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Congress shouldn’t repeal DC Death with Dignity Act

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I am an African-American doctor and lifelong D.C. resident, who is living with three cancer diagnoses. I love life, cherish my family, and want to live as long as possible, as long as I can enjoy a decent quality of life. That’s why I have endured multiple rounds of chemo for more than a year. But I am 80 years old, so even if my cancer treatments extend my life, I know I will die in the not too distant future and want to ensure I do not suffer needlessly when I do. As a result, it’s extremely important for me to have access to all of my end-of-life care options.

Congressional opponents of the end-of-life care option of medical aid in dying authorized in the District of Columbia by the D.C. Death with Dignity Act failed to repeal the law during a 30 legislative day review period that ended on Feb. 18.

{mosads}Now seven months later  congressional opponents of medical aid in dying are misusing the federal appropriations process to try to do what they could not openly do in February: repeal the D.C. Death with Dignity Act.

Similar to laws or bills in 32 states, the D.C. law gives mentally capable, terminally ill adults with six months or fewer to live the option to obtain prescription medication they can decide to take to end unbearable suffering and die peacefully in their sleep.

Despite polling showing two-thirds of D.C. residents support medical aid in dying, the House Appropriations Committee approved a rider authored by U.S. Rep. Andy Harris (R-Md.) to the 2018 Financial Services and General Government Appropriations Act (H.R. 3280) to repeal D.C.’s Death with Dignity Act.

In addition, national and state polls show a majority of Americans believe medical aid in dying is good policy and support this end-of-life care option across the ethnic, political and religious spectrum. This majority includes African-Americans, Asian-Americans, Hispanics-Latinos, conservatives, Democrats/Democratic-leaning independents, liberals, moderates, Republicans/Republican-leaning independents, Catholics, Christians, Protestants, people of other faiths, people living with disabilities, and physicians.

Contrary to claims by medical aid-in-dying opponents, I know from decades of experience as an internist and endocrinologist that for all its wonders, modern medicine cannot relieve suffering at the end of life in every single case.

In fact, a Journal of Palliative Medicine article in 2015 entitled, “Is Care for the Dying Improving in the United States?” concluded:

Striking changes occurred in health care in the United States between 2000 and 2013, including growth of hospice and hospital-based palliative care teams [yet] respondents from deaths in 2011–2013 were more likely to state that their loved ones experienced an unmet need for pain management (25% vs. 15% in 2000…)

The sad truth is that the statement by Rep. Harris, a practicing anesthesiologist, to introduce the rider in House Appropriations Committee is filled with inaccurate information. Any member of Congress can verify these errors by watching fact check video of his speech on YouTube.  

If Rep. Harris’ rider or similar legislation becomes law, it will inspire opponents of medical aid in dying to seek a nationwide ban on this end-of-life care option. In fact, they have tried to do it in the past, by prohibiting physicians from prescribing medication subject to the Controlled Substances Act for medical aid in dying: the Lethal Drug Abuse Prevention Act of 1998 and the Pain Relief Promotion Act of 1999.

Such a ban would void medical aid-in-dying laws in six states representing 18 percent of the nation’s population: California, Colorado, Montana, Oregon, Washington, and Vermont, as well as legislation introduced in 26 other states.

The six authorized states have 40 years of collective experience with medical aid-in-dying laws with no evidence of misuse, including nearly 20 years of experience in Oregon alone. Disability Rights Oregon (DRO) confirmed this fact on Feb. 10, 2016, “DRO has not received a complaint of exploitation or coercion of an individual with disabilities in the use of Oregon’s Death with Dignity Act.”

And according to a Journal of Medical Ethics report about the Oregon Death with Dignity Act, “Rates of assisted dying in Oregon…showed no evidence of heightened risk for the elderly, women, the uninsured…people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations.”

For all these reasons, members of Congress should oppose the Harris rider or similar legislation to repeal the D.C. Death with Dignity Act because dying residents in Washington, D.C. get peace of mind by knowing that this proven and safe medical practice is available to them and they should not be deprived of this option. A Los Angeles Times article published last week after just one year of experience with the California law shows that medical aid in dying enhances care for most terminally ill adults where it is authorized not just for the relatively few people who seek this option.

These repeated attempts to repeal D.C.’s law are an attack on individuals’ personal liberty to make their own end-of-life care decisions — in consultation with their doctors and loved ones — that honor the terminally ill person’s faith and values. They also are an abuse of power and a waste of time when Congress should be focusing on solving important national issues.

Regardless of their position on the issue, Senators and House members should oppose the Harris rider or similar legislation getting attached to the final appropriations bill or continuing resolution because it would violate the autonomy of D.C. officials to enact local laws that only affect their constituents.

Dr. Omega Silva was the first female president of the Howard University Medical Alumni Association and is former president of the American Medical Women’s Association, which supports medical aid in dying.

The views expressed by contributors are their own and are not the views of The Hill.

Tags Death with dignity laws Healthcare

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