Should terminally ill patients be allowed to choose when they die? The medical-aid-in-dying debate comes to Virginia

The fraught debate over medical aid in dying —or what some opponents refer to as physician-assisted suicide — has landed in Virginia.

The state’s Joint Commission on Health Care just completed a report on the issue, at the request of Del. Kaye Kory, D-Fairfax, which is currently up for public comment until Oct. 15.

And depending on how the commission votes, Kory said she may file a bill to authorize the practice in Virginia for this upcoming General Assembly session.

Aid in dying refers to a patient with terminal illness and less than six months to live obtaining lethal drugs through a physician to end his or her life. The patient must be over 18 and have a sound state of mind when making the decision. It is authorized in Washington, D.C. and seven states: Oregon, Washington, Montana, Vermont, California, Colorado and Hawaii.

For those in favor of the practice, such as the national advocacy group Compassion & Choices, it simply boils down to giving patients with a fatal disease an option for a more peaceful death on their own terms.

“It’s a decision that every person should be able to make,” said Maria Spencer, regional campaign and outreach manager with Compassion & Choices. “We support adults having the ability to make those end-of-life decisions for themselves.”

Kory said she believes having the ability to choose how you are going to die makes a difference, especially for terminal patients with less than six months to live, who must otherwise wait to die.

For opponents, though, such as the Virginia Catholic Conference, aid in dying simply boils down to suicide, which executive director Jeffrey Caruso said the government should not promote.

“If the state were to legalize assisted suicide, that would be doing a number of things that would be very harmful,” Caruso said. “It would be breaking our trust in doctors — their role is to heal, not to kill.”

He argued that the state should be considering ways to improve access to hospice and palliative care and developing better ways to treat pain.

“But the answer,” he said, “is not to end the lives of patients.”

Advocates for the practice, though, argue that terminal patients are already dying of an irreversible and untreatable disease. They must be rational and able to make their own decisions in order to be prescribed the drugs.

“Hospice is definitely a good support system, but it doesn’t allow you to choose anything about dying, except if you don’t want to take your medication anymore,” Kory said. “And that might be as physically and mentally painful as living with whatever it is that is causing you to die.”

There was a lukewarm reception for the practice among lawmakers when the report was presented to the Joint Commission on Health Care on Tuesday. Some raised the possibility that physicians might be wrong, for example, in giving a patient six months to live.

Del. Riley Ingram, R-Chesterfield, said his brother-in-law was given just months to live seven years ago, but is still alive and doing well.

“If I had to vote right now, I’d vote to not do anything,” he said, referencing one of the policy options before the commission: making no changes to Virginia laws.

Spencer said that in states where medical aid in dying has been authorized, patients must have a confirmed diagnosis from two doctors.

“This is not an overnight process,” she said. “There are steps that go into making the request and all of this is written in statute, so it’s a lengthy process that people have to go through to make sure they get this medication, and then they make the decision about when and if they choose to use the medication.”

Kory said she has not decided yet if she will file aid-in-dying legislation this year. She said it will depend on a number of factors, including whether or not the Joint Commission on Health Care decides to vote to recommend legislation during its November meeting.

But even if she doesn’t file a bill this year, she said she sees the Joint Commission’s report as the beginning of important dialogue on a subject that doesn’t get much attention.

Spencer said her group sees this as part of an ongoing conversation, and even if legislation isn’t passed this General Assembly session or even filed in the first place, Compassion & Choices members in Virginia will continue the push. Some states, she added, take years to pass the legislation.

“It’s a marathon, not a sprint,” she said.