Proposed medical aid in dying bill fails again at General Assembly

Editor's Note: The following is part of a class project originally initiated in the classroom of Ball State University professor Adam Kuban in fall 2021. Kuban continued the project this spring semester, challenging his students to find sustainability efforts in the Muncie area and pitch their ideas to Ron Wilkins, interim editor of The Star Press, Journal & Courier and Palladium-Item. This spring, stories related to health care will be featured.

INDIANAPOLIS — State Rep. Matt Pierce (D-Bloomington) introduced House Bill 1011 earlier this year, which sought to legalized medical aid in dying for terminally ill Indiana residents.

Pierce authored the bill on Jan. 8; however, the bill failed when it did not get a hearing in committee.

“This is really focused on an individual who is facing a very difficult end to their life,” Pierce said. "It’s just a question of whether you force them to go through a painful situation."

Pierce said he became involved in this issue after listening to his constituents advocate for an Indiana version of the Oregon Death with Dignity Bill. Pierce also noted that there are safeguards to his proposed bill so individuals will still qualify for life insurance benefits if they use medical aid in dying. The bill does not consider medical aid in dying to be a form of suicide, which ultimately obligates a life insurer to honor the deceased’s policy.

This is not Pierce's first proposed bill on this topic.

According to the Indiana General Assembly’s website, his first attempt was in 2018, but that bill failed after it went to the Committee on Public Health but never got a hearing. The current bill met the same fate.

Pierce said the 2024 bill is identical to his earlier bills but with updated wording modeled after updates to the Oregon Death with Dignity Act.

Constituent with terminal cancer inspired Indiana bill

Pierce said he became invested in this cause after one of his constituents, Carrol Krause, was diagnosed with terminal cancer and began writing about her struggles.

“She was asking, ‘Why is it that I can’t have the same option here in Indiana that people have in Oregon?’ ” Pierce said. “I think her bringing attention to that issue caused me to hear from a lot of constituents asking that exact same question.”

The Oregon Death with Dignity Act allows individuals with a terminal disease that will cause death within six months to end their lives through medication.

Under the Death with Dignity Act, the individual must submit a written request to their physician, signed in the presence of two witnesses. The patient’s current physician and a consulting physician then review the diagnosis for confirmation and assess the patient’s mental capability to make the decision.

Either physician may refer the patient for psychological examination if they deem it necessary.

The patient must wait 15 days after the request was filed to receive the medication to ensure the patient has considered all options. The individual must also be able to self-administer the medication and be able to make an informed decision to qualify.

If a patient does not meet these requirements, they will not be prescribed the medication.

The Indiana bill is nearly identical to the Oregon Death with Dignity Act; however, Pierce says he has no current plans to allow individuals living outside of Indiana to be able to qualify for the medication. According to the Oregon State Legislature, the residency requirement was removed from the Oregon Death with Dignity Act in 2023 to be more inclusive.

Opponents to medical aid in dying worry about encouraging suicide

“What we’re told from the local people is that the legislature is very unlikely to move that particular bill,” said Barbara Lyons, the Patients’ Rights Counsel special projects coordinator.

Lyons explained that her organization stands against medical aid in dying because of the risks that might arise from its use, including encouraging suicide. Lyons argues that these bills can put vulnerable individuals at risk, including elderly and disabled individuals.

“We think that we need to add services and care for people in those vulnerable groups rather than saying, ‘Well, you know, the only option we have for you is death,’ ” Lyons said.

Lyons argued that while these services might provide autonomy for some individuals, they also create unintended repercussions, including insurers potentially encouraging medical aid in dying to save money on care costs.

“We don’t think that the autonomy for some patients should create that great risk for others,” Lyons said.

Studies of MAID: Medical aid in dying

An article published in “JAMA Network Open,” a medical journal published by the American Medical Association, analyzed demographic trends in participants of medical aid in dying. The study used data from Oregon and Washington, two states which legalized medical aid in dying, also known as MAID.

The study used data from 2,558 patient deaths and found that “reasons patients choose to pursue MAID include loss of autonomy, impaired quality of life, inadequate pain control, and, in a small percentage, financial concerns.” However, the article also noted, “Concerns that MAID would unintentionally target socially disadvantaged patients have not materialized as evidenced by the data presented in this article.”

Angela Schultz, a manager for an end-of-life health care advocacy group, Compassion and Choices, disputes claims that these bills are discriminatory, noting that being elderly or disabled alone does not make a person eligible.

“Medical-aid-in-dying legislation has over two dozen safeguards, and there has never been a single case of coercion or abuse,” Schultz said. “Unfortunately, people come to conclusions before learning all the facts.”

A 2019 University of Pittsburgh School of Law report by Alan Meisel studied data from the Oregon Health Authority and analyzed the states and Washington, D.C., where medical aid in dying is authorized.

The report stated, “There is no evidence in either state that patients have been pressured into seeking physician-aided dying either by their physicians or their families nor that they lacked the capacity to make a decision to avail themselves of physician-aided dying.”

Schultz says she hopes that these bills will inspire discussions surrounding end-of-life care — even if they are not passed.

“We are hopeful the conversations will continue and that awareness of this issue will help others have more conversations about what is important to them at the end of life, become more informed of their options, and how they can have their values, beliefs and priorities honored at the end of their lives,” Schultz said.

This article originally appeared on Lafayette Journal & Courier: Indiana bill for medical aid in dying stuck in committee