Gov. Phil Murphy is soon expected to sign the ‚ÄúAid in Dying‚ÄĚ law, making New Jersey the eighth state to permit people with a terminal diagnosis to end their own lives using a prescription from a doctor.
Dozens of people living with incurable diseases or relatives of people who have died testified multiple times over the past six years to persuade state lawmakers to pass the bill sponsored by state Assemblyman John Burzichelli, D-Burlington and state Sen. Nicholas Scutari, D-Union. Many said that although they knew their death was inevitable, but letting them choose how they would spend their last days would give them peace.
The legislation has been met with fierce opposition from medical professionals and religious leaders and disability advocates. They warned that people facing the last months or weeks of their lives may be steered toward suicide by subtle family pressure, guilt over being a burden, and insurance companies‚Äô refusal to pay for complex and expensive care.
Former two-term Republican Gov. Chris Christie signaled he would never sign the bill into law. But Murphy, a Democrat who succeeded Christie, did not criticize the bill as it made its way through both houses of the Democratic-controlled state Legislature last year.
On March 25, when the bill won final passage, Murphy said, ‚ÄúAllowing terminally ill and dying residents the dignity to make end-of-life decisions according to their own consciences is the right thing to do.”
Here‚Äôs what you should know about the legislation (A1504):
Q: Who is allowed to use the law?
A: Adult New Jersey residents who have received a terminal diagnosis, defined as an incurable, irreversible and medically confirmed disease that will end the person‚Äôs life within six months. The legislation specifically states disabilities are not considered terminal illnesses, addressing a worry that physically or mentally challenged people would be vulnerable to coercion.
Q: When does the law take effect?
A: August 1.
Q: How do patients go about getting the prescription?
A: Patients will have to verbally ask their doctor twice over the span of 15 days, during which time patients would also need to submit a request in writing, stating they had been ‚Äúfully informed‚ÄĚ of palliative care, pain control and other alternatives. A second physician would need to verify the diagnosis.
The written declaration would need to be witnessed by two people who attest the person is acting voluntarily. One of the two must not be a relative or entitled to any portion of the patient‚Äôs estate, or be the person‚Äôs doctor or nursing home employee.
The law contains recommended language for the written declaration. ‚ÄúI understand the full import of this request, and I expect to die if and when I take the medication to be prescribed,‚ÄĚ according to an excerpt. ‚ÄúI further understand that, although most deaths occur within three hours, my death may take longer and my physician has counseled me about this possibility. I make this request voluntarily and without reservation, and I accept full responsibility for my decision.‚ÄĚ
Q: Which medication is prescribed for people using the Aid in Dying” law?
A: It‚Äôs not spelled out in the law. But in other states, physicians most often prescribe a barbiturate, either pentobarbital or secobarbital, according to deathwithdignity.org, an Oregon-based national nonprofit which promotes the passage of aid in dying laws. The dose is typically 9 grams of secobarbital in capsule form, or 10 grams of pentobarbital liquid, according to an article in the American Journal of Health-System Pharmacy.
Q: What is the difference between the terms ‚Äúphysician-assisted suicide‚ÄĚ and ‚Äúaid in dying?‚ÄĚ
A: Right-to-die proponents say the term physician-assisted suicide is an inaccurate because patients administer the drug themselves. Jack Kevorkian, the notorious advocate of physician-assisted suicide, administered the fatal dose of drugs and remained with the patient until death was confirmed.
Q: What if patients want someone with them while taking the life-ending medication? Is that person guilty of a crime?
A: The law makes a distinction between the criminal act of helping someone commit suicide, and any action taken in accordance with the Aid in Dying Law, which “shall not constitute suicide or assisted suicide.‚ÄĚ People who are with a terminally ill patient in his or her final moments will not face criminal charges.
Q: Not every patient who receives the prescription takes the medication. What happens to it?
A: The patient shall designate a person who shall be responsible for the lawful disposal of the medication.
Q: Are there consequences for people who force patients to apply for and take the lethal medication?
A: Anyone who coerces a patient into requesting or taking the medication would face up to three to five years in prison, a $15,000 or both.
Q: Would survivors lose out on benefits from a life insurance policy if a patient used the law?
A: No. ‚ÄúProcurement or issuance of a life, health, or accident insurance policy or annuity, or the premium or rate charged for the policy or annuity, shall not be conditioned upon or otherwise take into account the making or rescinding of a request for medication pursuant to‚ÄĚ the law.
Q: Which states have similar “aid in dying‚Äô laws?
A: California, Montana, Oregon, Washington and Vermont. Montana‚Äôs ‚Äúright-to-die‚ÄĚ was established under a court ruling, which provides physicians a legal defense or immunity from prosecution. The practice is also legal in Washington D.C.
Q: What do we know about how the law has worked in other states?
A: Oregon, which enacted its law 22 years ago, provides the most information. ‚ÄúSince the law was passed in 1997, prescriptions have been written for a total of 2,217 people under the Death With Dignity Act; 1,459 people (or 66 percent) have died from ingesting the medications,‚ÄĚ according to the state‚Äôs 2018 annual report.
Most patients, 62.5 percent, had cancer; 15 percent had a neurological disease; and 9.5 percent had heart or a circulatory illness, according to the report. Nearly everyone (99 percent) was covered by private or government-sponsored insurance. ‚ÄúThe three most frequently reported end-of-life concerns were loss of autonomy (92 percent), decreasing ability to participate in activities that made life enjoyable (90.5 percent), and loss of dignity (67 percent),‚ÄĚ the report said.
Q: Is the public entitled to information about the impact of the law?
A: Yes. The Health Department must compile an annual report and post it on its website. It must contain data on how many patients received the medication and how many took the drug and died. Prescribing physicians must report this information to the health department.
Susan K. Livio may be reached at [email protected]. Follow her on Twitter @SusanKLivio. Find NJ.com Politics on Facebook.