ST. GEORGE – On Feb. 2, House Minority Whip Rebecca Chavez-Houck, D-Salt Lake City, introduced a bill, HB 264 that, if passed, would would enact the End of Life Options Act and allow terminally-ill patients with less than six months to live the option to receive a lethal dose of drugs that they could use to end their lives. While a recent survey reported a majority of Utahns favoring some form of “right to die” law, religious leaders in the state have already voiced their opposition.

The question of whether someone with a terminal illness should be able to choose how they live — or don’t live — their final days is not a new one, but it is still surrounded by contention.

According to the DeathWithDignity.org website, four U.S. states currently have statutes that allow physician aid in dying: Oregon, Washington, Vermont and California. Oregon was the first state to enact such legislation, with voters approving the Death with Dignity Act in 1994. However, it has faced multiple challenges in the subsequent years, including the 2005 United States Supreme Court case of Gonzales v. Oregon (formerly Oregon v. Ashcroft).

In 2001, former U.S. Attorney General John Ashcroft attempted to block the Oregon Death with Dignity Act via his “Ashcroft Directive,” which directed DEA agents to investigate doctors prescribing federally controlled drugs as defined by the U.S. Controlled Substance Act to aid terminally-ill patients in dying. The Supreme Court ultimately found in favor of the Oregon Death with Dignity law, stating that Ashcroft had overstepped his authority.

In addition to the four states with current statutes, DeathWithDignity.org lists 13 other states where such legislation is under consideration. Utah is one of those states, and this isn’t the first time the issue has come in front of Utah legislators.

In 2015, Chavez-Houck proposed a similar bill which failed to make it to the floor of the Utah House. The 2015 bill, HB 391, proposed a Utah Death with Dignity Act, but only made it as far as the House Health and Human Services Committee.

The beginning of the journey in Utah

In her introduction to the committee on March 5, 2015, Chavez-Houck spoke of Brittany Maynard, the California woman who made headlines in 2014 when she was diagnosed with terminal brain cancer and moved to Oregon to end her own life.

“Her story has echoed those of 859 other Oregonians since 1997,” Chavez-Houck said. “After I heard about Brittany’s story, I began hearing from constituents and other Utahns who wondered in a state that so fiercely values self-determination, why we did not have this act in Utah.”

Several people spoke at the committee hearing on behalf of the 2015 bill, including hospice nurse and co-chair of the Utah Compassion and Choices chapter Kathryn Lewis and Dr. Anne Palmer, executive director of the Utah Commission on Aging. Other speakers related their personal experiences with family members diagnosed with terminal illnesses.

Speaking against the bill were representatives from United Families International and the Catholic Diocese of Utah. The concerns that were raised ranged from the professional side, including errors in diagnosis, to moral and ethical issues such as respecting the sanctity of life.

“It’s important to remember that the law is a teacher,” said Kristine Eberle of United Families International. “This bill, if made into a law, it would speak volumes about the worth of a life by implying that a person’s life is less important if they are not healthy.”

Dr. Louis Moench spoke on behalf of the Utah Psychiatric Association and Utah Medical Association, saying that he was not against the bill but rather against the passage of the bill at that time. Moench said he struggled deciding whether the bill represented dying with dignity or physician-assisted suicide and that the medical and psychiatric community seemed almost evenly divided on the issue. Ultimately, the bill was sent back to the House Rules Committee with a recommendation that the bill be referred to interim study.

From “Death with Dignity” to “End of Life Options”

Chavez-Houck returned with the new bill this year. While many aspects of the bill are the same as its predecessor — including the 15-day waiting period and requirement for two doctors to sign off on the request for the lethal prescription — this year’s bill also contains some adjustments, the most noticeable of which is the name change of the proposed law from “Utah Death with Dignity Act” to the “End of Life Options Act.”

Chavez-Houck told St. George News that when she was working on the original bill, she wanted to replicate the Oregon and Washington language because people were familiar with the Oregon law and the concept of death with dignity. However, after introducing the bill, she discovered that some people were offended by the terminology. She said:

I got a lot of people that came up to me — and rightly so — who said, ‘Are you telling me the journey my loved one took, because they didn’t take an option like this, wasn’t dignified?’ And that was by no means what I was intending to do. I don’t want to disparage or make a judgment on anyone’s journey.

I feel very strongly that this needs to be the patient’s choice, the patient’s prerogative, and they first and foremost need to be the ones determining what their fate is; so I definitely don’t want to cast aspersions or make it sound like this is the most dignified way that someone can hasten their death if they choose to do so. People that take a different journey, I want to respect that.

Chavez-Houck said that since introducing the bill last year, she has received numerous phone calls and emails of support, from health care providers to patients to patients’ family members. She said one of her constituents, a professor of medical ethics at the University of Utah who has done years of study related to physician aid in dying and other end-of-life issues, told her that more people in the general population — and even health care providers — were willing to have the conversation about this option, whereas they hadn’t been before.

A poll conducted by Dan Jones & Associates would seem to support this idea. In December of 2015, UtahPolicy.com released the results of the poll wherein 624 adult Utahns were asked the following: “Do you favor or oppose some kind of “right to die” law, where licensed medical personnel could help a terminally-ill, mentally-competent person die with allowed drugs if that person chooses?” Fifty-eight percent of respondents answered either “definitely favor” or “somewhat favor,” with 35 percent saying they oppose and 6 percent reporting being undecided.

When broken down by stated political affiliation, 41 percent of Republicans polled said they favored such a law, 90 percent of Democrats said they were in favor, and 67 percent of Independents were in favor. Of the stated religious affiliations — including Protestant, Catholic, and members of The Church of Jesus Christ of Latter-day Saints ranging from “not active” to “somewhat active” to “very active” — or lack of religious affiliation, only those who stated they were “very active” LDS Church members reported a majority in opposition.

The future of the End of Life Options Act

Following this year’s filing of HB 264, both The Church of Jesus Christ of Latter-day Saints and the Catholic Diocese came out against the bill. In statements to Fox 13 News’ Ben Winslow, the LDS Church said it is “opposed to euthanasia,” and the Catholic Diocese said it doesn’t believe the state should condone “an act of suicide.”

Besides disagreeing with the word choice — something which is very important to advocates of physician aid in dying — Chavez-Houck said she considers this mindset to be one of her biggest hurdles to getting the bill passed.

“People feel very strongly about life and protecting life in this state,” Chavez-Houck said. “What I would posit to them is, ‘What is the quality of life? And when does that quality get to a circumstance or a point that it really isn’t fair to the patient?’ … The patient needs to be the determining factor on this. They are the ones that need to be guiding the direction that they want with their care, with end of life care in general.”

Chavez-Houck said she finds it interesting how people view the issue differently regarding how it might relate to a loved one versus how it might relate to themselves. She said that when it comes to loved ones, most people say they don’t want their family members to give up and that they want them to fight to the end. However, when those people are asked what they would want for themselves in the same circumstances, the answer is very different.

“They are of the opinion of, ‘Well, I want to be able to decide, and I don’t want to suffer horribly, and I don’t want to be a burden.’ They look at it differently when they are evaluating how they see the end of their life, but they’re conflicted when they think about people that they love.”

Even given this apparent contradiction, Chavez-Houck said, she can respect the thinking behind the religious sentiments, having been raised in the Roman Catholic Church.

“I can’t say, having been raised Roman Catholic, if I would ever undertake this if I were in this circumstance,” she said. “However, I also strongly believe that spiritual discernment is very personal and that I shouldn’t impose what my perspective would be on someone else.”

Chavez-Houck referred to the people who have used Oregon’s Death with Dignity Law and said that a large number of them considered themselves “spiritual” but that they didn’t necessarily associate with any organized religion.

“I need to respect their autonomy, and that’s what I’m asking others to consider,” she said. “I don’t think the government should impose a certain stricture on how an individual does their own spiritual discernment and how they perceive their journey if they are dying of a terminal illness.”

Currently Chavez-Houck’s bill to enact the End of Life Options Act is in the House Rules Committee.

Resources

• H.B. 264 “End of Life Options Act”
• H.B. 391 “Utah Death with Dignity Act”
• DeathWithDignity.org
• UtahPolicy.com “Poll: Majority of Utahns Support ‘Right-to-Die’ Legislation”

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