The D.C. Council gave final approval on Tuesday to a bill that would authorize doctors to prescribe a lethal dose of drugs to terminally ill patients with a prognosis of six months or less to live, sending the legislation to the desk of Mayor Muriel Bowser for her signature.
Sponsored by council member Mary Cheh, the Death With Dignity Act cleared the council in an 11-2 vote, enough to override a veto from the mayor’s office.
Ms. Cheh, Ward 3 Democrat, said there is an “urgent need” in the District for “terminally ill residents to have the end-of-life care option of medical aid in dying.”
“This law is designed to keep the government from taking away people’s freedom and liberty to make these fundamentally personal decisions in consultation with their family, physician and spiritual advisors,” she said in a statement.
A spokesperson for the mayor said Ms. Bowser expects the bill to become law, after which it will go to Congress for review.
Marilyn Golden, a senior policy analyst at the Disability Rights Education & Defense Fund, said opponents of the legislation will petition Congress to intervene.
“We really want to share with Congress why this bill is so dangerous, that if they want to look at overturning it, they really need to understand what the problems are,” Ms. Golden said.
But Michael Kaplan, whose husband, the late reality TV star Sean Sasser, died from HIV-exacerbated mesothelioma, said no one should be forced to endure suffering in their final moments.
He said Congress ought to “respect the will of the people and allow this bill to become law.”
The Death With Dignity Act passed its initial vote in Council on Nov. 1 by the same margin. Democratic members Yvette Alexander of Ward 7 and Brianne Nadeau of Ward 1 cast the opposing votes each time.
The District seeks to join six states where aid in dying is legal.
The most recent state to permit the practice, Colorado, did so through a ballot measure this election cycle. Oregon first legalized physician-assisted suicide in 1994, and subsequent state laws, like the proposed D.C. measure, have all been based on the Oregon model.
Ms. Golden said the bill puts vulnerable populations — including the poor, elderly and disabled — at significant risk. It does not contain sufficient safeguards against medical error, coercion and abuse, she said.
“Much as the proponents protest over and over again that there are adequate safeguards, they are in no way adequate,” Ms. Golden said.
The law authorizes physicians to prescribe a lethal dose of drugs to terminally ill patients, who then self-administer the life-ending pills at home. Patients also must consult with two doctors over a span of at least two weeks in order to obtain the fatal drugs, and two witnesses must attest to the voluntary nature of the decision.
Ms. Golden questioned why the bill does not require patients to undergo a psychological evaluation before obtaining the fatal drugs. She said it is not uncommon for terminally ill patients to go through bouts of depression, and pointed to incidents in other states where mentally ill patients have acquired lethal prescriptions.
“There’s the case of Michael Freeland out of Oregon, who had a 43-year medical record of acute depression and suicide attempts, yet was deemed not to need any kind of psychological or psychiatric exam,” Ms. Golden said. “That was deemed unnecessary, in someone with a 43-year medical record of acute depression. That was deemed unnecessary. That doesn’t sound like a strong safeguard to me, and the D.C. bill doesn’t have any that are in any way greater.”
Omega Silva, former president of the American Medical Women’s Association, which supports physician-assisted suicide, said the measure is a compassionate way to alleviate the suffering of the terminally ill.
“I have three cancer diagnoses,” Ms. Silva said in a statement. “As an internist and endocrinologist for 45 years, I know from experience some dying people suffer unbearably, even if they have the best spiritual support, hospice and palliative care.”
But Ms. Golden said recent improvements in the quality of end-of-life care make physician-assisted suicide an unnecessary risk. Pointing to surveys from states where the practice is legal, she said most patients seek out life-ending drugs not because of pain, but due to a desire to control the dying process.
The Council took an “extremely dangerous” step for very little in return, she said.
“They’re taking a huge risk that this doesn’t put everyone — very much including the poor people who make up so much of the Washington, D.C., populace — at very significant risk of serious harm.”