(Source: MIRS.news, Published 11/14/2023) Terminally ill patients in Michigan, determined to have up to six months left to live, could request life-ending medication under bills the Legislature could likely take up next year.
"We wanted to make sure to introduce it before this holiday season in order to continue to work with stakeholders, for (it), against (it)...or even people that might have questions," said Sen. Mary Cavanagh (D-Redford Twp.), the lead sponsor behind this term's "Death with Dignity" bill package, to MIRS. "But, it is not my intent to shove anything down that we haven't had full vetting and full conversations of what is the best thing for Michigan, and who might be utilizing some of these new access points in end-of-life care."
On the last day of regular session activities for 2023, Cavanagh and Sens. Kevin Hertel (D-St. Clair Shores), Veronica Klinefelt (D-Eastpointe) and Sam Singh (D-East Lansing) introduced SB 678, SB 679, SB 680 and SB 681. In order to access the end-of-life care established through the legislation, a patient must be specifically diagnosed as terminally ill and cannot have more than six months remaining to live, based on medical judgements.
Life-ending medication must be prescribed by an attending physician and a consulting physician under the bills, and the patient must be evaluated to ensure they're capable of decision making and rational thought.
The legislation additionally calls for the participation of two witnesses, with one barred from being a relative or someone who could benefit from the patient's death and the passing down of their estate.
The bills also create a 15-day waiting period following a patient's verbal request for life-ending medication, and a 48-hour waiting period after they submit a written request.
"Unfortunately, I do believe that most of us, not only in the chambers of Lansing, but in Michigan and all across the country, have experienced or are currently experiencing loss of a loved one who really could have benefited from end-of-life options," Cavanagh said. "We really wanted to be very strategic that it wasn't an overarching or full-umbrella over anybody."
For Cavanagh personally, she thinks of her deceased grandmother. Following a dementia diagnosis, Cavanagh said her grandmother spent more time sleeping than being coherent, with morphine being popped into her system throughout the end of her life.
"It tore at my heartstrings because that was a time where I do believe, if there (were) more options, that my grandma wouldn't want to have passed the way that she did, and (in) the amount of pain that she experienced," she said.
However, Cavanagh clarified how the example of her grandma "doesn't really fit in this legislation," as bill sponsors aimed to zoom in on terminal illnesses as opposed to wider, and potentially foggier, areas dealing with dementia and continual pain.
In 1998, Michigan voters encountered Proposal B, the Physician Assisted Death Initiative, on the General Election ballot. The question dealt with permitting Michigan patients to obtain lethal medication doses – for the purpose of ending their lives – if two physicians confirmed they were terminally ill, with no more than six months left to live, and if one physician verified they were mentally competent.
More than 71% – or 2.1 million – voters opposed the ballot question. Proposal B failed as numerous headlines were focused on Dr. Jack Kevorkian, the Oakland County pathologist and euthanasia activist who participated in 130 "assisted suicides."
Around five months after Proposal B was defeated, Kevorkian was sentenced to 10 to 25 years in prison for second-degree murder by an Oakland County circuit judge, as well as three to seven years in prison for delivery of a controlled substance. He was released on parole in 2007.
When similar legislation was introduced in 2016 by Singh while he was in the House and by previous Rep. Tom Cochran, a Mason Democrat, then-House Health Policy Chair Mike Callton – a Nashville Republican and self-proclaimed moderate – said to MIRS he didn't see the bills going anywhere.
More recently, near the end of their 2023 interim meeting in Maryland on Monday, the American Medical Association's (AMA's) policy-making House of Delegates rejected two resolutions intended to alter the association's position on physician-assisted suicide, which currently describes the practice as "fundamentally incompatible with the physician's role as healer."
One resolution would have changed the AMA's position to one of support, reading that "medical aid in dying" is legal "in 11 US jurisdictions, covering 1 in 4 US adults." The other resolution would have switched the position to "neutral," reading "61% of US adults support allowing medical assistance in dying, and whereas, medical aid in dying can provide comfort and dignity for terminally ill patients who are suffering and have exhausted all other treatment options."
In Michigan, the state's Catholic Conference and Right to Life of Michigan have been consistent opponents to policy efforts like the "Death with Dignity" legislation.
Through a conversation with David Maluchnik, the vice president of communications for the Michigan Catholic Conference, MIRS learned that pre-existing opposition to such proposals is being further intensified by Canada's Medical Assistance in Dying (MAID) statute, which will no longer exclude serious mental illness starting in March 2024.
In an email exchange with MIRS, Maluchnik said the Canadian MAID law proves "the goal posts move after the law has passed to allow for broader categories of persons who are neither terminal nor even dying to receive medications to end their lives."
"MCC believes that those who are already vulnerable – the disabled, homeless, people who are sick and in need of health care that heals rather than kills – are placed at greater risk with 'Death and Dignity' MAID-type laws," Maluchnik said. "And we're familiar with arguments that assisted suicide incentivizes insurers and healthcare providers against paying for end-of-life care."
