Know the Facts

Legislation was introduced this year in the Maryland General Assembly (HB 404/SB 418) that would legalize physician assisted suicide — allowing doctors to legally prescribe a lethal medication at the request of a patient who has received a  six-month terminal diagnosis.  The legislation is very similar to a bill that was filed in 2015 and did not advance out of committee, but proponents continue their aggressive campaign to pass this misguided bill. 

There is a lot of misinformation surrounding this debate and misunderstandings about the legislation. We want you to clearly understand why this bill is so troubling and such a bad idea for Maryland. Here’s an in-depth set of reasons why we strongly oppose these bills. 

(If you want something to print out, click here to access our one page fact sheet.) 


No doctor, nurse, family member or independent witness is required to be present when the lethal dose is taken.

  • This creates a huge opportunity for abuse of patients – coercion of the elderly by those with a financial stake; forcing of the lethal prescription on those who cannot self-administer (e.g. an ALS patient) or who do not have the mental capacity to understand (e.g. an Alzheimer’s’ patient)
  • The large majority of assisted suicide does not take place in a healthcare setting. 89.5% of assisted suicides in Oregon in 2014 happened at home.[1] What if something goes wrong and the patient needs medical help immediately? There is no one there to help.

Patients will pick up their lethal prescriptions at their local pharmacies.

  • A typical dose is 90-100 pills
  • The Maryland proposal does not require safe disposal of lethal prescription if it is not taken by a patient (i.e. patient dies before taking it.) Only 68% of Oregon residents receiving a PAS prescription in 2014 took the lethal dose. What happened to the lethal medication for the other 32% (totaling 50 people)?

There is no requirement that patients receive a psychological evaluation before doctors can authorize physician assisted suicide. A screening from a doctor untrained in mental health is not sufficient.

  • We know that patients with a terminal diagnosis have much higher rates of depression[2]. Why shouldn’t a depressed person receive treatment for that condition before they are even allowed to consider suicide?

Accurately predicting a six-month terminal diagnosis is next to impossible – even doctors admit that it is simply an educated guess.

  • The Oregon “Death with Dignity” data makes this argument for us: 11 patients receiving a PAS prescription in 2012 or 2013 took the lethal dose in 2014. That means they outlived a 6 month terminal diagnosis by more than a year, at least.
  • We all know people who have outlived their terminal diagnosis by months to years.
  • JJ Hanson was diagnosed with the same cancer as Brittney Maynard in May 2014 and was told he has 3 months to live. As of December 2015, he is now a leading national opponent of physician assisted suicide and his cancer is in remission[3].
  • New treatments for once untreatable diseases are being discovered every day. Earlier this year, researchers from the Preston Robert Tisch Brain Tumor Center at Duke University announced they made a breakthrough in a potential treatment for Glioblastoma, one of the deadliest forms of brain cancer – and the same cancer Brittney Maynard had before she committed suicide.

Suicide contagion is a real problem that proponents refuse to answer for.

  • A new study in the Southern Medical Journal shows a direct link between legalizing physician assisted suicide and an increase in non-PAS suicides statewide[4].

PAS is seen as a cost savings measure for insurance companies, including state Medicaid programs.

  • In states like Oregon, both private and public insurance cover the cost of assisted suicide drugs. This increases pressure on insurance companies and the state to offer PAS instead of life saving treatments that are likely much more expensive.

Pain is not even in the top 5 reasons why patients wanted physician assisted suicide (it’s 6th)

  • As noted in the Oregon 2014 report, “the three most frequently mentioned end-of-life concerns were: loss of autonomy (91.4%), decreasing ability to participate in activities that made life enjoyable (86.7%), and loss of dignity (71.4%).”

Maryland Residents Already Have Excellent End of Life Care Options 

  • Palliative care is available to all patients dealing with a serious illness, whether terminal or not, and is a multidisciplinary approach to providing relief from pain, stress, etc. that comes with serious illness.  
  • Hospice care is available to all with a terminal illness and provides pain relief and symptom management – all of which is paid for by Medicare/Medicaid and almost all private insurance plans.
  • Why isn’t the Maryland Legislature doing everything it can to increase use of palliative and hospice care before it even considers legalizing suicide? The Workgroup Report on Hospice Care, Palliative Care and End of Life Counseling[5] summarized this issue well and helped implement a number of changes in Maryland to increase access. However, more can still be done on this issue.
  • Medicare is now covering end of life counseling. This should increase the number of Medicare patients who are fully educated about existing end of life care options such as palliative care and hospice care. We know from Oregon that 60.2% of those receiving a PAS prescription in 2014 were on Medicare or Medicaid[6].

 

[1] Oregon Death with Dignity Act – 2014 Report – Oregon Public Health Division https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf

[2]Depression and end-of-life care for patients with cancer, Donald L. Rosenstein, March 2011 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181973/

[3] “A Fighter Trains His Ire on Assisted Suicide” New Boston Post, November 30, 2015 http://newbostonpost.com/2015/11/30/a-fighter-takes-aim-at-assisted-suicide/

[4] “How Does Legalization of Physician-Assisted Suicide Affect Rates of Suicide?” Southern Medical Journal, October 2015 http://stopassistedsuicidemd.org/app/uploads/2015/11/Assisted-Suicide-Affect-Rates-of-Suicide.pdf

[5] http://www.oag.state.md.us/healthpol/hospice_and_palliative_care_workgroup_report.pdf

[6] Oregon Death with Dignity Act – 2014 Report – Oregon Public Health Division https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf

[7]CDC Minority Health Summary  http://www.cdc.gov/minorityhealth/populations/REMP/black.html

[8] National Hospice and Palliative Care Organization, Facts and Figures: Hospice Care in America, 2015 http://www.nhpco.org/sites/default/files/public/Statistics_Research/2015_Facts_Figures.pdf

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