Doctor

Lee Marshall, a Gloucester psychotherapist, is among those supporting proposed legislation that would allow terminally ill patients to be prescribed a lethal dose of medication to end their lives. Marshall has stage-four breast cancer and has been given less than a year to live. (Photo by  Christian M. Wade)

BOSTON -- Lee Marshall was diagnosed with stage-four metastatic breast cancer several years ago, and the latest prognosis gives her less than a year to live.

"I thought I'd live to my 80s but I probably won't see 70," Marshall, a Gloucester psychotherapist, told a legislative committee on Friday. "There is no miracle that will rid me of my cancer. As time passes, and I become sicker, I grow more and more concerned about my limited end-of-life options."

Marshall would have the choice to end her life under a proposal being considered by lawmakers that would put Massachusetts in line with Vermont, Maine and eight other states that allow assisted suicide for those with terminal illness.

She said approval of the "medical aid in dying" proposal is her only "hope for a peaceful death."

"This bill is imperative for me and other terminally ill residents of Massachusetts to be able to die with some control in peace of mind still intact," Marshall told members of the Legislature's Joint Committee on Public Health.

More than 80 lawmakers have signed onto the proposals, filed by Rep. Jim O'Day, D-West Boylston, and Sen. Joanne Comerford, D-Northampton. The bills would allow terminally ill patients to be prescribed a lethal dose of medication to end their lives. They received an emotional airing Friday before the committee.

Critics of assisted suicide, including medical and religious groups and advocates for those with disabilities, say misdiagnoses are common. They urged lawmakers not to approve the practice.

Terminally ill patients suffer from depression, they noted, and may irrationally decide to end their lives.

Others argued that legalizing physician assisted suicide would encourage suicide among those suffering from depression and other mental health issues.

"Suicide, or the idea of taking one's own life, is a social contagion," said Andrew Beckwith, executive director of the Massachusetts Family Institute, a conservative group which opposes the proposal. He cited data showing a rise in suicides among the general population in Oregon, which legalized physician assisted suicide in 1994.

Supporters say the proposal has safeguards, including rules to keep doctors from prescribing lethal drugs to those with mental health issues or impaired judgment.

The bill would require patients to make two verbal requests for a doctor's intervention at least 15 days apart, as well as a written request signed by two witnesses. A physician would need to certify that the patient seeking access to lethal medicine is suffering from an incurable, irreversible condition.

In 2012, Massachusetts voters rejected a ballot question that would have allowed the terminally ill to end their lives with medication prescribed by physicians. The referendum was narrowly defeated, with 51% voting against it.

Proponents of the practice got a boost in 2017 when the Massachusetts Medical Society dropped its longstanding opposition to physician-assisted suicide.

The society’s governing body adopted a neutral stance on the practice, which it refers to as "medical aid in dying," allowing the organization of about 25,000 physicians and medical students to "serve as a medical and scientific resource as part of legislative efforts."

A U.S. Supreme Court ruling in 1997 left the issue largely up to states. Thirty-seven states have since banned the practice, either at the ballot box or by legislative act.

But physician-assisted suicide is legal in the District of Columbia and at least 10 states including Vermont, Maine, Hawaii, Washington, Colorado and California.

Maine's "death with dignity" law went into effect in 2019 after it was passed by the Democratic-led Legislature and signed into law by Gov. Janet Mills.

Methods of physician-assisted suicide vary by state but generally involve a prescription. Doctors are required to notify patients of alternatives, such as hospice care, and wait at least 48 hours after receiving a written request from a patient.

A 2020 poll by Suffolk University found more than 70% of Massachusetts residents believe doctors should be allowed to end a patient's life by painless means.

Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group's newspapers and websites. Email him at cwade@northofboston.com

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