Tuesday, March 12, 2024

Minnesota Assisted Suicide Bill is on a paved road to euthanasia.

Testimony in strong opposition to Minnesota Bill HF 1930 End of Life Option Act
March 12, 2024

Stephen Mendelsohn
By Stephen Mendelsohn

Rep. Jamie Becker Finn and members of the House Judiciary and Civil Law Committee:

I am an autistic adult and one of the leaders of Second Thoughts Connecticut, a coalition of disabled people opposed to the legalization of assisted suicide. I also serve on the board of directors of Euthanasia Prevention Coalition-USA.

I submit this testimony in response and opposition to previous testimony from Thaddeus Mason Pope, JD, PhD on March 7, 2024 before the House Public Safety Finance and Policy Committee.1 Pope argues that there is no “slippery slope” leading to a radical euthanasia regime like that in Canada. I will demonstrate that this “slippery slope” is actually a paved road, in which proponents have openly boasted about using an incrementalist, bait-and-switch strategy to first pass less ambitious legislation and then later expand the law whether by legislation or through the courts.

Pope erroneously claims that the Minnesota Legislature has total control to regulate the parameters of assisted suicide (which he calls “medical aid in dying” or MAID). Not so: Compassion & Choices has successfully sued the states of Oregon and Vermont to get them to eliminate their residency requirements. They currently have a lawsuit against New Jersey on the same issue. This shows that states that have legalized assisted suicide do not have full control over regulating the parameters of the legislation they pass.

It is true that under Washington v. Glucksberg, the Supreme Court has ruled there is no constitutional right to assisted suicide, and state courts have consistently rejected attempts to compel enactment of these laws. Nonetheless, challenges to laws legalizing assisted suicide based on equal protection and/or the Americans with Disabilities Act (ADA) from both sides remains largely an untested issue.

While one case (Shavelson et al. v. Bonta et al.) seeking to force California to allow for lethal injections for persons who may not be capable or may lose the ability was denied, it is easily conceivable that another court in another jurisdiction would rule otherwise. The core “safeguards” of six months terminal illness, mental competence, and self-administration all make distinctions on the basis of disability, granting some people suicide prevention and others suicide assistance. I would also note there is currently a disability-rights lawsuit, United Spinal Association et al. v. State of California et al., seeking to overturn the End of Life Option Act on ADA and 14th Amendment equal protection grounds.2

Pope claims that “… no U.S. legislature has ever even considered removing the terminal illness requirement. No U.S. legislature has ever even considered removing the self-ingestion requirement.” His testimony was rendered utterly false a mere one day after it was submitted. On March 8, 2024, California State Senator Catherine Blakespear submitted a press release on SB 1196, explaining the provisions of her bill to radically expand that state’s End of Life Options Act.3 This legislation would eliminate the terminal illness requirement, replacing it with “a grievous and irremediable medical condition” similar to what was originally enacted in Canada. It would allow people with early to mid-stage dementia to access the law, and would also allow for lethal injection, moving from assisted suicide to active euthanasia. In addition, it would eliminate the meager 48 hour waiting period, allowing for a same-day death.

Pope himself is a zealous advocate of expansion in this direction.4 He posted to his Medical Futility Blog, “California Makes Big Move on Medical Aid in Dying,” approvingly.5 Even under current law, he has advocated using voluntary stopping of eating and drinking (VSED) as a bridge to enable non-terminal patients to qualify for assisted suicide in states such as Oregon, California, New Mexico, and Hawai‘i which have either significantly shortened the waiting period or allowed it to be waived. Pope published an article in the Journal of the American Geriatrics Society approvingly citing the case of Cody Sontag, an Oregon woman with early-stage dementia who used VSED to qualify for lethal drugs under that state’s law.6 He notes that “if anyone can access VSED, then anyone can qualify for MAID,” thereby doing an end-run around the law’s terminal illness requirement.

The American Clinicians Academy on Medical Aid in Dying (ACAMAID) has an “Ethics Consultation Service” report on “Voluntary Stopping of Eating and Drinking and Medical Aid in Dying” noting that:

Legally, there is nothing in the letter of the law of any of the U.S. states’ aid in dying bills that explicitly prohibits accepting voluntary stopping of eating and drinking as a terminal diagnosis to qualify for aid in dying. This remains a legal gray zone.7
ACAMAID confirms that allowing VSED to qualify for lethal prescriptions would “essentially eliminate the criteria of terminal illness to qualify.”

Most significantly, if passed, HF 1930 would be the most expansive and permissive assisted suicide law in the nation to date. Similar to the extreme euthanasia bill in California, it has no waiting period at all, thus allowing anyone—theoretically even otherwise healthy people who may be depressed—to instantly qualify for the lethal dose and die on the same day. It would thereby enact two principal elements of Canada’s radical death regime—widespread eligibility for non-terminal conditions and same day deaths.

Passage of HF 1930 would also shift the Overton window toward more radical legislation. Over the past two years, while no new states have enacted laws to legalize assisted suicide, several states have moved to expand their laws. It is far easier to pass an expansion bill after a state accepts the principle that it is acceptable for doctors to prescribe lethal drugs to patients than it is to pass legislation to legalize the practice in the first place.

Proponents of assisted suicide bills across the United States have not been shy about their incrementalist bait-and-switch strategy and desire for future expansion. In my home state of Connecticut, Rep. Josh Elliott openly admitted he wanted to get anything on the books even if it was unusable so it could be later expanded. Paul Bass reports in the New Haven Independent:

Elliott has been sponsoring bills for years to allow terminally ill people to take their lives (aka “aid in dying”). The bill finally passed the legislature’s Public Health committee; it got stuck in Judiciary.

The version he plans to resubmit this year has been narrowed to cover terminally ill people with prognoses of less than six months to live, with sign-offs from two doctors and a mental health professional, monthly check-ins, and at least a year of state residence.

“Almost no one” would qualify under that restricted version of the law, Elliott said. But passing it would open the door to evaluation and expansion.8

Here is the full on-air quote from Rep. Elliott on Dateline New Haven:

The bill would be, um, exceptionally narrow in scope, it would be the most narrow in scope bill of this kind were we to pass it. It would be, uh, six months left to live, you have to get sign-offs from multiple doctors—two doctors and one mental health physician—uh, and then you need to go for frequent check ins—I think it's like once a month—and you have, there is a one year residency requirement, so there are so many ways we limit who could actually use this bill, to the point I believe if we were actually to implement the way that we are talking about it, almost nobody would use it. But the important thing for me is to get this bill on the books, and then see how it's working, and if it's not and people aren't using it, than make those corrections to actually allow people to use it. So that is what we've been discussing.9
Similarly, J.M. Sorrell, Executive Director of Massachusetts Death with Dignity, was quoted on a similar bill in his state, saying “Once you get something passed, you can always work on amendments later.”10 And Compassion & Choices past president, Barbara Coombs Lee said almost ten years ago regarding assisted suicide for people with dementia unable to consent, ““It is an issue for another day but is no less compelling.”11

There is much here that I have not covered. To cite a couple of examples, there is an explicit requirement in HF 1930 Section 12 to falsify the death certificate as to the cause and manner of death, thereby covering up foul play. There is also widespread evidence, most recently from ACAMAID, that the laws in other states are not being followed, and with no consequences to the prescribing medical practitioners.12 You will hear plenty of testimony on other problems with this legislation, particularly from others in the disability rights community.

I conclude by emphasizing that HF 1930 is not merely a “slippery slope,” but a paved road north to Canada’s radical euthanasia regime where disabled people are routinely denied services needed to survive but offered “medical aid in dying” instead. Please do not put Minnesota—and the rest of the nation—on this path. 

Please reject HF 1930. Thank you.

1 Thaddeus Mason Pope, JD, PhD, Written Testimony in Support of H.F. 1930 , Before the Minnesota House of Representatives Committee on Public Safety Finance and Policy: https://www.house.mn.gov/comm/docs/peqp-qSyH0aRdWY7Tn41Bw.pdf, pp. 95-98
2 United Spinal Association et al. v. State of California et al. https://endassistedsuicide.org/wp-content/uploads/2023/04/Complaint_Accessible.pdf; for more detail, see https://endassistedsuicide.org
3 Senator Catherine Blakespear, Factsheet on SB 1196: https://img1.wsimg.com/blobby/go/cd607dce-3325-492b-b030-b0a22331af65/downloads/SB%201196%20(Blakespear)%20Factsheet.pdf?ver=1709911469736
4 Thaddeus Mason Pope (2023) Top Ten New and Needed Expansions of U.S. Medical Aid in Dying Laws, The American Journal of Bioethics, 23:11, 89-91, DOI: 10.1080/15265161.2023.2256244 https://www.tandfonline.com/doi/full/10.1080/15265161.2023.2256244
5 https://medicalfutility.blogspot.com/2024/03/california-makes-big-move-on-medical.html
6 Thaddeus Mason Pope, JD, PhD, Lisa Brodoff, JD, Medical Aid in Dying to Avoid Late-Stage Dementia, “ https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.18785?domain=author&token=VA68TTBJN9VDRCRMRPIP
7 American Clinicians Academy on Medical Aid in Dying, Ethics Consultation Service, “Voluntary Stopping of Eating and Drinking and Medical Aid in Dying, January 3, 2023: https://www.acamaid.org/wp-content/uploads/2023/01/Voluntary-Stopping-Eating-and-Drinking-and-Medical-Aid-in-Dying.pdf Pope is part of ACAMAID’s Ethics Consultation Service’s team.
8 Paul Bass, Elliott Readies Next Legislative Steps Toward Freedom, New Haven Independent, January 4, 2004: https://www.newhavenindependent.org/article/elliott_readies_next_legislative_steps_toward_freedom
9 https://www.youtube.com/watch?v=Z0hWOjITspE at clip position 21:30

1 comment:

Kimberly Howard said...

Thank you Mr.Mendelsohn for your excellent testimony. Your salient points are spot on.
Your advocacy is greatly appreciated.

HF1903 is ethically and morally repugnant. My beloved mother was euthanized in a hospice facility in St.Paul, MN in 2020. She was not in an active state of dying. Her death by terminal sedation was horrific! I don't want another person or family to endure the medical trauma and gas lighting that my mother and I experienced at the hospice facility.

I am appalled that Minnesota is fast tracking this murderous legislation.I have submitted my written testimony for HF1903 and SF1813 end of life option. I've heard from a few of my MN representatives who strongly oppose this legislation. Vast majority support legalized euthanasia in our state. It is tragic and heartbreaking.