporters and opponents share a fundamental commitment to values of care, compassion, respect, and dignity.

I have had 48 years of professional experience with death and dying and one very tragic personal experience. It's taking me too long to die. These were the words of my father, a dignified, proud, and respected physician who had metastatic prostate cancer. After a month in hospice, a 30 pound weight loss, black and blue marks all over his body, and crying in pain daily when he was not sedated to an almost7119 comatose state, he died in 30 days as he predicted. Esteemed members of this committee, the time to act is now. The people are with you, doctors are with you. Terminally ill patients are begging you. Please support the Massachusetts end of life options act. Support choice and7138 autonomy at the end of life.7140 Who does not want a peaceful death? Thank you.
SHOW NON-ESSENTIAL DIALOGUE


REP O'DAY - HB 2505 - SB 1486 - Good morning. Thank you very much for taking me out of turn, Madam Chair, Mr. Chair, members of the committee, I appreciate that very much. And I am here today to speak specifically on the end of life options bill that we're here for this morning. I have the great honor of being the lead sponsor of this bill and I will do my best not to be redundant. I'm sure you've heard from other testifiers over the last hour or so, two hours. But this is really for me a very straightforward and very common sense piece of legislation. This is about quality of life, this is about choice, and this is about trying to avoid horrific pain and discomfort at the end of one's life. I know that this is a topic that many people shudder to talk about, but guess what, everyone in this room is gonna have an end of life termination at some point in time.

This bill really looks towards and works towards trying to make that end as painless as possible with an individual's choice. I have no objections to those who feel that this is not something they want to involve themselves with. That's fine with me. But if it's something I, as an individual, want to have the option, at the end of my life, I'm not sure that I feel that anyone else's opinion should address that issue the way I want to address it. I many times cringe when I hear this bill being referred to as physician assisted suicide. That is not what this bill does. This merely gives that individual at the end of their life an option to make a choice, those who are of sound mind, to make a choice that they no longer want to live in a way that is completely alien to how they used to live.

And how I really became involved with this effort was my own dad. He was a tough character, former Worcester police sergeant who lived life to its fullest. And at the end of his life, there was no reasonable similarities to the person that was in that hospital bed to the guy that I knew and respected and spent a lot of quality time with. And one of these conversations that I had over the years with dad was that he wanted to make sure that he wasn't going to die at an extended period of time in misery. He expected me to take care of that for him. I wasn't sure how I was gonna do that. There wasn't a way for me to do that. But this bill allows those who wanna make that decision to have that opportunity. And I know my time is up and I appreciate the offer. I really appreciate the committee's willingness to bring this bill forward so early in our session, giving us the opportunity to really speak to it. Thank you very much.

SPEAKER1 - Thank you, representative. Thanks. At this time, I would like to welcome Michael Martinetti.7387

Somebody go help move the chairs out of there.

SPEAKER29 - Thank you. You're welcome.

MICHAEL MARTINETTI - CONCERNED CITIZEN - HB 2505 - SB 1486 - Good to see you again. Been a year, a little less, but it's gonna be a good year. So I hope, so, forgive me for reading, but Okay. So you've heard plenty of testimony since this bill was first filed by Rep Kafka, and now by, Rep Phillips behind me, and Rep. O'Day, who you just heard from and Senator Comerford, of how Mass residents have needlessly suffered in the last months of their lives. I've had my fair share, I've told you over the years, of loved ones who have suffered as well. But today, I wanna just talk about common sense and the hope, you know, the good feelings that I have because we've explained this bill to the residents of the state, to legislators. I think we pretty well vetted it. We know what the parameters are.

What I guess, was, oh, yeah, I wanna talk about common sense and ask you to, like, Rep O'Day, to move this bill as quickly as you can out of this committee so that we can can get to a vote of both chambers. Last year, the bill had great momentum, more co sponsors than ever are moving through this committee. Thank you for that. And the Joint Committee on Healthcare Finances and Ways and Means for the first time ever. And now we are testifying at the earliest hearing this bill has ever had. Again, thank you for that. We know that the momentum continues to grow. Just some positive points, and I'll be quick. Over 75% of Mass residents want this7561 bill passed. You can look7563 at many polls that show that. The Mass Medical Society reaffirmed their stance of engaged neutrality by a 4 to 1 vote. So that's, you know, our major group of docs in this state.

The Boston Center for Independent Living, I'm a member. They represent 50,000 Mass disabled residents and they do not oppose this bill. Governor Healey has indicated that she is supportive of the bill if the issues and safeguards are right, and they are in this bill. This bill has more clear and protective conditions than any other similar bill in the country because we have a mental health qualification. Medical aid and dying bills are already in 11 jurisdictions, Mass, we hope, will be the 12th. For these reasons, please, we7634 ask that the bill will move quickly and favorably out7638 of this committee and that all of our legislators take it up with all the colleagues. Please let leadership know that your constituents want this bill and you want to vote on this bill this session. It's common sense not to suffer needlessly at the end of life. Please push your bill forward to vote this year. Our time has come. Thank you all very much.

Thank you. Yep.

SPEAKER1 - Senator Keenan, are you

SPEAKER47 - No. I'm I'm at the meeting, but I'm just thinking Okay. You're here.

SPEAKER4 - Thank you.

SPEAKER1 - At this time, I am looking at

Fred Pelka. Are you on the phone, Fred?

Fred Palka, are you on the phone?

K. We can't confirm that Fred is on the phone, so we're going to move to Dennis Patrick Canty.

DENNIS CANTY - CONCERNED CITIZEN - HB 2505 - SB 1486 - Members of the committee, thank you for the opportunity to speak with you today in support of H2505 and S1486, an act relative to the end of life options. My father was a lot of things, hardworking, a provider. He loved boats, good food, his family. He really loved his grandchildren. He would have loved getting to know his newest granddaughter, Ayla. He loved watches. He studied them, collected them. I'm wearing one of his watches today. He thought a lot about time, more so after he was diagnosed with ALS in October of 2023. Time became a regular topic of discussion at our family dinners. How much time did he have left? What should we do at that time? What happens when time runs out? The hardest of these conversations, what would this time look like?

As most know, ALS is one of many nervous system disorders that causes loss of muscle control. First, his legs, then his left arm, his right arm started to go too. He started to have occasional difficulty swallowing or clearing his throat, and we knew time was running out. All the while, he was fully conscious of his fate. In fact, his mind seemed sharper than ever. For many ALS patients, the end is gruesome. Trapped in your body as it shuts down. I remember reading an article where some ALS patients' only remaining way to communicate was through blinking. And the hardest part of ALS, there is no definitive timeline, months, a few years, 10 or more. In Massachusetts, his options were limited. He could voluntarily stop eating7841 and drinking and very slowly and drinking and very slowly weaken until he died or wait for ALS to eventually weaken his respiratory system until fatal. And this was a man that counted hours and minutes with precision. He valued time. That wasn't how he wanted to spend a little time he had left. Turns out it wouldn't need to be.

As we researched end of life options for our father, we learned that medical aid in dying was available in Vermont for nonresidents. The requirements, onerous. Letters from doctors, two in person visits, two weeks apart. Second opinions, only one pharmacist in the entire state. The administration had to be in Vermont. We understood why, but we wished he could have done this all at home here in Massachusetts. This past November 13, my father self administered the medication prescribed to him and prepared by some of the most ethical and compassionate medical professionals with whom any of us had ever encountered. And as he sat surrounded by his family, he uttered his last words to us, I did it. I did it for you.

He didn't die from physician assisted suicide. His death was not suicide. His final moments were not hopeless. He was not alone. In the end, it was his last act of free will after being robbed of his bodily autonomy. His death was hope for a tomorrow he was no longer promised. In that moment, he was grateful to be able to control his time, his watch, his clock. He didn't want to languish or be in pain. He didn't want to put his family through the horror of watching him waste away. He took quite literally time into his own hands. I think all the time of those with terminal illnesses who may never be as fortunate as he was, who didn't or who won't get to get the chance to be the keeper of their own time. I implore you,7945 I beg of you, to advance this legislation forward and to enact it as law. Time is fleeting. Thank you.7951

SPEAKER13 - Thank you. At this time, I

SPEAKER1 - would welcome Teresa Visconti. Teresa Visconti.

Teresa? Okay.

I will welcome, Richard Stanton, who is joining us by way of Teams

or not. Okay.

Ron Hoffman.

Okay. We don't see Ron on Teams either. Simon Amaya Price.

SIMON PRICE - CONCERNED CITIZEN - HB 2505 - SB 1486 - Hi. My name is Simon Amaya Price. Thank you for allowing me to testify against these bills. I've also submitted written testimony. I'm a 20 year old lifelong resident of Boston. I received my bachelor's degree from Berkeley College of Music last December with additional coursework at Harvard University in statistics. I have lost two friends to suicide. A former undergraduate classmate of mine diagnosed with borderline personality disorder was on the waitlist for assisted suicide in Switzerland. She was told that BPD was terminal and incurable. However, according to the NIH, BPD has a higher than 50% remission rate after five years. Why should we allow, based on the fallacious beliefs of the segment of the medical profession, that she be administered lethal medications? This would not be the first time we have seen this as a result of so called assisted suicide legislation in the Western world.

In 2024, an otherwise healthy 28 year old Dutch woman was suffering from depression and decided to take her own life with the help of a doctor despite being otherwise healthy. We have also seen in Canada a man who was misdiagnosed with a terminal illness fast tracked to assisted suicide. Luckily, he did not die. I can't help but think that there were others who were not so lucky. The principle of primum nom no crit, first do no harm, as a cornerstone of medical ethics. What is the administration of lethal drugs if not harm? Proponents of this know, may contend that the emotional harm of continued suffering outweighs the ultimate harm of death. This is a consequentialist assertion that is devoid of any substance beyond anecdotes from those in mental distress who by definition are not of sound mind, or justifications from certain strains of postmodernist moral relativism.

The fact that we are even having this debate demonstrates that the morality of assisted suicide is uncertain. What is certain, however, is the ultimate harm of death. Suicidality itself is a symptom of illness. We do not treat suicidality by helping or encouraging patients to kill themselves any more than we would tell an emaciated anorexic teen that she is in fact not skinny enough and then prescribe her Ozempic. This bill creates a financial incentive for insurance companies to prioritize the cheaper assisted suicide over palliative or hospice care. How can we guarantee patients aren't pressured into assisted suicide for financial reasons? Why is capital punishment wrong? Because it is irreversible. Once applied, no further evidence, no further hope is relevant.

We acknowledge the fallibility of human judgment, recognizing that8149 both the citizens and the institutions of our great state can be wrong. We have determined that we treat the worst of the worst in our society with this in mind. People who murder, who murder dozens, who rape, kidnap, mutilate, and murder children. We have decided that it is unethical to put them to death because even then, we may be wrong. Yet for people having the worst days of their lives due to health struggles, we forget our fallibility? Why do we want to extend better protections to8179 the kidnappers, rapists, and murderers of8181 children than to those afflicted with putatively terminal illnesses? Doctors should not kill people. This bill would legalize what is manslaughter according to a 2022 Massachusetts Supreme Court case. I urge you to vote against this bill. Thank you for listening.

SPEAKER1 - Thank you. At this time, I would welcome, doctor Thomas Hain by way of Teams.

Doctor Hain, we welcome.

SPEAKER49 - Sorry. Can you see me?

SPEAKER4 - We can

SPEAKER1 - see you and hear you. Welcome.

THOMAS HYNE - MGH - HB 2505 - SB 1486 - Great. Thank you. Respect to the legislators. Thanks for the opportunity to speak. I'm attending physician in internal medicine at Mass General, and so I'm exactly the kind of person who'd be prescribing the medical aid in dying meds that are outlined in these bills. Of course, my disclaimers, I'm speaking for myself and not my institution. But I know I speak for many of my colleagues when I say I strongly oppose this bill on all bills aim to legalize medical aid in dying, which obviously is more accurately termed physician assisted8250 suicide or PAS. If you're for many other physicians today about8254 how the largest associations like the AMA and ACP oppose PAS, and my palliative care friends oppose PAS.8260 And we've all heard sick patients lament, doctor, I8264 just wanna die. The question is, how do we as compassionate healers respond to this?

Any good physician will be teaching their medical students that this is a cry for help. Maybe the patient is suffering untreated pain or feel like they're burdening others. Helping patients like this takes a lot of time. It takes compassionate listening. Obviously, it'd be faster and less costly just to help them commit suicide. And that's where medicines to be headed these days. It's faster, less costly. But I certainly worry that if PAS were on the table here in Massachusetts, it would worsen already tragic crisis in the patient physician relationship. Patients already have too many extra pressures, and we can look at testimonies from Oregon and California that suggest that some insurance companies are gladly offering to pay for assisted suicide drugs, but not other more expensive treatments. Push for PAS is taking away the focus from what's needed, good palliative care.

Trauma patients need not choose between excruciating pain and suicide. This bill is described as an act relative to end of life options. We should bolster our best option on the table, good palliative care, and not bolster most tragic options, suicide. To all of the people who have given these very moving stories in favor of PAS, let me be frank, you're all talking about choices, but the tragic choice you want, it's already there. Anyone with the Internet can figure out how to end their own life in an8345 online fashion. What is on the8347 table is whether we doctors should be assisting in the suicide. They want us8351 to sanction this decision. They want you, the state, to sanction this decision. It's almost like asking a priest to get absolution in advance. In every other American medicine, when a person wants to kill themselves, we step in and we walk beside them, and we say, no. Let's help you. Let's help you. Instead, this is like instead of just having a stethoscope or meds in my white coat, it's also I've got cyanide in there that could kill.

In closing, obviously, I think the slippery slope argument is very real. We've heard testimony about that in Europe of child euthanasia and voluntary euthanasia. In the US, there's troubling cases of people with mental health like anorexia or dying without PAS. And finally, I mentioned that a push for PAS in the United States has come overwhelmingly from privileged white people. Survey showed that Hispanics and blacks overwhelmingly reject PAS. So maybe8400 we'd all do well to learn lesson from these minority constituents, a life of hardship merits assistance, not suicide. If you want suicide, keep us physicians out of it. Thank you very much.

SPEAKER1 - Thank you. At this time, I would welcome the, honorable reverend doctor Timothy Schottmeyer.

TIMOTHY SHOTMEYER - THE PROGRESSIVE EPISCOPAL CHURCH - HB 2505 - SB 1486 - Madam Chair, Mr. Chair, my name is the Reverend Tim Shotmeyer from Marblehead, a proud resident of the Essex Third. I've come today to support, come out today in support of bills H 2505 and S 1486. As part of my career vocation over many years, I've been called to stand by and walk with many families and individuals as they go through the end process of their lives. And I know for many people we all hope for a peaceful death. And we have in our mind though that one of many people slowly sleeping off into a dream and going quietly. Unfortunately, that is not often the case as all of us know. Not only is the death painful for the individual going through it and the suffering that they're going through, it often also leaves deep emotional scars for their families that are involved in that love and care for them as well, seeing them suffer through those injuries. It is not a dignified, if I dare I say it is the least thing, but a dignified way to go.

As a theologian, I think it's fair to say that we look at physician enabled suicide, assisted suicide, the whole word suicide, I could go8531 on for hours about that. But physician assisted death, death with dignity through the lens, through a puritanical lens, and through Puritan theology. And it often leaves us with puritanical guilt when we think about these issues. I would like to say that I am a proud,8553 give me the indulgence for one second if I just ask us to reframe in conclusion what8559 we're dealing with. I am proudly pro choice both when it comes to a woman's right to choice with their bodies but also when it comes to the choice of somebody that is terminally ill that meets the robust and rigid requirements as they are outlined in this bill.

And if anyone could see the chances of someone accidentally being coerced or something along those lines are near impossible. I believe in choice for these individuals, that they should have the choice over their bodies to die in the way that they see appropriate in a compassionate manner, in a dignified manner, in the manner that we would like to see ourselves go, but more importantly8612 in the manner that we would like to see our mothers, fathers, and loved ones go. Thank you very much for your8620 time and consideration. I ask you to support8622 these bills. I appreciate them that's moving on so early. Let's get them to the floor and get them passed this year. Thank you very much and have a blessed day.

SPEAKER1 - Thank you. At this time, I would like to welcome by way of teams, Mark

SPEAKER4 - Peterson.

SPEAKER1 - Welcome.

SPEAKER47 - Can you hear me?

SPEAKER24 - Can you hear me?

SPEAKER47 - Yes. You can.

SPEAKER1 - We can hear you. Welcome.

MARK PETERSON - CONCERNED CITIZEN - HB 2505 - SB 1486 - Thank you very much, and thank you for advancing this bill so soon. I wanna8670 tell a very personal story associated with my mother, who was an avowed atheist. She was not in any sense enamored by biblical and theistic arguments. At the age of 75, she was diagnosed with COPD, chronic obstructive pulmonary disease. And from that point on, she was on oxygen 24/7. At the age of 78, near Thanksgiving several years ago, she made the choice. She said she wanted to die. At that point, her favorite thing to do was read and she was going blind. She was also having trouble with continents and unable to move easily. And she was, basically, saying, I've had enough. I can't do this anymore. She didn't have an option to medical aid in dying.

And in fact, what she did in January of the next year, when she had consulted with her tax CPA to determine what would be better for her children. She stopped eating, she stopped drinking, she stopped8762 all of the medications she took that8764 gave her some comfort. And for five days, I watched the agony of her8770 panting for breath, and it was terrible to watch. And the reason I'm sitting here is to say she didn't need that, she should have had an option. I strongly disagree with the use of the inflammatory term suicide. My mother would have wanted to die and we would have gladly, under the circum, if they were the circumstances, we would have helped her do that and be with her as she passed. As a result, we were there, but it was excruciating to watch. And I beg you to please advance this bill as soon as you can. Thank you very much for hearing my testimony.

SPEAKER1 - Thank you. At this time, I wanna welcome Laurie Dammerin.

LORI DAMERON - CONCERNED CITIZEN - HB 2505 - SB 1486 - Hi. My name is Lori Dameron, and I'm here to express my strong support for an act relative to the life end of life options. But first, I want to extend my gratitude to each of you for your dedication and hard work in this current political landscape. Thank you very much. As a proud resident of Massachusetts, I'm grateful for the opportunity to address you today. I support this bill and medical aid in dying for three primary reasons. First is choice. This legislation offers terminally ill individuals a dignified choice as they face the challenges of their terminal illness and the8871 inevitable deterioration of their health. The second reason is that this bill provides an end to needless pain and suffering. Terminal illnesses bring immense pain and suffering with death as the eventual outcome.

When faced with disease progression that promises death within six months the option to end suffering peacefully is a compassionate response that many individuals seek. And lastly, it's personal experience. Excuse me. As someone living with stage 3C ovarian cancer who was diagnosed 3 and a half years ago, I have battled through treatments, enjoyed remissions, only to discover that my disease has returned again and again. In fact, I was at Mass Gen this morning undergoing treatment. While I hold out hope for a miracle, I am also realistic about the nature of my disease. Ovarian cancer, incurable and relentless, will likely claim my life in a very painful and cruel manner. Having lived a healthy and vibrant life, I wish to retain the legal right to peacefully end my life surrounded by my loved ones, sparing them8948 the anguish of witnessing my suffering. As my condition inevitably worsens and my body succumbs to the ravages of this disease, it is not death that I fear, it's living. I urge the committee to pass this act providing a vital option in healthcare decision making for terminally ill individuals across the commonwealth. Thank you very much for8971 your time and consideration.

SPEAKER1 - Thank you for your time.

At this time, I wanna welcome Mark Carey by way of Teams.

Okay. Mark is not here on Teams, but I do see my colleague, senator Cream. It's always nice to see you.

SPEAKER18 - Thank you. I don't did anyone see senator Collins? Oh, okay. Because I saw him upstairs and he said he was coming down to testify. So I'm gonna include him even though, I think you may hear the same thing again.

SEN CREEM - SB 1489 - Thank you all very much. Thank you for taking me out of turn. It's always a pleasure to be sponsoring something with my friend, Representative Decker. So, I wanna take a moment to acknowledge Mr. Daryl Settles. Let me start by saying I'm speaking on9032 Senate 1489. So I want to take a moment to acknowledge mister Daryl Settles who,9040 though unable to be here today, has been a powerful advocate in support of this bill. His strength in channeling unimaginable loss into action has been deeply moving and instrumental in bringing this issue forward. We are here today largely in part because of the life of his son, Preston, and the urgent lesson his story9064 imparts. 15 year old Preston Settles collapsed during a basketball game due to, we know them now as, sudden cardiac arrest, and tragically he did not survive.

His passing shook the Newton and broader Massachusetts communities And it also9084 brought critical truth into the sharper focus that quick access to an automatic external defibrillator, an AED, can be the difference between life and death. In the United9098 States, approximately 100 to 150 sudden cardiac deaths occur during competitive sports each year. Survival rates can be high as 90% when a defibrillator is used within the first minute but drop by 10% for every minute that passes without one. And yet, as far too many athletic events, especially youth sporting events, AEDs are not available, or those nearby are untrained in how to use them. That's not acceptable. That's why I filed Senate 1489 along with Senator Collins, and I do believe Representative Decker, to require9147 at least one automatic extended defibrillator on-site and ensure the presence of trained individuals capable of using it during athletic activities.

This bill is about being prepared. It's about equipping coaches, volunteers, and athletic staff with the tools they need when seconds matter most. And9171 above all, it's about saving lives. Implementation of this bill will require coordination from school districts, municipalities, to health departments, and private partners. It's doable. It's worth it. I can say in a personal note that my father was in an ambulance and had a sudden health issue, a heart issue, and there was9198 no defibrillator. That was9200 some many years ago, but if there had been, he himself would not have9206 died. Now there are defibrillators in ambulances, but that's just an example of then what happened. So I urge the committee to give a favorable report. I think my time is up. Thank you very much. I'm happy to answer any questions if you have any. Glad to see my colleague Representative Sangiolo.

SPEAKER1 - Thank you,

SPEAKER18 - Sarah. Great. And I know that senator Collins is on his way. Great. Thank you.

SPEAKER1 - Good to see you. At this time, I wanna welcome on by way of teams, Christian Antilex. Oh, actually, Christian. I don't think Christian is on.

Tracy Lawrence.

Is Tracy Lawrence here?

Okay. By way of teams, Griffin Lysinger Lysinger?

SPEAKER51 - Yes. Hello.

SPEAKER1 - Welcome.

SPEAKER51 - Lys well, thank you.

GRIFFIN LEISTINGER - HAMPSHIRE COLLEGE - SB 1486 - HB 2505 - Hello and, thank you to the committee for giving me the time to speak today. My name is Griffin Leistinger. I work right now at Hampshire College in its accessibility office where I serve hundreds of disabled students. I teach disability policy, eugenics, and disability studies at the University of Massachusetts Amherst where I also conduct research on higher education disability policy. I'm here today on my own accord as a disabled individual to express my opposition to bill 1486. In a more perfect world where we can have the compassionate choices with all the care that we need, I may be able to support this bill. I truly believe in autonomous and peaceful death options and deeply empathize with the experiences of those in support of this bill. I've also watched those I love and care for die slowly.

Fortunately, however, we do not live in a more perfect world. Rather we live in a9316 world where a broken wheelchair can turn into life in a nursing home and a lost job can delay necessary preventative care and terminal illness. Where policy measures that prevent terminal illness like Medicaid, Medicare, and social security are facing real immediate risks of being disrupted or dismantled. And where those in control of federal funds are calling disabled people parasites and preaching new jacks. And data demonstrates that disabled people are already being given death rather than access that states where this law is enacted. The 2022 Oregon Death With Dignity data summary, for example, showed that 44% of people choose to end their life because they perceive themselves to be a burden on their family. 88% of people felt unable to access the activities that made their life enjoyable. Over 60% felt that they had lost dignity in life. And 6%, which is 17 people in 2022, ended their life because treatment would have cost too much.

When we see this data, we do not see suffering fully due to illness. We see suffering due to lack of access and care. We see structural coercion and illegally sanctioned killing of disabled people. And the United Nations is clear that using disability to sanction MAID is legally authorized ableism and a violation of international disability rights. The bill does not exist in a vacuum. At a time of direct care workforce shortages, deep federal funding cuts, and rising national eugenics rhetoric, pushing this bill through is far too risky. Just days ago, RFK Jr fired thousands of HHS employees that run critical programming preventing terminal illness. He's actively dismantling the administration for community living, which keeps people out of institutional settings and plays a key role9402 in preventing elder and disability abuse and9404 coercion.9404 The result of these actions will increasingly manufacture terminal illness in disabled people and fail to keep terminally ill patients safe from structural and interpersonal coercion. I ask the committee, at least revisit this legislation at a laser session when the impacts of these federal actions are more understood. It would be dangerous to construct such an infrastructure of death making at a time of rising eugenics in America. Thank you. I appreciate the time. I have a longer written testimony as well.

SPEAKER1 - Thank you. If you haven't already, you can still submit that to the committee.

9436 Thank9436 you. At this time, I would welcome, I believe in person Anne9440 Thierault.

Teriel. Anne Teriel. Welcome.

ANN TERRIO - CONCERNED CITIZEN - HB 2505 - SB 1486 - Thank you Madam Chairperson and committee members. In opposition to these bills,9465 an organizing principle exists in a society so that people can make sense of change. Science appears to be the current organizing principle, but that doesn't mean it will last forever, something will come along to replace it. The attempt to legalize physician assisted suicide may seem progressive on the surface, but in reality is old business, reflecting a history of organizations through generations who have been gathering replacement members to continue the obsolete mindset, the death wish. Their hidden agenda is far more lethal than the swallowing of pills in front of a loved one. They've changed their organizational names, of course, to erase the negative image associated with their selves.

Medical aid and dying, as9519 proponents like to call it then, suggests that you would be legislating a humanitarian or human right. Nothing is further from the truth. We're all aware of the suffering wife, who suffers with her terminally ill husband, who in turn suffers because his wife is suffering. The existence of the bill itself suggests that no one else seems to care, but that sentiment is far from the truth. Society does care if given the chance. No. What you are trying to legislate is autonomy rights. Does a person have the right to kill himself? I assert to you that he already has this right in the form of refusing food and water, so the bills are frivolous. You could say that what you want to do is to give the physicians the right to kill patients but there's nothing merciful or humanitarian about that. Assisted suicide is fundamentally incompatible with the physician's role as healer, so says the American Medical Association.

The consequences of this select group of citizens in and out of the state, pushing for and achieving the right for a doctor to use agency to create a death is that, A, many terminally ill people who are alone will die alone. No loved one holding their hands. Wow. That's some organizing principle you've got there. B, the proponents of more death legislation, from those old fashioned euthanasia societies I mentioned, will push for more extensive legislation once a party has come forward about the law being unfair because it doesn't cover his own condition, and he's decided his life is not worth living. And, C, people with lingering illnesses may be branded as an economic liability, so don't think you'd9643 be doing a noble thing. The terminal patient is facing9647 despair and turns to the doctor who has become the doctor of despair and fulfills his death wish. Death has thus become an idol and the citizens, idol worshipers. These are only a few of the myriad reasons why the law is unfair to the citizens of the Commonwealth.9663 You need to lead9665 by example, so you would have to reject these bills. Thank you.

SPEAKER1 - Thank you. This time, I'd like to welcome, doctor Lou Cohen by wave teams.

Okay. Gonna move on to, Pamela Daley and Ellen Lee.

Welcome.

SPEAKER42 - Thank you. Thank you.

SPEAKER24 - If you just give us an image, no worries.

SPEAKER13 - We'll get9741 it closed on. Okay.

ELLEN LEE - CONCERNED CITIZEN - HB 2505 - SB 1486 - Hello. Okay. I'm Ellen Lee and I live with serious illness, a spinal cord disorder, and use a power wheelchair. I initially supported this type of legislation until I had second thoughts learning more about it. I learned that it's really all about disability. The top five reasons in Oregon involve depending on others, feeling like a burden, and shame, loss of dignity. We all have inherent dignity and do not lose it when we become ill and disabled. Bringing dignity into this only increases feelings of shame and burden for choosing to live. Countless times I've been told, if I were you, I'd wanna9808 kill myself. Every day I face an uphill battle to be included in a society that determines worth based on abilities, a culture that conditions us to value productivity above all else, judgments abound about my ability to have a life worth living.

I had a scary experience of being in septic shock, told I might die, and then pressured by a doctor to get a DNR. I was so sick and exhausted, I thought maybe I should just let go. I recall being shocked when I was essentially encouraged to die. I can't imagine why there would be any other reason for this other than a presumed low quality of life because of my disability and wheelchair use. I was weak, it was hard to breathe, but9864 I was able to assert my desire to have life support. And I'm still haunted9868 by the thought of what might have happened if I had just gone9872 along with this doctor's suggestion of what they thought was9877 best. If I was just too worn out from justifying my existence, I would not be here with9883 you today.

People in healthcare are subject to the same ableist biases so prevalent9889 in our culture. Recent Harvard studies9891 show that over 82% of doctors perceive people with disabilities to have a worse quality of life, and that they often do not want to care for them. The National Council on Disability study found that assisted suicide laws are rife with dangers. The safeguards are ineffective and oversight and reporting of abuses and mistakes are absent. Assisted suicide harms the doctor patient relationship. I want my doctors fighting for me and my life. I don't want to fear going to them or to the ER to get care and whether they're going to raise this as an option. Overwhelmed by limited or no9934 options, threats to life saving care, offered suicide approval versus suicide prevention when most distressed, being seen as better off dead? What kind of choice is that?

When we lack equity in healthcare or adequate supports and services, when society makes us feel like a burden just for being alive, this is no fair9962 choice. It's a false one. Look at all the cuts on the table. I've been at9970 the state house twice recently fighting for PCA services. We have threats to Social Security, Medicare, MassHealth, cutting housing funding, Meals on Wheels getting gutted. And now I'm fighting also to keep assisted suicide out of healthcare where it doesn't belong. These bills are about ending lives, not taking care of them. Our society fears becoming sick, older, and disabled, then devalues people to the point where they're seen as better off dead. Instead of offering suicide prevention, we'll offer assistance by physicians to die. What are we doing?

I'm opposed to these bills due to the inevitable abuse and harm that will come with legalized assisted suicide. Let's be realistic about the dangers. We live in a real world where there won't be true oversight, where people will get hurt. This is not the time to push this through. Think of the implications in the real world. How will you protect me? I'm terrified. People are already being harmed in other states. This will only perpetuate deadly discrimination against ill older adults and the disabled who are already at high risk for abuse. This is just too risky. The consequences are too great and they cannot be undone. We must protect vulnerable and marginalized people like me. I just wanted to say these bills are not in the common good. It's too divisive. Please, it's not the time to push this through. Thank you.

SPEAKER15 - Do I have more than 45 seconds?

SPEAKER1 - So you had 6 minutes as a panel.

SPEAKER24 - I didn't talk for 6 minutes. You spoke for 5 minutes and twice

SPEAKER53 - I know I didn't.

SPEAKER24 - I know I didn't because

SPEAKER1 - just I'm gonna move on now at this time. I'm gonna give you your full 3 minutes and ask them to start, and I'm gonna remind people that when you sign up, the notice tells you that you have 6 minutes as a panel. But go ahead. You're welcome. Okay. Thank you.

SPEAKER15 - Thank you for hearing me.

SPEAKER53 - 7 states with legalized assisted suicide have already claimed legal.

PAMELA DALEY - CONCERNED CITIZEN - HB 2505 - SB 1486 - Seven states with legalized assisted suicide have abandoned initial10110 safeguards to their bills in order to expand suicide laws. They've added reduced waiting periods. They've allowed registered nurses to prescribe the drugs, in addition to the physicians. They've removed residency requirements and sunset clauses. In Oregon, thankfully, their request to euthanize patients with dementia or Alzheimer's did not pass.10140 You have to ask yourself, how many people will start to believe that any amount of discomfort is not tolerable? Then where are we? I spoke with a Mass senator who assured me that such add ons10157 would not be allowed in a10159 Massachusetts bill. I don't believe that he understood the10164 enormous pressure the the Legislature would be under to remove initial safeguards.

It would be a nightmare of life10174 versus death decisions the state would need to take on, like we've seen in Canada where young adults with eating disorders make themselves so sick that they qualify and are offered medication. Is Massachusetts ready to take on a situation like that because it will happen? With healthcare inequity as it is, these bills will endanger far more people than they'll help. You pass these laws to satisfy the lucky ones who want to make a choice between living and dying. That's fine. But most people will never be that privileged. I won't be asked if I10224 want an exorbitantly expensive lifesaving operation. I won't be asked that question. What I'll get is, do you10232 want to sign a DNR or have you considered assisted suicide?

10238 I10238 spoke to a woman in the statehouse last year10240 at a rally for Compassion & Choices. I was there to protest. This woman came up to me and said that she has stage10247 4 lung cancer and that she doesn't wanna die. She wants more than10251 anything to live long enough to meet her unborn grandchild. She said she took great offense that I would fight against her right to choose when to die. I replied, I hear you, but I wanna live too. And your desire to have that medication on your nightstand ready to go infringes on my right to live without having to10276 look over my shoulder every time I go to the ER. This is a dangerous bill. It's not designed10282 to be compatible with underprivileged or vulnerable people. And all of us will be vulnerable people if we live long enough. Please think hard. Think of all your constituents. Our lives10299 are in your hands and are you ready to take that on?

SPEAKER1 - Thank you.

SPEAKER53 - Thank you.

SPEAKER1 - Thank you both. At this time, I would, actually senator Collins, I will welcome you.

SEN COLLINS - SB 1489 - HB 2391 - Thank you, Chair Decker, and Chair Driscoll, and members of the committee. I'm here this morning to testify in support of S 1489 and H 2391, an act requiring automated external defibrillators at sporting events. The current law requires that all health clubs have at least one AED at the facility and one volunteer present, who has been trained in cardiopulmonary resuscitation and an AED operation in accordance with standards set by the American Red Heart and Red Cross Associations. This legislation maintains that requirement while expanding critical areas of the law to ensure that all people, especially children, who are playing a sport or engaging in any athletic activity are not at risk of serious cardiac arrest.

The addition of facility to10398 the definitions ensures that public10400 stadiums and gymnasiums where a large majority of events take10404 place are required to follow these mandates. It expands on current measures to ensure the facilities create guidelines and action plans on the next steps if volunteers are not immediately available. It requires the operator of the facility to identify another individual who has been properly trained to administer the AED before participation resumes. It also requires that the location of an AED is posted and labeled properly to ensure swift action. It's crucial that we expand the scope of this legislation to maintain the health and safety of our commonwealth.

These standards will ensure that individuals can act quickly to save lives. It is crucial that we take action on this legislation. I know that we've made great strides here in the Commonwealth, and this would further in that area. You know, we know that issues affecting young people aren't always identifiable, and so people may be participating in sports or strenuous activity, and, either underlying issues or undiagnosed issues can bubble up and create serious problems. And, you know, I know some of the issues and concerns, when we deal with new mandates, it has to do with funding. I think maybe with respect to the public health funding and trusts that are set up in existence, we may make that available for municipalities and others, if there are funding issues. But with that, I ask for the committee to look upon this favorably as you had last session. And thank you very much for the time. Happy to take any questions.

SPEAKER1 - Thank you, senator.

SPEAKER54 - Alright. Thank you.

SPEAKER1 - Thanks. Okay. At this time, I will welcome, Isabelle Carr. Isabella?

Thank you, Scott.

ISABELLA CARR - CONCERNED CITIZEN - HB 2505 - SB 1486 - Good morning. Or, oh, I guess, just afternoon. Thank you so much, Chairwoman Decker, and Chairman Driscoll, and the rest of the10543 committee for having us here today. My name is Isabella Carr, and I'm in my final year at Harvard Divinity School. I live in Arlington and I'm a death doula, a scholar, an advocate and I'm here to testify in strong support of the end of life options act. So I'm originally from Portland, Oregon where medical aid in dying has been safe and legal, a safe and legal option since 1997. I10569 consider myself very fortunate to have been from Oregon. And I consider10573 myself very fortunate now to live in Massachusetts, a global leader in education and health care innovation, and the birthplace of American Liberty, which has fought for 250 years, very soon, to protect its citizens' rights and dignity. Yet without access to MAID, we are denying terminally ill individuals in our communities a fundamental right, the right to die on their own terms free from unbearable suffering.

As an apprentice in doula, I worked with a client whose cancer had returned and metastasized. She was only 38 years old with two small children, a husband, a career, and a life ahead of her that she desperately wanted to live, but she was given less than six months. She decided with her doctors and family support to stop all treatment. She did not want to be forced to suffer away from her family, hooked up to machines, and unable to cuddle her babies. She wanted another option. And throughout many conversations with us, her doula team, her family, and her care providers, she decided to pursue MAID and spend the time she had left enjoying her life and preparing for what came next. We supported10645 her as she initiated the process and navigated the substantial and numerous safeguards, including waiting periods, written and oral requests, second opinions, and a psychosocial assessment.

We helped her plan for her death and found ways, as difficult and heartbreaking as it was, to have her family10663 participate in the process. She died shortly after, aided by10667 MAID, comfortably at home, surrounded by the people she loved the most. If I leave you with nothing else, let it be this, MAID is not about choosing death, it is not suicide. It's about giving people who meet these rigorous criteria standards choices about how they die. It is not choosing death but a different process. And when death is imminent and inevitable, Massachusetts has the10699 opportunity to pass a law that would10701 unabashedly affirm life and give its residents with terminal illnesses a choice. I respectfully ask that you move the end of life options act forward quickly and favorably out of the committee. Thank you for your time.

SPEAKER1 - Thank you. This time, I would welcome Angelina Ramirez.

ANGELINA RAMIREZ - STAVROS - HB 2505 - SB 1486 - Good morning, and thank you for the opportunity. My name is Angelina Ramirez. I'm the CEO at Stavros Center for Independent Living, one of the oldest independent living centers in the country. We oppose the assisted suicide bill. Massachusetts prides itself on being progressive state where we protect the rights of people as such, we're always looking for ways to improve our quality of care, our response rate, our service health index, to name a few. Yes, this proposed bill will send us in an opposite direction towards giving up in our humanity. During my 35 year career at Stavros, I have seen many family members and friends move through complicated decision making processes and deal with the consequences of their decisions. There are10785 no simple sources or solutions. These choices become even more clouded when we are under the stress, when we are told that our quality of life is not going to be optimal.

That is the case for one of my coworkers, Paul. He had stage 4 lung cancer diagnosis and he was given an oxygen tank, a phone number to call when he was ready for hospice with fewer than six months to live. There was seemingly no hope for him, no informed choices, no drug trial, no palliative care, no reason to go on. Luckily for him, the community came together, and we embraced him with care and compassion for the next three years. We were there for him. We saw his daughter get married, his grandchildren being born, and mended fences with brothers and sisters that had long been distraught. Was he in pain? Certainly. Did he have a good quality of life? Absolutely. His quality of life included pain management, palliative, and hospice care when it was needed. And for the last three years, his life was not only bearable, but valuable. All these precious gifts after being told that he only had six months to live. I am very concerned that six months to live in the language, as a prognosis in this bill is something that would have taken away all those experiences for Paul and for so many like him.

Even today, there's no mental health counseling that accompanied this diagnosis. There's no real language that provides for treatment of depression and anxiety after receiving a diagnosis. And yes, there's provision of this bill to engage in mental health services, but it's only to prove that you are in the right state of mind while making your decisions. Six months prognosis sends us down a wrong path. According academic publisher, factors influencing physicians prognosis is coping review. Physicians diagnosis lean heavily on the pessimistic side10909 and particularly among those whose practices expose them to actually ill patients. I will submit the rest of10917 my testimony in writing. Thank you.

Thank you.

SPEAKER1 - At this time, I wanna welcome, Deborah Lieberson.

DEBORAH LIEBERSON - CONCERNED CITIZEN - HB 2505 - SB 1486 - I'm here to offer, testimony in support of the End of Life Options Act and would like to share my personal experience. My husband, Rich, and I thought we did everything right. We discussed end of life care with his extraordinary providers, signed DNRs, designated his healthcare proxy, power of attorney. All of his caregivers knew and supported his final wishes to be home for our son's third birthday, and then to discontinue all life prolonging care. What we couldn't have known was that his pain would dramatically increase on10975 a weekend and the on call doctor would be someone we had never met. Over the previous weeks, powerful drugs, codeine, Demerol, Vicodin no longer10985 relieved Rich's pain. Intravenous morphine helped at first.

Rich's lucid times became less frequent over time, but when he was awake, he was in severe pain. The last time he opened his eyes, he looked at me and tried to speak, but he could not. He cried out in pain. I pushed the button on his IV that provided a boost of morphine and then I pressed it again and again, even though I knew it would make no difference. The pump had been programmed to not allow me to do what I think I was trying to do. My conversation with the on call doctor was brief. I told her what was happening and she responded that she would increase Rich's morphine by 5 milligrams. Concerned that such a small increase might11036 not be enough to relieve his pain, I asked if she would prescribe more. I was cut off mid sentence. She sounded angry. Look, this is not your decision. There are medical legal issues I have to think about. I knew what she meant. High doses of morphine can suppress respiration and in some cases hasten death. I asked if she could contact the physician who had been providing and coordinating Rich's care for years but was tersely informed she's not on call. Could you please contact her and let her decide if she wants to talk to me? She mumbled something and hung up.

Rich's brother was with me and was furious. After he calm down, he told me he had a plan. Deb, I've been watching the nurses closely. I'm pretty sure I can reset the IV pump to increase Rich's morphine and shorten the interval between boosts. But Rob's plan terrified me. What if the pump11098 broke and Rich would have no medication? What if11102 someone reported what we had done? What would happen to my son? I was contemplating all of the things that could go wrong when the phone rang. Hi, it's Joan. What's going on? Rich's doctor's voice was11116 calm and reassuring. I'll get a prescription down to11120 the pharmacy and contact the visiting nurses. Is there anything else I can do? Rich slept peacefully that night and died the following day. No one, no one should ever spend their last hours in pain, and no one should have to watch someone they love suffer needlessly. Thank you.

SPEAKER1 - Thank you.

At this time, I would welcome Caitlin Stober.

KAITLIN STOBER - MDDC - HB 2505 - SB 1486 - Good afternoon now, Senator Driscoll, Representative Decker, and members of the Joint Committee on Public Health. My name is Caitlin Stober and I'm a policy research associate with the Massachusetts Developmental Disabilities Council. Our council is an independent agency funded by the federal government dedicated to empowering people with developmental disabilities and their families. I'm here to provide information regarding H 2505 and S 1486 based on community conversations, research, and historical developments. MDDC's mandate is to educate and inform. I am not here to oppose or support11196 the bill. We have been having conversations about medical assistance in dying with community members. It's a complex issue. People within the disability community hold different personal opinions on the matter.

Some people believe11210 MAID could help people with terminal illnesses have dignity and11214 self determination about how they die. Others are concerned about11218 the danger MAID poses to people with disabilities. This concern is echoed by some disability organizations, including the Arc of the United States, the National Council on Disability, and TASH, all of whom oppose the legalization of MAID. So, MAID happens in healthcare systems, they11236 can't11236 be separated. There's extensive11238 research that documents how11240 people with disabilities are treated differently than people without disabilities in our healthcare11244 systems. A national survey revealed that over 80% of physicians believe11249 that people with disabilities have a worse11251 quality of life based on disability alone.

MAID requires medical professionals to distinguish cases that are eligible for suicide assistance from cases that require suicide intervention. And the persistent inequities in healthcare cast doubt that MAID could always be administered in an equitable way. We know that MAID is legal in other states and countries, and there is evidence that there has been some erosion of safeguards over time. We've heard about Oregon and that some folks who are accessing MAID in Oregon have reported doing so because they felt a burden to their family, they did not have enough money to continue treatments, or they did not have supports to be comfortable and manage pain at the end of their lives. In Canada, MAID was originally intended for people with terminal illnesses but eligibility has since expanded to include people with chronic conditions that overlap with many developmental disabilities.

While there are many safeguards written into this proposed bill, history checks the absolute trust of these written provisions. We have seen them change. So on one hand, there's concern that legalizing MAID may have unintended consequences and disproportionately assist people with disabilities to end their lives. On the other hand, there's concern that, as written, this bill prohibits some people with disabilities from having equal access to MAID. People with guardians are not eligible. And the requisite of oral and written communication may disqualify individuals who are deaf or use other communication methods. Thank you for your consideration.

SPEAKER1 - Thank you. Just

SPEAKER4 - just had

SPEAKER2 - a question. Sorry. Yeah.

SPEAKER4 - Of course.

SPEAKER2 - There you go.

SEN DRISCOLL - Thank you so much for being here. Not familiar with your organization before today, so thanks for coming. Do you have data on, we heard a little bit earlier about DNRs in terms of the community that you work with. Do you have data on what might be in practice across your community or if, you know, any kind of tracking of those types of things?

STOBER - Specifically for do not resuscitate orders?

DRISCOLL - Yes.

STOBER - So, what I can offer, I actually have our testimony printed, which has a QR code for our resource sheet that will have some resources that do talk about DNRs in the umbrella category of advanced care planning, which MAID falls under. I cannot offer you data points at this time, and I'm happy to get you some. What I can say is, we do have community members who have come to us that particularly in the COVID-19, the onset of this pandemic, they were affected by11406 crisis standards of care. We actually have a citizen member whose daughter passed away because she was, inappropriately had been labeled with a DNR sticker above her bed in the hospital. So we do know that this is one of the reasons that some people with developmental disabilities are particularly concerned about MAID legislation because they have seen some of this distrust or concern has been exacerbated by DNR orders and how there has been some different treatment of people with disabilities in the administration of that. that some people with developmental disabilities are particularly concerned about MAID legislation because they have seen some of this distrust or concern has been exacerbated by DNR orders and how there has been some different treatment of people with disabilities in the administration of that.

DRISCOLL - Great. Thank you.
SHOW NON-ESSENTIAL DIALOGUE


JOHN KELLY - NOT DEAD YET - HB 2505 - SB 1486 - Chair Decker and Driscoll, members of the committee on public health, I am communications director for Not Dead Yet and I lead Second Thoughts Massachusetts, disability rights advocates against assisted suicide. We started Second Thoughts in 2021 to oppose the ballot referendum on assisted suicide, and we helped defeat it. In 2018, I was near death11557 from necrotizing pneumonia. A doctor asked my brothers, not me, about my quote unquote quality of life. Yes. The magic words, quality of life, that can lead to death for old, ill, and disabled people like me. I am now 67 years old. Charlie and Stuart understood where the doctor was going with this, so they outdid themselves in saying how11598 great my quality of life is. If they had said my life was very poor and I wished that I had died ever since my injury at the age of 25, things might have turned out quite different. I might not be here today.

When Senator Brownsberger, who's my senator, a man I respect a lot, told me he couldn't imagine me being eligible for assisted suicide, I always knew that I was vulnerable in other ways. The social climate supporting my death churns out movie after movie about11649 a character in my situation clamoring for death, promoting the idea that we, that I would be better off dead. Even more menacing is the statistic about doctors. 82%, you've heard that before, including, it seems, my doctor at Boston Medical Center believes that our quality of life is inferior. When that doctor was querying my brothers on my quality of life, I was having ICU psychological psychosis, thinking all people were trying to kill me. Turns out I wasn't that far off.

Our concerns are visceral. We know from history and personal experience that assisted suicide programs are fueled by deadly social views about disability from raw prejudice against needing assistance with daily tasks to elite discourses on autonomy and dignity. When proponents insist that their safeguards are strict, and that any program would be limited to people judged terminal, we know that these programs already entail the deaths of non terminal disabled people through misdiagnosis and incorrect prognosis. And we learned that people suffering from anorexia nervosa, more than 60 so far, yes, this is documented, have been labeled terminal and are taking the poison. They say it's only voluntary. The person must choose themselves. My question is, they must choose or what, or what? The witness is dead. In this and in other ways, we are making social justice arguments against systemic discrimination against vulnerable communities. Our state must not sponsor people's suicides because other people consider them or us a burden because they believe they are dying when they're not, and because they have been denied the treatment and support services that would keep them alive. Thank you.

ANITA CAMERON - NOT DEAD YET - HB 2505 - SB 1486 - Good afternoon. I'm Anita Cameron, and I'm director of community outreach of Not Dead Yet. And I'm here in opposition to H 2505 and S 1486, obviously known as the end of life options act. I live with intractable pain and I have multiple disabilities. Two of them are degenerative and one will take my life. And one of my conditions, though, chronic, can become terminal if I lose access to treatment. So the proponents11910 of this bill speak of pain as the main reason that they want assisted suicide, but this can be addressed by effective pain control, palliative care,11924 hospice services, and palliative sedation. I live with chronic pain and I'm often hospitalized for pain management because I am allergic to all opiates and opioids. And at my last hospitalization, the pain literally became life threatening. My blood pressure skyrocketed and I began to go into cardiac arrest. And the doctors saved my life by giving me a powerful pain medication that I'm allergic to. It stopped my pain immediately, so they were able to treat the cardiac issues and adjust the allergy. And I'm on a pain regimen right now and I've been referred to a palliative care specialist.

Rather than immediately jump to assisted suicide as an an answer for pain and suffering, palliative care should be provided. This law is gonna put sick people, seniors, and disabled people especially, at risk due to the view of doctors that we have a lower quality of life, and therefore, leading them to devalue our lives. And this bias means that we are often diagnosed as terminally ill. And this bill is for those deemed terminally ill with six months or less to live. But make no mistake, terminally ill people are disabled people supposedly protected under law. Unfortunately, we in the disability community experience discrimination in healthcare to the point that the National Institute of Health has designated us as a community that experiences healthcare disparities. And listen, as long as disability discrimination and disparities in healthcare exist, assisted suicide laws have no place in Massachusetts. Please vote no on H 2505 and S 1486. Thank you.

SPEAKER1 - Thank you both.

At this time, I would welcome Suzanne Alexander.

SUZANNE ALEXANDER - CONCERNED CITIZEN - HB 2505 - SB 1486 - Good afternoon. I'm Suzanne Alexander. I'm a veterinarian, and I am retired from the US Army Veterinary Corps. I was stationed all over the world and saw how different cultures and different things respond to end of life issues. I am strongly in support of H 2505 and S 1486, an act relative to end of life options. I have been support in support of these options since very early in my career when I was able to witness and participate in the difference between a good death and a bad death. I do not equate animals to humans. I understand the difference and the legality parts are very pronounced. I am also very sick. In 2021, I was diagnosed with breast cancer, invasive surgery, chemo, radiation, the whole deal. I was continuing to try to work part time. I was having difficulties with my side effects from chemo and that became difficult. So now I'm retired on disability. I still volunteer at a couple of humane societies when I'm strong enough. I'm strong enough to be here today simply because I had a blood transfusion last week. Normally, I'm quite weak and unable to get around very well.

I was also diagnosed with advanced ovarian cancer in February. It is throughout my entire abdomen. It is not responding to chemo. I'm already in my first recurrence. I had massive surgery, chemotherapy, the whole deal. It went into remission for about nine months, and since I am a early recurrence person, my prognosis is said to be significantly worse. Oh, boy. I have a phenomenal team at Dana Farber. They're trying to get me into clinical trials, but in the current environment with NIH being gutted, it's like we're very worried about funding for continued research for additional things for treatment resistant ovarian cancer. I've read very thoroughly through these bills and I am impressed with their robust protections. It is voluntary, somebody has to be coherent. There's checks and balances, the terminal ill, the six months. And I am also concerned about DNRs that are not respected.

It's like when you're in the emergency room and DNRs are overwritten because they're not positives. Like you get treatment whether you want it or not. My main options at the12314 moment, as I see them, is to travel or move to another state. Vermont, as testified beautifully, is on my list. My mother is Canadian. Could I move to Canada? I have an aunt in Switzerland. Could I afford to go to Switzerland? Do I need to do anything while I'm still capable of some autonomy? My greatest fear is where is this disease gonna go next? Is it gonna go to my brain? Am I gonna have a stroke where I will no longer be determined competent for making my own decisions? Being kept alive against my will. I am already in kidney12355 failure. How is that going to impact my ability? I also12361 appreciate in the bill the protections that are built in for physicians and pharmacists that choose to participate in assisting us that are interested in pursuing MAID. Thank you. I'm sorry I ran over.

SPEAKER1 - Okay. Thank you for your time. And if you wish to submit any additional testimony, please. Say again? If you wish to submit any additional testimony.

SPEAKER16 - I will. I will. Thank you so much. Thank you for

SPEAKER1 - your time and service. At this time, I would welcome, by way of teams, Andrew Starr.

Okay. Andrew is not with us. Doctor Richard Florentine.

Doctor Florentine, are you on the phone? Because we can't see your name.

SPEAKER35 - Yes.

SPEAKER1 - Welcome.

SPEAKER4 - Yes. Can you hear me?

SPEAKER1 - We can hear you.

RICHARD FLORENTINE - CONCERNED CITIZEN - HB 2505 - SB 1486 - Thank you for12407 allowing me to speak. I am speaking as an individual against SB 1486 and HB 2505. I'm retired board certified and Massachusetts licensed physician with over 30 years of practice experience as a primary care physician including caring for hospice, terminally ill, disabled patients and veterans. I speak in strong opposition to this dangerous legislation. In the words of the AMA, physician assisted suicide is fundamentally incompatible with physician's role as healer, would be difficult to control, and could provide serious societal risks, many of which have already been discussed. And palliative care is the best option to primarily protect the patient's dignity while maximally providing the comfort with expertise of qualified physicians to make sure a patient's death is a good death. This bill uses so much deceptive languages such as MAID12481 which is in fact provider assisted suicide12484 dressed in euphemistic term to distract it from its accurate description.12488

It is a practice imposed by the Hippocratic Oath for over 2000 years. It claims that physicians can accurately determine a patient's death12498 within six months. Evidence in the medical literature says otherwise shows that greater than 50% of the time, physicians' prognoses are incorrect. It claims the patients can anticipate a peaceful death with no evidence supporting such a claim. Most bills involving this encourage non tracking and not accurately monitoring this procedure. There's no one present to describe what is really an experimental practice. And this it, is focused on, maximizing the procedure and not protecting the most vulnerable patients who are at greatest risk at a great, very vulnerable time.

The practitioners of this continue to alter the experimental concoctions of medication12551 because of unpleasant patient experiences, which are often unwitnessed by trained observers, which seems to be the design of this legislation so as to keep it in the dark and not understood well. Some patients can take many hours to die, after taking these12574 experimental medications and I would hardly call this a peaceful death. Doctors are encouraged to inaccurately portray the cause of12582 death to protect the executioner from legal liability rather than focusing accurate tracking patient safety and comfort. This practice12592 is likely to polarize and alter12594 interaction between physicians and hospital employees whose constances will undoubtedly clash in a system that requires mutual cooperation and untenable coverage situations that will further stress a already faltering healthcare system.

SPEAKER24 - Thank you, doctor quarantine.

SPEAKER4 - Increasing access.

SPEAKER1 - Thank you. If you wish to submit further testimony, please do to the committee.

SPEAKER4 - Okay. Thank you.

SPEAKER1 - Thank you for your time.

At this time, I would welcome,

Joanne Visiello.

Believe, Joanne,12644 you might be with us by way of Teams.

Okay. At this time, Janet Simons Folger.

JANET FOLGER - CONCERNED CITIZEN - HB 2505 - SB 1486 - Chairwoman Decker, Chairman Driscoll, and committee members, thank you for permitting me to testify in favor of an act relative to end of life options. My name is Janet12689 Simons Folger, and I am here12691 for the seventh or eighth time on behalf of my late husband, David. Dave started the oceanographic12698 program at Middlebury College in Vermont before moving to Falmouth to lead the US Geological Survey. He was a retired navy captain, an active outdoorsman, a husband and father of five, and his smile and enthusiasm are legendary. Dave passionately believed in the right of self determination at the end of life. He was diagnosed, in January 2017, with terminal pancreatic cancer and began symptomatic treatment including palliative12735 care and hospice.

When Dave was diagnosed, we looked into a move back to Vermont take advantage of their medical aid in dying law. Unfortunately, Dave's illness progressed too quickly for him to tolerate the physical difficulty of the move. How is it that a law that is so full of compassion for terminally ill individuals in Vermont was so out of reach to my suffering husband one state over? Dave considered taking an overdose of pain medications that we had amassed over the years but was concerned about the legal ramifications for me. Access to a medical aid in dying law in Massachusetts, such as that being proposed, would have given Dave significant peace of mind and allow him to maximize the quality of his last days.

His treatment was at a top was at a top Boston cancer center, where he had a pain pump surgically implanted to deliver the very powerful pain medication Dilaudid. He underwent palliative chemotherapy and took heavy doses of oral narcotics. His wonderful caregivers were unable to make his pain bearable. By the end, Dave, by the end of February, Dave was ready for death as he had connected12820 deeply with family and friends and he felt that he could no longer12824 tolerate his suffering. In mid March, after discussion with his care team and our family, he decided to stop eating and drinking as the only way to end his terrible suffering. My husband was not suicidal. He12839 loved life. In the days before his death, Dave suffered with agitated end of life delirium, thrashing, pleas for help, labored breathing, and ever increasing and12851 spreading pain. It was a horrible death. Dave did not feel he was a burden to us. We were privileged to spend his final intimate weeks with him.

I promised Dave that he would be able to remain in our bed next to me until his death. In the last week of his life, I broke this promise because he was developing12871 painful bedsores and toileting was excruciating. What would it have mattered to anyone other than Dave and our family12879 if he had been given the opportunity to choose an earlier death when he was alert and relatively peaceful and could have avoided the unremitting pain and severe difficulties that took away his enjoyment of life. Before Dave died, he asked me to fight for the passage of a medical aid in dying law in Massachusetts so others would not have to needlessly suffer excruciating deaths. Please help all the Daves out there and move this bill quickly and favorably out of committee. Thank you. Sorry.

SPEAKER1 - It's okay. Thank you. This yeah.

Theresa Visconti.

TERESA VISCONTI - CONCERNED CITIZEN - HB 2505 - SB 1486 - My name is Teresa Visconti. I'm a Massachusetts native and a pharmacist. I was planning on going through the progression of what we've been through with patients having to swallow large amounts of pills and vomiting and up to the cocktails that we have today. But, speaking with pharmacist colleagues in states where assisted suicide is legal, I continue to hear horror stories of seizures and long drawn out deaths because the effectiveness of these12989 cocktails is highly variable depending on the patient's weight, muscle mass, physical condition, etcetera. Because this entire industry has been shrouded in secrecy, we have little concrete data and thousands of horror stories from family members who witnessed non peaceful deaths of their loved ones. Suffering patients have been turned into human guinea pigs in an uncontrolled decades long experiment called compassionate care or death with dignity when it was anything but that.

I believe this cruel and unusual punishment of patients and their family members needs to stop. We have sufficient legally13029 approved and clinically tested medications to keep patients comfortable and pain free during their end of life transition. We do not need13039 to be helping kill innocent human beings. As Doctor Peter Kreeft from Boston College and others have told us, those who commit suicide go through considerably worse suffering and torment after death than anything they would have experienced prior, and there, they cannot get themselves out of it. Those who assist them or assent to this have committed a grave evil. They, and their families, and our land suffer great consequences as a result. When my father was diagnosed13070 with a rare cancer and given five months to live, I saw healthcare professionals and others try to convince him to end his life. He lived 17 years.

From what I've seen in my many years as a pharmacist and with my personal experiences, we do not need assisted suicide here in Massachusetts. Additionally, we should not force physicians to lie about the cause of death on death certificates. We should not foolishly believe that the 40% of unused suicide medications will be properly disposed of and not misused by others. We should not deceive people into thinking suicide is not suicide by changing its name to make it more palatable. We should not require medical professionals who choose13116 not to be involved in this agenda to have to refer patients to others who will. This still makes us complicit13122 in the intentional killing of an innocent human being, nor should we require them to provide all the written documents described in this bill. Saying no should be enough.

13134 We13134 should not open the door to youth suicides or other abuses as we see in other states. We should not make Massachusetts into a killing13140 mecca like Colorado or Vermont, and we should not continue calling evil good and good evil. What we should do is get back to speaking the truth, calling evil out for what it is, and truly lovingly supporting the dignity of every human being to the moment of natural death regardless of their physical or mental health or capabilities. In Massachusetts, we pride ourselves with our intelligence. What we need now is wisdom. Killing an innocent human being is not an heroic act. Lovingly accompanying them through to the end is. Let's choose to do what is most life giving and bring blessings, not evil, upon us and our land. Please vote no on these bills. They are not in the best interest13182 of our citizens or our great commonwealth.

SPEAKER1 - Thank you. Thank you. At this time, I would welcome, Jessica Rogers.

JESSICA ROGERS - PATIENTS RIGHTS ACTION FUND - HB 2505 - SB 1486 - Good afternoon. Thank you, honorable members of the committee. My name is Jessica Rogers. I'm the coalition's director for the Patients Rights Action Fund and I'm here in opposition to the assisted suicide bills before you today. As you're considering public policy decisions that will impact every citizen, we have to examine the data in the states where this is already legal. And that data makes it clear that the supposed safeguards are, unfortunately, nothing more than smoke screens with no protection for vulnerable patients who need support in living. Assisted suicide is legal in Colorado where young women with anorexia have been given drugs to end their life. Despite being a treatable mental health condition, these young women died in state sanctioned suicides after receiving lethal drugs from a physician. Similarly, in Oregon, diabetes has been a qualifying condition. And to be clear, anorexia would qualify here in Massachusetts as13267 well.

The language of the13269 Massachusetts bill is a terminal diagnosis with or without treatment. If you do not treat anorexia, that is in fact terminal. That's the justification that was used in Colorado. I wonder if the committee would be surprised that in almost 30 years in Oregon, 70% of patients have never mentioned pain or fear of future pain as a reason for their request. Only 30% of patients in almost 30 years. So why are people requesting this? In practice, it is for reasons of disability and13306 not wanting to be a burden on their13308 friends and their family. I was a caregiver for my mother who fought and ultimately died13314 from ovarian cancer, outliving13316 her initial terminal prognosis by three years. And as a caregiver and as a social worker, I can tell you that when someone says that they feel like a burden, the appropriate answer has never been to agree with them and to help them die.

Some claim the bill's provisions protect against coercion but all of these are circumventable. And the reality is that after the drugs are dispensed, the oversight ends. In Oregon, patients have held on to these drugs for years and there's no further oversight that that patient has retained capacity and there's no further oversight on what that diagnosis or prognosis is. Behind closed doors years later after getting these13359 drugs, we have no way of protecting these patients. We have no way of knowing if there's coercion from tired caregivers or greedy heirs. Patients in Oregon also self report asking for drugs to13371 end their life because they're concerned about the financial implications of treatment. Over the last few years, that percentage in Oregon continues to grow. There are well documented instances of patients denied life saving treatment by the same insurance companies that cover assisted suicide. There is no autonomy in a system that is not equitable. Thank you.

SPEAKER1 - K. At this time, I will welcome,

doctor James Kelly who will be joining us by Teams.

SPEAKER30 - Can you hear me?

SPEAKER1 - We can hear you.

SPEAKER30 - Okay. Very good. Thank you.

JAMES KELLY - AMA - HB 2505 - SB 1486 - Good afternoon. I am doctor James Kelly. I'm a physician and a psychiatrist of13418 39 years. I am speaking on behalf of the Nationwide Association of the American Physicians and Surgeons. The AMA code of medical ethics states, and I quote, physician assisted suicide is fundamentally incompatible with the physician's role as healer. Instead, the physician must respond to the patient's needs. I wanna repeat that. Physician assisted suicide, and that is the correct term, is fundamentally incompatible with the role of the physician as healer. Instead of physician assisted suicide, the physician must respond to the patient's needs. You're hearing many nice euphemisms today to avoid the accurate terms, physician assisted suicide or physician assisted murder. That's what suicide is. The terms are being used, the euphemisms are being used to get you to think this is a good thing. But the reality is is that this is killing vulnerable people. Please do not be deceived.

Hypothetical safeguards are in this bill, but they're only hypothetical. They're mostly smokescreens to delude you into a sense of security. They will be reinterpreted, they will be challenged in court, they will be changed, and they will be eliminated. And this will be the first step to euthanasia in Massachusetts. House bill 2505, Senate bill 1486 will weaponize13531 physicians and the medical industry against the most vulnerable patients for profit, and legalize abandoning medical ethics and the Hippocratic Oath by physicians. Massachusetts has outlawed the death penalty for violent murderers because it's cruel and inhumane. This bill reestablishes the death penalty for law abiding citizens by using the same cruel and inhumane drugs that are used in the death penalty. I also work with incarcerated patients. They're another group of vulnerable patients. If this bill passes, they will suffer because profits will always be greater when we substitute death for healthcare. This bill weaponizes physicians against patients. Please do not authorize us physicians to kill people. Vote no on this bill.

SPEAKER1 - Thank you for your time. At this time, I would welcome,

doctor, No.

SPEAKER18 - Let's see.

SPEAKER1 - Do we have Joan Kavanaugh?

Okay. Just for the edification of members, we have maybe about 7 folks left. We have a lot of folks from outside of the state who are interested in in weighing in at this time. And so just so folks can manage the rest of their schedule for the day. 7 more, and thank you to all of the members who are still here and listening.

You're Joan, you're on. We can see you. Welcome.

Joan, we can't hear you.

Are you able to unmute?

SPEAKER13 - Okay, Joan. You are if you're not able

SPEAKER1 - to unmute,13665 we'll give you another couple of seconds, but you're also welcome to submit testimony to us in writing.

We still13673 can't hear you.

SPEAKER13 - Okay, Joan. We're gonna move on

SPEAKER1 - to the next and, you are welcome to submit testimony. Apologies for that. At this time, I want to welcome, Jules Good. Jules, are you with us by way of Teams?

Okay. Jules is not here. Alex,

Schadenberg.

ALEX SCHADENBERG - EPC - HB 2505 - SB 1486 - Hello. I'm happy to be here with you today. I'm gonna be talking to you a bit about the data from Oregon and what's going on in other states. So I'm the executive director of the Euthanasia Prevention Coalition in the US. And if you look at the data out of Oregon, it's very important to point that out of the 607 lethal prescriptions that were written in 2024 and the 2024 data and 376 reported assisted suicide deaths, the ingestion status was unknown in 178 of those. So the oversight of the law is very much of a problem because the Oregon Health Authority makes it quite clear they have no authority to investigate what happens to those other 178. Now some of those 178 will be people who died a natural death. Some of them will be people who were late reported assisted suicide deaths, meaning the report hadn't come in yet, or they died in 2025. They'll die in this year, 2025 by assisted suicide. But some of them could be underreported or nonreported deaths, but you can't know because no investigation has been done into what's happened with these people.

Considering that the Oregon law and the Massachusetts law uses a self reporting system, meaning the doctor carries out the death as the one responsible for reporting death, it shouldn't be surprising if you get some unreported deaths. Now, similar to Massachusetts, Oregon requires a referral for psychiatric assessment if there's concerns. But in 2024, only three psychiatric assessments were done out of 607 people who are prescribed the lethal dose.13801 So, the other thing is about complications. In Oregon, there was nine reported complications out of 121 reports. Now, why is this out of 121 reports in 2024? And that's because the only time that complications can be reported is when the physician was at the death. So there's only 121 reports that came in with that kind of information on it. In 2023, there was 10 known complications out of 102 reports, which would be about a 10% complication rate in 2023.

The other thing is this whole thing about this fast death is it's, you know, nice clean death. Well, in 2023, the longest time of death was 137 hours in Oregon, which will be 5.5 days. In 2024, the report showed that the time of death ranged from seven minutes to 26 hours. So this whole idea that these would be peaceful, quick, gets, it's a fallacy. The other thing, of course, is that nearly every US state that has legalized assisted suicide has expanded their lives. And13864 why is this important? Because Massachusetts is emphasizing the importance of this tight bill. Well, the tight bill or the bill that's written specifically to be how it is seen as the most restrictive in the US, I don't actually think it is. Your language is not that tight. Nonetheless, it's designed to sell the bill because later you will be pressured based on equality and by the assisted suicide lobby to expand your bill. So it's important to say that even JM Sorrell recognizes this.

Thank you.

SPEAKER1 - You are welcome to submit any further written testimony to the committee. We appreciate your time.

SPEAKER63 - Thank you, Mike.

SPEAKER1 - Thank you. At this time, on, I think, Teams, we have Ian McIntosh.

SPEAKER64 - Great. Thank13912 you. Can you hear me?

SPEAKER1 - We can hear you. Welcome.

IAN MCINTOSH - NOT DEAD YET - HB 2505 - SB 1486 - Thank you so much. Members of the committee, my name is Ian McIntosh, interim13918 executive director for Not Dead Yet, a leading national disability rights13922 organization that opposes this assisted suicide. And on behalf of members in Massachusetts and as a Canadian with disabilities living in America, I urge you to stop these assisted suicide bills before it's too late. Autonomy is about informed choice with transparent and verifiable information. But when readily transparent and verifiable information runs contrary to repeated representation, it can't be trusted. Enter unwitting ableism which takes many forms but today it takes the form in this legislature discussing real healthcare bills about say, defibrillators and deferring to authorities like the American Heart Association, while somehow talking about assisted suicide laws that would be public policy while ignoring its authoritative body of opposition.

That type of selective engagement dares to raise the idea that all national disability organizations with a position, the AMA, the ACP, the National Council on Disability, and the UN Committee on the Rights of Persons with Disabilities and its treaty, which was based on the ADA and American disability leadership, who are in perception of all available verifiable data, are wrong while you are right. That is ableism. Death by ableism requires limitless terminological elasticity and industrious camouflage rendering words and promises meaningless. But so called right to die assisted suicide icon, Doctor Jack Kevorkian, had no problem calling it by what it really is. And noting its Nazi era healthcare origins as something positive saying, quote, I believe that there are people who are healthy and mentally competent enough to decide on suicide and, quote, intense emotionalism engendered by the concentration camp atrocities of World War 2 has unfairly stigmatized this honorable concept and cloaked it in silence.

Many have noted the momentum of 10 legalized states of DC in the absence of concern and part of the disability community with the furnishing this bill, which absolutely falls on its face. So I'm holding in my hand a report from NCD. And in it, it notes that as of January 2019, 269 attempts were defeated, since then, we're over 300. And I would note for your concern, John Kelly and Anita Cameron, who testified on behalf of NBY, are on pages 42, 40 3, 40 8, and 49 of this federal report. I'd like to ask about this idea of reconciling Canada as an apples to oranges comparison with the US by US proponents, and by extension not an example of the removal of these so called safeguards. In 2016, Compassion & Choices posted on their website that the Canadian government followed the Oregon model. Last year, California's end of life options act author noted that SB 1196 would risk the gains that they've made for going too far too soon. Her concern wasn't about the substance of the bill, but the perception of speed. Thaddeus Pope, an American bioethicist is a Fulbright scholar in 2019 under the project name End of Life Liberty in Canada and The US.

Thank you for your time.

SPEAKER1 - You are welcome to submit any further testimony in writing. Thank you.

SPEAKER64 - Right. Thank you.

SPEAKER1 - At this time, I would welcome Elaine Marie Cole.

SPEAKER65 - Okay.

SPEAKER1 - Elaine yeah. Welcome back, Teams.

SPEAKER65 - Okay. I'm on. Right? Okay.

ELAINE KOLB - NOT DEAD YET - HB 2505 - SB 1486 - My name is Elaine Marie Kolb. I am sitting here in my apartment14130 in a wheelchair, in West Haven, Connecticut. I was one of the people, along with thousands of others, who demonstrated, risked our lives, and many of us got arrested to get the Americans with Disabilities Act passed 35 years ago. I was also ADAPT. Look it up. ADAPT. I also a spin off of ADAPT was Not Dead Yet. That was founded in 1996. Look it up. Adapt. Not dead yet yet. Now the outcasts of the outcasts become the leaders of today. The ones we used to throw away to die are teaching us a better way. I'm positive if you're HIV, you can understand the song. The last will be first and the first will be last and there's more than 1 way to be strong.

When you take away our services, we don't know how we'll survive. Since death is cost effective, do you want us dead or alive? When you take away the things we need, we don't know how we will cope. When you14228 cut our means of purity, you take away our hope. They're gonna take away Medicaid. Millions of us will die. If Medicaid does not aid us, if Medicare does not care, millions of us will suffer. How can you believe that's fair? If you want to cut back funding, stop the welfare for the rich. Billions bail out billionaires. We're trapped down the ditch, but we're not dead yet. And we could boogie with the best of them. We are not dead yet. And we could laugh and have some fun because we're not dead yet. We're fighting for our freedom and we'll never14292 die because our spirit will live on. I'm 75. I was literally stabbed in the back resulting in a spinal cord injury, and I'm not dead yet. And I'm absolutely against your assisted suicide. If you pass it, you will be killing my people.

DECKER - Elaine from Connecticut. I have to tell you it's the first I've heard somebody sing their testimony. I very much appreciated it, and, thank you for your time.

KOLB - Well, thank you. And I wrote it in 1996. And I'm probably, along with a few others that have testified, I'm one of the people who has demonstrated and got arrested and risked my life to try to save your lives.

SPEAKER1 - Thank you, Elaine. Thank you.

Democracy, we we want people using their voices. Mhmm. And I have a feeling she's been at a lot of these and it's what makes this country great. So thank you.

At this time, I'm I have,

Katie Kelly.14372

Okay. Then we have some folks who've signed up for day who we our rules allow you to sign up the day14381 of for in person testifying, so we'll go to that list next. Thank you. Welcome. Thank you.

CATIE KELLEY - AUL - HB 2505 - SB 1486 - Good afternoon. My name is Catie Kelley. I am a policy counsel attorney with Americans United for Life. Thank you for your time and your service today. I respectfully urge your opposition of the End of Life Options Act. I do ask that you not take this opposition as any attempt to trivialize or ignore the pain and suffering that individuals and patients experiencing terminal illnesses and their families have faced. Anyone facing a terminal diagnosis deserves to be treated with kindness, compassion, and hope.14425 I will note, I have read the bills and I do recognize the additional safeguards that Massachusetts has incorporated, especially as compared to other states' possible or enacted legislation. But we do also reiterate the concerns of those in the disability community about bias among the medical profession and insurance companies disproportionately offering medical aid in dying to individuals with disabilities and chronic illnesses, instead of prioritizing life sustaining, life prolonging, and pain management treatment options.

We are also concerned about the preemptive deaths of vulnerable14465 patients who may be suffering from depression that is commonly associated with terminal illnesses, as well as individuals who might be being coerced14473 or who fear being a financial burden to their families if they want to pursue expensive treatment. It is a valid concern that insurance companies may deny coverage for life saving treatments in lieu of medical aid in dying. As discussed and cited in my written testimony, one doctor reported in 2020 that he referred two of his patients, who would be terminal without treatment, to life prolonging treatment. Both patients' insurance companies denied coverage for these treatment options and instead offered medical aid in dying. Next, although the physician under this bill is required to refer a patient to a mental health professional, the patient is only required to meet with a mental health professional one time before being evaluated.

Diagnoses of depression are highly associated with terminal illnesses, but an accurate depression diagnosis can take time and be significantly impacted by implicit biases on the part of both the mental health professional and the patient. Depression symptoms are commonly masked among elderly patients and those with terminal illnesses. And these symptoms can be affected by the grieving process that is also associated with end of life illnesses. In one study, only 6% of psychiatrists reported that they were confident that they could assess a patient's mental state in a single session. These challenges with diagnosing and treating depression in terminally ill patients may result in some individuals being deemed capable even though they should not have been after a more thorough evaluation process. Thank you for your time.

DECKER - Thank you. And, Catie, I believe you are from Connecticut?

KELLEY - Our office is based in Washington, DC.

DECKER - Okay. Mhmm. I had you signed up saying you're from Connecticut.

KELLEY - Oh, I'm not sure. Oh, you know what? Our Washington, DC office is on Connecticut Avenue.

DECKER - Are you based here in Massachusetts yourself?

KELLEY - No. I am a remote attorney for Americans United for Life, so I actually live in Georgia. But we

DECKER - So I just wanna assure you that nobody in the Massachusetts legislature who sits on this committee is looking at this as a trivial issue. Mhmm. So happy to have you here in Massachusetts. And regardless of where any member of this committee falls, I promise you this is not trivial to any of them.

KELLEY - Oh, I can tell. I appreciate it. Thank you.

SPEAKER2 - Okay. I think 1 more before 1 more person14616 who, I think was14618 from out of state was Isabella Peters, who had already signed up prior to

today.

SPEAKER3 - Welcome.

ISABELLA PETERS - CONCERNED CITIZEN - HB 2505 - SB 1486 - Thank you. You have the right to options. This choice is a personal decision. Don't worry about what family or friends might think. You deserve to end your pain. We will make this as peaceful as possible. These are the phrases spoken to the terminally ill, disabled, and elderly citizens of our communities every day. And the next day, they don't wake up. I was just under 2 years old when these phrases were used in an attempt to help my grandfather end his life. He had suffered from Parkinson's disease, heart failure, kidney failure and various other health issues. My grandmother was a state representative at the time who happened to be fighting a bill that listed those very illnesses as reasons to die. Both my grandparents were appalled at this piece of legislation which would allow a physician to end the life of their patient.

For four years, the doctors persisted, telling my grandpa that he didn't have much time left and that they could help him die with dignity, but he didn't listen. Instead, he would give me rides down the driveway in his motor chair until my grandma would come running out of the garage to scold him. He would teach me and my cousins how to play Clue and rummy while feeding us peppermint bark for me, seemingly never ending stash. On my sixth birthday, grandpa passed away. If he had given into the pressure of the palliative care system, I would have never gotten to know him. Those few golden memories of my childhood simply wouldn't have existed. My grandmother continued to be a big advocate for life, talking about this issue across the country. In the book Personhood, Tree of Life, my grandmother Nancy Elliot wrote these words, quote, euthanasia and assisted suicide deny the personhood of an individual in the most permanent way. These practices imply that people are disposable, that as soon as a person is14753 no longer productive to society, they ought to be removed. End quote.14757

In the Washington versus Glucksburg Supreme Court case, the Supreme Court unanimously found that assisted suicide is unconstitutional. And they voted this way because they wanted to14767 protect, quote, they valued protecting vulnerable14771 groups from psychological14773 and financial pressure to end their lives, end quote. There's the thickest deception in society wrapped in the message that assisted suicide is not murder but rather dying with dignity. And that the physicians helping patients relieve their pain should therefore be honored. There is no honor in taking a life. Is it really admirable for a physician to be able to prescribe death to their patient? I'm here in opposition of these bills because I think that assisted suicide is a slippery slope to vulnerable populations because denying the personhood of an individual is immoral and because the healers of society should not be helping end lives. Thank you.

SPEAKER2 - Thank you. This time I'm gonna call on Joanne Vizzilio. Joanne, I think you are with14819 us by phone. Vizzielio. Vizzielio.

SPEAKER4 - I can

SPEAKER2 - Welcome, Joanne. Your your state rep, the vice chair, Sally Cairns, is taking good care of you here.

JOANN VIZZIELLO - COMPASSION & CHOICES - HB 2505 - SB 1486 - Yes. Thank you so much. Thank you so much. I'm so sorry. I had technical problems logging back in on the link on the team. So thank you for hearing me. I am very much in support of medical aid in dying and end of life options. I first became a supporter of this initiative years ago after watching a very close friend of mine. She had suffered for years from a debilitating illness and then finally she was on her final deathbed. She was on her deathbed and she was in excruciating pain and she begged me to help her end her life. I didn't do that. That was 30 plus years ago and I'm still haunted by guilt. And the guilt is there because I knew she was suffering, and she was in pain, and she needed help and nothing was going to alleviate that suffering.

Fast forward many, many years here in 2017, I was diagnosed with an incurable blood cancer. Ever since then, I've been on chemotherapy. In addition to chemo, and stem cell transplants, and other Western medicine, I've given up flour, sugar and alcohol. I share that to make very clear to14909 you that I am doing everything I possibly can to stay alive. I want to live and it makes me so very angry when I hear others speak about suicide as if this is our choice. I am not making a choice to die, the cancer is making that choice for me. So when you hear suicide, it's a14931 fallacy. We want to stay alive, what we don't want is to be in pain. When you're told you have incurable cancer, the one thing you do is you do everything you can to stay alive. The second thing you do is you think a lot about death. And thinking about death, I did my homework, I prepared. I am okay with going to a a spiritual life form at another time. Not now, but when it happens, I will be okay with it. What I'm not okay with is the dying process. I do not want to be suffering and in pain. And I've seen that even with the best hospice care, you are not necessarily relieved of pain. Many doctors have testified to that.

I do not wanna be in pain nor do I wanna be so doped up on morphine like many people are that they're basically rendered unconscious and14983 live that way for days and many14985 times weeks, many weeks, basically unconscious on morphine just so that there's no pain at all being felt. And then that doesn't even help, there's breakthrough pain even with that. So I'm here asking with you. I'm here pleading with you, please. The choice should be mine and mine15004 alone. Nobody else needs to do this. No doctor needs to do this. No patient needs to do this. It is my choice and every patient's15014 choice alone. It affects nobody15016 else but the15017 individual. So I thank you for your time and I thank you for moving this bill forward.

SPEAKER2 - Thank you. At this time, I'm going to welcome15027 in person Becky Gladstone.

BECKY GLADSTONE - CONCERNED CITIZEN - HB 2505 - SB 1486 - Feel like I'm the last one standing almost but, thank you for your time, the joint committee, and the chairs. My name is Becky Gladstone. I live in Beacon Hill. And prior to that, I was a Dover resident for about 31 years. On 04/12/2024, almost one year ago today, my husband Doug experienced a grand mal seizure in my arms. He had had a car accident on the Leverett Circle. He spent the next 12 days at Boston Medical, where doctors conducted a myriad of tests and prescribed medications to eliminate the constant seizure activity he was experiencing. MGH neurologists evaluated Doug in May, but we opted to wait until after our eldest daughter's June wedding to have a neurosurgeon conduct his brain biopsy. And on January 17, National Glioblastoma Awareness Day, Doug was diagnosed with glioblastoma, the most common, the most aggressive, and a terminal brain cancer.

Surgery to remove the tumors was not an option since they are in four areas of his brain, multifocal and expansile. He had six weeks of radiation on his right temporal, vermis, and occipital lobes as well as daily chemotherapy. And he has been on the same chemo drug for five days each month since November. He weighs 155 pounds, but he is still able to walk almost okay and talk and function somewhat normally. But in his head is the constant reminder that he is going to die much sooner than he ever expected. Glioblastoma, or GBM, is a monster of a cancer. There is no other way to describe it. Individuals like Doug have a poor prognosis and a poor quality of life as the disease progresses. It can cause a variety of neurological, psychological, and cognitive disabilities.

Doug is a bright, independent, funny, and headstrong 64 year old who recently had to retire from the company he founded in 2001 because he struggles with basic executive functioning. He is getting treated by a top Mass General Hospital neuro oncologist and he is working extremely hard to improve himself both mentally and physically with the help from his palliative care team. He signed on to palliative care months and months ago. You can do that right as you get diagnosed with a terminal disease. It is extremely helpful in this process. It is not hospice care. You can do palliative care. Helpful in this process. It is not hospice care. You can do palliative care as you have treatment. I just want to make sure that's a point because I've listened to people mention, doctors mention palliative care as like that's the end.

Anyway, he is constantly exhausted and often depressed. We don't know what the plan is once he completes his six round of 523 chemo this month, but he knows he does not have much time. He also knows he wants to live. He wants to see his grandchildren, but he knows he wants to die with dignity. We have three daughters and they are all on board with this. He's talking about going to Vermont but, to me, that's hardly even possible right now. He wants to do this in the comfort of his own home. Anyway, anyone who is faced with a similar diagnosis, similar terminal diagnosis, we just, we want this choice. As Rabbi Lieberman said, there's a time to be born, a time to die. As Barbara Witherstone just said, don't we all want that gift? There's Dennis' metaphor that he mentioned of time. This is not suicide. This is not cruel. This is not inhumane. This is our rightful option. Thank you very much for your time.

SPEAKER2 - Thank you for your time. At this time, I welcome John Robinson.

JOHN ROBINSON - CONCERNED CITIZEN - HB 2505 - SB 1486 - Thank you very much for letting me speak. My name is John Robinson, I'm 76 years old. I live in Somerville, Massachusetts. Due to a premature birth, I'm legally blind in one eye and visually impaired in the other eye, so I've been disabled all my life. I was segregated in schools when I was coming up, so I always had an inferiority complex about being disabled. I always thought I was less than other people, so I've always had to struggle with that all my life. And I want you to understand that being disabled is a fact of life that everybody is gonna experience in their life once they get older. So I just wanna say, I oppose all physician assisted suicide bills. Assisted suicide laws are not rational, social, real life responses or solutions to ableism, depression, mental illness, poverty, racism, and suicide contagion.

And I wanna talk about my mother. My mother has severe, not depression, but Alzheimer's and dementia. But she knew the family, she knew my father, she knew me. And when we would go to visit her in a nursing home, where they stole her clothes and treated her so bad, she always would cry out our names when we were about to leave after we were visiting her. And I bring up my mother because there was a waiting list for home care in Massachusetts, and this should not be. You should fund home care so there is no waiting list for home care in Massachusetts. This is very important. I agree with the speakers from Second Thoughts. I'm a member of second thoughts. Anita Cameron, my sister, she said it all.15469 John Kelly, all those people and all the other people who testified with disabilities.

And I also wanna bring15477 up lastly, economics are in the background of the right to die movement. Money is being valued over people in the healthcare system. Managed care corporations rationing healthcare costs under the guise of cost containment. Don't be fooled. I relate to the people who are in pain because I've suffered pain myself. Anita suffers in pain all her life. But please do the right thing. Don't follow Elon Musk and Donald Trump because when they get rid of Social Security, all of us are gonna be in the street, myself included, because I'm on Social Security. Thank you very much.

SPEAKER2 - Thank you for your time, John. At this time, I welcome Grace Garcia.

SPEAKER7 - Okay.

Welcome.

GRACE GARCIA - LULAC - HB 2505 - SB 1486 - Hi. Good afternoon. The League of United Latin American Citizens, LULAC, is the oldest Hispanic organization in The United States and is represented by 200,000 active volunteer members. LULAC has been in Massachusetts for over 35 years, and I, Grace Garcia, represent the state as the Massachusetts LULAC state director. Massachusetts LULAC opposes House Bill 2505 and Senate Bill 1486. What is needed is quality healthcare for the Hispanic population provided with dignity for everyone. Many Hispanics do not know the language well and will be pressured into assisted suicide without even knowing what they are agreeing to. The Hispanic people15609 need chances, choices, and opportunities to survive in our fast improving medical technology world.

The assisted suicide bills are dangerous and discriminatory to the Hispanic population. There is no equity in medical coverage of black and Hispanic people. Equitable access to high quality15630 healthcare is essential to reduce barriers and promote fairness to healthcare services and to overcome racial bias in healthcare. Assisted suicide endangers disadvantaged diverse populations, often overwhelmed by institutional virus, and has widespread implication in a historically racially oppressive society. Inadequate healthcare is experienced more acutely by the financially poor, the elderly, poorly educated, and non English speakers. The Hispanic community includes immigrants that fall into these categories and need to be protected. How can a doctor say one has only six months to live? It could be true, but a person could live less or even years longer.

Medical aid in dying is only gonna be reported to the Massachusetts Department of Public Health, and doctors are gonna be required to write down the, cause of the death. Transparency is needed. People have to see the real reason they die. It will be a dangerous decision to decriminalize physical physician assisted suicide or medical aid in dying as it will show that Massachusetts no longer has interest in protecting and preserving human life. Massachusetts already faces a problem with drug overdose, with use of illegal drugs without a new law providing more. 8 million is being budgeted in Massachusetts for the prevention of suicide. Massachusetts is working to educate people to reduce the access of lethal means by promoting safe and storage, and education on safe deposit of over the counter drugs and unused prescriptions. Nationally, 250 million is budgeted to prevent suicide. Even the veterans administration is against assisted suicide for veterans. And palliative care needs to be used and, just we do oppose these bills. And15760 thank you very much. And I don't wanna go over.

SPEAKER2 - That's okay. Thank you. And15764 if you wanna submit anything more in writing, please15766 do.

SPEAKER8 - Yes. I will send something Okay. Afterwards. Okay. Thank you.15770 Thank you.

15773 SPEAKER215773 -15773 At15773 this time, I wanna welcome Elaine15775 Aversa.

ELENA VERSA - CONCERNED CITIZEN - HB 2505 - SB 1486 - Thank you. My name is Elena Versa. I'm a retired registered nurse, and wanted to15801 just speak on behalf of my elderly mother who was, her life was cut very short. She was essentially assisted into her death by assisted15813 suicide at the age of 93. My mother at 92 with very moderate dementia had one fall, which could have been prevented. She broke one rib and the emergency room doctor basically wrote her life away that night and said that, your mother really does not like hospitals. I'll make it so that she never has to return to a hospital. I will diagnose her. She only, excuse me. She only has15850 six months to live. I will make it so she never has to return15854 back to a hospital. I will quote, qualify your mother for hospice care.

My mother has had no metastatic cancer diagnosis ever, no cardiac disease, she had no cardiopulmonary end stage respiratory COPD. My mother then was signed on to hospice without my other sister and I being aware. She was systematically being given, quote, a vitamin as I witnessed them squirt morphine in her mouth. And every time I went to visit her over the15888 next four months, my mother was chemically restrained in the living room and in her bedroom. My oldest sister fought back as I did to her15898 primary care and they modified her, quote, vitamin, morphine to a very low dose, given systematically every evening. This past February 28, we got word that the floor was15912 on lockdown. She had15914 the flu. Within three days,15916 she could not eat or drink. They allowed me to go and see her, she15920 was15920 unresponsive. Hospice was again called in. My mother was systematically given morphine every four hours.

She runs a very low sodium level so I could see she was going into seizures and her sodium was dropping. They would not do a chest x-ray. I insisted, the chest x-ray was negative. They would not start IV fluids because a nurse practitioner said, she will third space and drown, which was false. My mother died seven days later. The last seven days of her life15952 were worse than I would put any rat through. It was a horrific death watching every single healthy organ fail. My mother drowned to death.15965 I don't know what death report is going to show but the solution to this problem is to oppose this bill. The solution is education. The solution is keep every patient with their primary care doctor, I beg this. I beg for a reevaluation. Hospice and palliative care are not what they were designed to be. We need to end that scenario. Patients must stay with their primary care doctors. Thank you.
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JANINE BEDOUIN - CONCERNED CITIZEN - HB 2505 - SB 1486 - I thank the committee, and legislators, and all those who are here today taking valuable time to listen to my thoughts which are humble and probably not as professional as some of the others. However, I think I speak for many who would not be here, who have never stepped foot in the state house or knew really how to effectively communicate with legislators. I've learned that in the past 10 years, and it's made a difference I hope in some instances, and I thank you so much for being available. I don't have to repeat a lot of what was said. The efficacy is questionable of the medications used in assisted suicides. In some countries they've had to resort to euthanasia because16085 the process took longer and was not as smooth as they predicted. So I think people need to be very aware that what they hear and what they even see in16097 the media really needs to be examined.

My screen of examining is through my faith. I believe in a creator who from the beginning has had a plan for each of our lives to be as meaningful as possible and as wonderful and beautiful as possible if not in this world at least in the one to come. And I think there are hundreds, thousands, in Massachusetts, who know this, believe this, and have lived by this. And so I'm just simply sharing a little bit of my experience. I've done a little bit of research. However, the article16131 in the British Medical Journal listed in the National Library of Medicines supports very strongly the lack of proper evaluation from clinicians' point of view. I'll be emailing in some references for this if you want to16152 read more about it. And there are also some cases where people have reported their very unfortunate experiences as they were present to a loving one in helping them to try to ingest the enormous amount of medicine.

What I will share, however, is, my belief in palliative care. I've seen it operate in different ways. My mother herself died from a stroke, leaving her very, very disabled for a long, long time. But in a very special way, a friend of mine, who I had a chance to spend some time with before her death, she was her third bout with cancer, she had remissions from the other two. This time she says no, I don't want to go through chemotherapy, I just want to allow what my, and she was a Christian, what my creator will help me with. And so I visited her, she had a little morphine drip next to her. And she said, I can deal with the pain because I know that I will be very soon someplace much better than I've ever been. So I just wanna share this with you. Thank you very much for your time.

SPEAKER2 - Thank you for your time. Okay. Stephen Walsh, you got in at the nick of time.

SPEAKER3 - Welcome.

SPEAKER10 - Hey. Thanks for having me.

SPEAKER2 - Thanks for being here. To be

SPEAKER10 - able to talk to the right people.

SPEAKER4 - Talk to the right people.

STEPHEN WALSH - CONCERNED CITIZEN - HB 2505 - SB 1486 - So, I've been an EMT for over 40 years. I have seen hundreds of people die, hundreds, and I see them die very sadly alone. I've seen young people die of overdoses, I've seen dead babies, I've seen all sorts of people die. Anyone who would suggest that you're better off dead is nobody's friend. And I think the issues with end of life issues, obviously, is difficult things and ethical things to consider. I know of two people who were advised to end it all because they were facing dialysis for kidney problems. I also know people who've had kidney problems on dialysis for 25 years. So somehow they were convinced that their life was not living because they had some challenges. Also, in my workplace, I've seen people come back from pretty serious injuries in the street. I've actually had times when I seen people, the first impression is that they're dead and they've come back. I've seen people actually talking after the assumption was they were dying. So there's a lot of variables on this, and I think to facilitate someone's death is just wrong. And I think people you know, if you study it, you see what's happening in Europe, you see what's happening in Canada. It's very popular. It's very hip. It's very cool. It's16320 wrong. If somebody suggests you're16322 better off dead, they're not your friend. That's all I got to say. Thanks.
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