HARTFORD — Some call it aid-in-dying, others assisted suicide. The language divide explains the fundamental disagreement about whether the state of Connecticut should allow a person with a terminal illness to end their life with medicine prescribed by a doctor.
At the Capitol on Wednesday, some told stories of cherished last moments with dying loved ones, the resolution of grievances and feuds, others of watching them suffer, helpless to ease their pain. The differing views of hospice workers, physicians, nurses, disability advocates, and those who have watched members of their own family die, only underscored that divide.
The bill has been proposed in the legislature for a decade, but last year was the first time it made it out of the Public Health Committee. On Wednesday, the Public Health Committee voted 22-7 to bring the bill forward again to a public hearing.
State Sen. Saud Anwar, D-South Windsor, a physician and supporter of the bill, said the legislation requires that a person requesting to end their life have a terminal illness with the expectation of only six months to live. A physician has to verify that the patient is mentally capable of making the decision, and the law requires a waiting period to make sure that the decision has not been made in the spur of the moment.
A previous draft of the bill required that a patient make two requests, fifteen days apart, for the lethal medication, and that the requests be attended by two witnesses attesting that the decision was made “of sound mind.” The witnesses cannot be relatives of the patient, affiliated with the health facility where the patient is being treated or in any way in line to inherit from the person making the request. Two physicians have to determine that the person is, in fact, suffering from a terminal illness, and must refer the person to counseling if they find that the person is suffering from a psychological condition like depression.
Anwar said that the legislature has worked this year to add further safeguards into the bill to protect against abuse.
But State Sen. Heather Somers, R-Groton, said she felt the safeguards simply weren’t strong enough. She also said she felt the state was “hypocritical” in that it was doing a lot of work in suicide prevention, particularly among adolescent girls, but that “when you become at a certain level of your life, if you have an illness, if you are just unhappy with your life — then it’s okay to partake in suicide.”
Somers said she didn’t understand how a medical doctor could both try to preserve life and also prescribe medicine that would hasten death.
“Being a physician, you cannot advocate for life, and also death,” said Somers. “Death is a part of the process that we have of life.”
Anwar said that doctors are “hardwired” to protect life. But he said that he also understands that certain terminal illnesses leave people with difficult and “unnecessary” struggles at the end of their lives.
“As physicians, from day one, you’re trying to do whatever is in your power to save and prolong life and then help an individual,” said Anwar. “But you recognize that when you are not in control, and when you realize that the suffering of that individual cannot be managed by the best possible teams that are available, you have a responsibility, at that time, to give those people an option.”
“Love, grace, forgiveness and meaning”
Among the people speaking against the proposal were several pastors and leaders from the Hispanic community, who said they were in favor of supporting life from beginning to end.
Carlo Rodriguez, who represents the Hispanic Pastors in the City of New Britain, said he felt that hospice could make a big difference in end-of-life care.
“As a pastor, what I always have noticed, when the individual, that family member … knows that his time is short — it’s just, the love, the hugs and the care,” he said. “At that time is when you hear about that loving and those conversations that were never said … and to see family members are able to close their eyes in peace and love because their pet or their family’s there.”
Rebecca Gagne-Henderson, an APRN with extensive experience in palliative care and end-of-life care, told a story of a 22-year-old young woman named Jackie who was diagnosed with metastatic cervical cancer. She was placed in hospice care, where the nurse caring for her asked her what her final wish would be before she died. She replied that she wanted her parents, who had divorced when she was five and had an acrimonious relationship, to come and care for her together.
The chaplain who worked with the organization went and spoke to Jackie’s parents, who finally agreed to Jackie’s request. According to Gagne-Henderson, the parents had reconciled by the third day, asked Jackie’s forgiveness and said they would spend time with her siblings, as a family.
“Had Jackie ended her life preemptively, she would not have escaped her suffering. She would’ve died amidst her unresolved anguish and demoralizing,” said Gagne-Henderson. “She found love, grace, forgiveness, and meaning. That is the absolute most any of us could possibly ask for at the end of our lives.”
“Trying to absorb some of his agony”
But others recounted pain and trauma overshadowing their own loved ones’ deaths. Jill Hammerberg, whose husband, Mark, was diagnosed with prostate cancer, said that he spent six weeks in hospice care, during which time they spent together, telling stories and watching favorite movies. She said that, had Mark had the option to request medication that would end his life, he would have done it.
“On a sunny Friday when we were all together, we would’ve been wearing our Red Sox caps singing, ‘Hey, Jude’, followed by a Guinness toast,” said Hammerberg.
Instead, she said, she had to watch him fight for breath and struggle in pain as they waited for the pain medication to take effect.
“All I could do was to hold him in my arms trying to absorb some of his agony,” Hammerberg said.
Kira Philips’ mother was diagnosed with multiple myeloma, which attacked her spine, leaving her in chronic pain. In June 2021, Phillips said, her mother shot herself with the family’s gun in the backyard shed in the early hours of the morning.
“It’s unfathomable still that she was capable of even doing something like that, given who she was as a person — being a gentle and kind, compassionate soul. My dad, her husband of over 40 years, had to find her that morning,” said Philips. “What we went through is something we’ll have to live with for the rest of our lives.”
Jennifer Barahona, whose mother, Barbara Donalds, died from ALS, said she wanted to stop “re-traumatizing” people by bringing them up to testify about the deaths of their loved ones year after year.
Barahona said that she eventually made the decision, with her mother’s consent, to remove her mother’s feeding tube, only to watch her mother die slowly over the course of two weeks. Ultimately, she said, her mother died in the middle of the night, without her and her siblings present. She said that at the end, her mother could only blink once for yes and twice for no as a way to communicate with them.
“I want a choice. The people of Connecticut have spoken and they want a choice. So let’s get this done this year and make sure no one else has to die waiting,” said Barahona.
Fears of Abuse
Ten states plus the District of Columbia have already passed laws allowing assisted suicide. Tim Appleton, the Connecticut campaign director for Compassion and Choices said that, since the first of these laws was enacted in Oregon in 1997, just over 5,000 people across the country have actually taken the medication.
But many of the people present at the Capitol were disability advocates who feared that the bill would become a tool for a healthcare system that did not want to pay for costly treatment for disabled individuals.
“Assisted suicide cannot and will not stay limited to a select population. The ostensible safeguards in legislation here in Connecticut are now called barriers in other states, including Oregon and Washington, and are being removed through legislation or the court process,” said Cathy Ludlum, a resident of Manchester and a leader of a group of disabled individuals who are against the legislation.
Somers also referenced Canada, which has come under scrutiny for potential abuses of euthanasia.
Somers said that while she could not see herself ever supporting the Aid-in-Dying bill, she did plan to push for changes that would put more safeguards around who could have access. She said she believed the physician prescribing the medication should be the person who has been responsible for the patient’s care over a period of time, not a physician who has never met the patient before. She also said that rather than allowing people to pick up the lethal medication from a pharmacist, the drugs should be administered in a clinical environment with a doctor present.
Another concern that Somers and advocates raised was the death certificate. Ludlum said that last year’s legislation did not require physicians to list lethal drugs and assisted suicide as the cause of death, which she said could leave room for “foul play.” Several Republicans are sponsoring a bill that would require lethal medication to be listed as a cause of death on the death certificate.
Somers said she believed the best way to address the suffering of terminally ill patients was to improve end-of-life care. She said people needed to be able to give the same type of hospice care at home that could be given in a hospital, that family members needed to be educated about what hospice care was, and that insurance companies needed to be required to cover hospice.
“If we can do a better job of educating and have more supportive care at home through hospice, [if] we have insurance that’s willing to cover it properly, I think we would be having a different conversation,” said Somers.