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Opinion: Death is non-partisan, pass the End of Life Options Act

Rep. Bob Lynn (Rockingham-District 17) chairs the House Judiciary Committee and previously served as Chief Justice of the New Hampshire Supreme Court. Rep. Marjorie Smith (Strafford – District 10) is the prime sponsor of the N.H. End of Life Options Act and serves on the House Judiciary Committee, which she formerly served as chairman.

‘My beloved husband, Bob James, died in 2022 of tongue cancer,” the Rev. Mary James of Durham told the House Judiciary Committee in February. “Bob simultaneously bled to death – not gently – and drowned in his own blood. As a minister, I do not believe that either his disease or the manner of his death were ‘God’s will’ for him. Let’s change that, so that a dying, suffering person may say instead to their doctor: ‘I’d like to pursue medical aid in dying. I’ve fought hard. I am ready to go in peace.’”

Rev. James’ heartbreaking testimony mirrored dozens of testimonies we listened to during a hearing last month in support of our bipartisan medical-aid-in-dying bill, the N.H. End of Life Options Act (HB 1283). The legislation would allow mentally capable, terminally ill adults to have the liberty to request a doctor’s prescription for medication they could take to peacefully end unbearable suffering, in their sleep, at home, surrounded by loved ones.

These kinds of raw testimonies spurred the House Judiciary Committee last week to recommend in a bipartisan 13-7 vote that the full House pass this urgently needed legislation.

It is unusual for the two of us, from opposing political parties, as well as our Republican and Democratic committee colleagues who joined us, to agree on public policy. But death is the ultimate non-partisan issue. It doesn’t care what your political views are. Sooner or later, we all die. If you have helplessly watched a loved one die in agony, you are very likely to want the option of medical aid in dying to avoid it.

Seven out of 10 Granite Staters (71%) support medical aid-in-dying legislation, and majorities across the regional, religious, and political spectrums, including 63% of Governor Sununu’s supporters, according to an October 2023 survey by the nonpartisan UNH Survey Center. Only one out of six residents (17%) oppose the bill.

Better end-of-life experiences start with better access for all New Hampshire people to quality, affordable healthcare, including hospice and palliative care, both of which are underutilized in our state. But we learned in testimony that there are cases, such as Rev. James’ husband, when the best pain management strategies don’t work, when patients’ experience of suffering cannot be alleviated. Hospice and palliative care nurses and physicians testified that for these patients, the option of medical aid in dying offers hope, comfort, and peace of mind. Just knowing they have the option can make an enormous difference for patients. We heard this over and over from loved ones of patients and from mental health and medical professionals.

The NH End of Life Options Act is conservative, modeled after time-tested laws since 1997 in numerous other states proven to prevent coercion. It offers terminally ill patients the freedom to make informed decisions based on their own values about how they want to experience the last days of their lives. This bill is entirely consistent with existing New Hampshire law, which says that our state “recognizes that individual persons have the right, founded in the autonomy and sanctity of a person, to control decisions relating to the rendering of their own medical care.” (RSA 137-J:1)

The Act is compassionate and it protects the vulnerable. The option of medical aid in dying offers solace to suffering patients and their loved ones and helps foster honest conversations about end-of-life care. To qualify for medical aid in dying, a patient must confer with two healthcare providers with expertise in end-of-life care. Both these providers must advise the patient about all other treatment and care alternatives, including hospice and palliative care. They both must assess that the patient is able to fully understand and make decisions about their death and that they are not being unduly influenced by others. The providers must also affirm that the patient has a terminal condition, is expected to live no more than six months and that they can take the aid-in-dying medications themselves.

We also know there is no substantiated correlation between medical aid in dying and suicide. Suicide is a public health and medical concern that requires collective efforts to address. The conflation, intentional or accidental, of medical aid in dying with suicide traumatizes the loved ones of people with an unresolved mental health crisis who actually died by suicide, and offends terminally ill individuals, who desperately want to live but are destined to die no matter what, and just want to die peacefully.

We respect that some of our colleagues will never want the option of medical aid in dying. We ask only that they respect the vast majority of our constituents who want this option, by passing this legislation for terminally ill Granite Staters who may not be with us next year. Otherwise, they may die with needless suffering like Bob James did.