PROVIDENCE — The Senate Judiciary Committee has heard testimony relating to the Lila Manfield Sapinsley Compassionate Care Act, a bill that would legalize physician-assisted suicide in the State of Rhode Island.
The Senate Judiciary Committee’s consideration of this bill on March 6 comes but three weeks after the House Judiciary considered the same bill. As in the House hearing, the members of the Committee chose to table the bill for further study.
SB2093, popularly known as the Lila Manfield Sapinsley Compassionate Care Act, was proposed before the Senate by Senator Meghan Kallman (D) of District 15 (Pawtucket, Providence).
According to the bill, healthcare professionals cannot be subject to civil or criminal penalties or professional disciplinary action for prescribing life-ending substances to a patient if the patient is terminally ill, which the bill defines as any medical condition likely to result in death within the next six months.
The bill further specifies that the patient must ask for the life-ending substances of their own accord in the form of two oral requests and one written request, with the written request being signed in the presence of two witnesses, at least one of whom is not an interested party (the doctor, the owner or operator of the hospital, or a spouse, family member or heir). In addition, the medication must be ingested or administered by the patient themself.
Sen. Kallman, in introducing the bill, frequently referred to such measures as “death with dignity,” implying that the bill helps to maintain a sense of respect for those close to death. Nonetheless, another equally important effect of the bill pointed out by Sen. Kallman is its affirmation of bodily autonomy, connecting the bill to other recent pro-choice legislation passed by the General Assembly.
“Several years ago, this body took the honorable and ethical decision to codify respect for physical and bodily autonomy by codifying the Reproductive Privacy Act. This bill, in my view, represents the same line of thinking, that the patient is their own best ethicist, in that how we care for our health, including at the end of our lives, we ought to have access to the full spectrum of choices,” Sen. Kallman said, going on to assert, “The Compassionate Care proposal respects and honors an individual’s choices, including how we define a dignified death.”
But many of the witnesses questioned whether the bill, in fact, helps to maintain the dignity of the sick and dying.
Matt Kwasnik, a medical student at Brown University, asserted that this bill goes against the goals inherent to the medical profession.
“This is the question: what is the good of the medical profession? That’s what we’re talking about here today. It is, as was said earlier today, by individuals on both sides of this question, that it is to ease suffering, not to prolong life unnecessarily, but I would also say not to shorten life unnecessarily,” Kwasnik said.
“It’s dangerous to market death as a treatment,” Kwasnik continued. “Is there anything besides a lethal dose of medicine that we can think of, in all of our industriousness, all our creativity, to ease the suffering of another individual in the throes of a terminal illness?”
Some went another step further, noting that the bill is not only a failure to seek better alternatives to help those at the point of death, but may also serve to decrease the sense of empathy among caretakers and worsen the emotional state of those near death.
Such was the message of Dr. Timothy Flanigan, an infectious disease doctor and professor at Brown Medical School.
“Depression at the time of death is normal. It’s called reactive depression. … Lack of control is so common and normal, and we all lose our dignity during that period of time,” Dr. Flanigan noted. “This bill, which says at that time, when patients are most vulnerable, we should give them the medical tools to end their life…is the wrong approach. What we need is more care.”
“We all fear being alone. We all fear having to be a burden on others. We all fear losing our dignity. It’s a given,” Dr. Flanigan continued. “The antidote for that is not to be able to plan your demise exactly as you want it. The antidote is to receive care, to show love and to be accompanied.”
He went on to note that according to some statistics, in Oregon, the first state to implement laws legalizing physician-assisted suicide, only three percent of those who ask for physician-assisted suicide do so due to the immensity of the pain, with the vast majority desiring to receive life ending substances due to a sense of fear at the events immediately leading up to death and a sense of the loss of dignity due to the crippling effects of life-threatening diseases and injuries.
Barth Bracy, the executive director for Rhode Island Right to Life, noted how an emphasis on maintaining bodily autonomy served as the central motive for many of those who favored the bill, which often overshadowed an openness to pain management-based methods of care.
“Some even granted that pain can be well managed with modern palliative care but based their argument on loss of autonomy and dignity,” Bracy said.
“I would suggest that the compassionate response to human beings suffering from physical or emotional distress is not to provide them with the means and the encouragement to take their lives but, rather, to surround them with loving affirmation and provide them with the supportive care that will allow them to live their lives with dignity.
