COVID-19 Increasing Awareness of Life’s Fragility, Support for Aid in Dying Growing

COMMENTARY

The COVID-19 pandemic turbocharged the development of lifesaving vaccines at record-breaking speed, but COVID’s relentless death toll has reinforced life’s fragility and the limits of modern medicine to eliminate suffering at life’s end.

At the same time, we are seeing increased support in our nation for advanced care planning and ensuring that every U.S. resident has the full range of end-of-life care options, including the option of medical aid in dying — MAID for short — for terminally ill adults to end unbearable suffering peacefully.

While people who die from COVID-19 die too quickly to complete the multi-step eligibility process for MAID, their agonizing deaths still vividly illustrate that people who die from slower-acting diseases like cancer and ALS should have this peaceful dying option to avoid needless suffering.

For decades, lawmakers feared that sponsoring MAID bills would harm their chances for reelection. It took until 2013 before Vermont became the nation’s first state legislature to pass a MAID law. Today, Washington, D.C., and 10 states representing one out of five U.S. residents (22%) have authorized MAID, including six jurisdictions via legislative action since 2015.

Despite the growing momentum and progress on this issue, some lawmakers still thought COVID-19 might negatively impact voter support for MAID, but the evidence since the pandemic spiked in early 2020 shows support has only grown and intensified.

A poll commissioned by Compassion & Choices and conducted by Susquehanna Polling & Research shows voters nationwide are eight times “more likely” (51%) than “less likely” (6%) to vote for a state legislative candidate who sponsors or supports MAID legislation.

In addition, the survey showed two of three voters (67%) personally want this end-of-life care option for themselves, including a strong majority of voters (62% or higher) regardless of party affiliation, race or religion.

The November 2020 elections also debunked lawmakers’ concerns that MAID is a political albatross.

Our biannual analysis of the 2019 and 2020 legislative sessions shows nearly 400 lawmakers from both sides of the aisle signed onto MAID bills as sponsors or cosponsors across 24 states.

They range from northeast blue states like Connecticut, Delaware, Massachusetts, New York and Rhode Island to southern, Midwest and western red states like Arkansas, Indiana, Kansas, Kentucky and Utah. The reelection rate of these lawmakers was 95% in November 2020, a three-point jump from the 92% reelection rate in 2018.

Some lawmakers recognize and are responding to this growing support for MAID. For example, New Mexico lawmakers first tried to pass a MAID bill in 2009. Twelve years later — this past April, with the pandemic still raging — New Mexico passed a MAID law to ensure terminally ill adults have access to this end-of-life care option.

What makes New Mexico’s law unique is it doesn’t include as many of the unnecessary, time-consuming steps that subject a dying person to prolonged suffering, which are mandated in most other MAID laws.

For example, a dying person doesn’t have to endure the unnecessary, prolonged 15-day waiting period that is mandatory in most other jurisdictions where MAID is authorized before they can get their prescription for peace of mind. The New Mexico lawmakers reduced the waiting period to 48 hours and gave providers the ability to waive the waiting period for patients who are imminently going to die. Yet, the New Mexico law maintains the same core, multi-step safeguards that protect patients from abuse and coercion.

Similarly, California Governor Gavin Newsom signed legislation on Oct. 5, 2021, that state lawmakers overwhelmingly passed, Senate Bill 380, to eliminate needless time-consuming requirements in its MAID law after evidence confirmed patients were dying during the lengthy and unnecessary waiting period. For example, one hospital system study showed 21% of terminally ill state residents eligible to use MAID died during the 15-day waiting period. In response, lawmakers wisely and compassionately reduced the waiting period to 48 hours for all eligible patients.

One key lawmaker who had a change of heart on the issue over the last few years was Dr. Richard Pan, Democratic chair of California’s Senate Health Committee. Here is what Dr. Pan said to the coauthor of the California End of Life Option Act and lead author of SB380, State Sen. Susan Talamantes Eggman, during the Senate Health Committee hearing:

“…when you brought the original bill [the 2015 End of Life Option Act], I was a bit of a skeptic and I have to admit I did not vote for the bill; I had concerns. But … I think that it’s clear that this is something people in California want and we need to make sure works, and that’s why I’m in support of this bill [SB 380] … there were a lot of protections in the original bill. I don’t think we’re weakening those protections at all with what you’re doing with this bill … we’re … making it more workable for the people who really desire and want this option.”

The Journal of Palliative Medicine has reported that MAID laws have spurred important doctor-patient conversations about the full range of end-of-life care options, resulting in earlier, more effective use of hospice and palliative care.

This positive data helps explain why an August 2021 survey of gynecological oncologists showed nearly seven of 10 respondents (69%) believed MAID should be legal.

In sum, given such strong physician and public support, lawmakers who support MAID will be rewarded by grateful constituents for sparing their dying loved ones from needless suffering at the inevitable end of life.

Kim Callinan is president/CEO of Compassion & Choices, and its sister organization, Compassion & Choices Action Network. Kim holds a master’s degree in public policy from Georgetown University and a bachelor’s degree in government from Oberlin College. You can email Kim here or follow her on Twitter @KimCallinan.