By GARRY RAYNO, InDepthNH.org

CONCORD — The terminally ill deserve the right to determine when and how they die, supporters of House Bill 1283 told the House Judiciary Committee Wednesday.

Supporters and opponents packed a double hearing room to make their wishes known as more than 90 people signed up to speak, including physicians, clergy, social workers, professional advocates for and against, citizens and Vermont physicians and officials where a similar law has been in place for 10 years.

“The time is now for New Hampshire to join its sister states in providing this option to its citizens,” said the bill’s prime sponsor Rep. Marjorie Smith, D-Durham. “This is a very narrow and conservative bill, designed that way to give New Hampshire a chance to put its toe in the water.”

Under the bill, a terminally ill person would be able to obtain a doctor’s prescription for a lethal dose the individual would be able to administer to himself or herself.

The person would have to be mentally competent, be terminally ill with no more than six months to live and voluntarily make the request to a physician to obtain the medication.

Two doctors would need to approve the request and the patient would need two witnesses to attest to his or her wishes.

Currently 10 states have medical aid in dying laws, including Maine and Vermont.

Oregon, the first state with a medical assist law, passed it 25 years ago.

Several physicians told the committee, many people who are approved for medical aid in dying never use the medication, but are comforted to know it is there if their pain and suffering become unbearable.

A Vermont official said in the first 10 years under their law, 203 people did end their lives, although far more had been approved, said Betsy Walkerman, president of Patient Choices Vermont.

She said her state has not had a single report of abuse or suspected abuse, and noted many New Hampshire residents visit the state’s website and call the helpline.

Opponents argued the bill may be narrow now, but it would be a slippery slope and eventually would reach wider and wider to the point where disabled and elderly people may be encouraged to participate in the program, and insurance companies encourage its use to save money, all eventually leading to euthanasia.

Dr. Johathan Eddinger, chair of the state Board of Medicine and a physician at Catholic Medical Center, said no one wants patients to have pain and suffering. He said the medical community did not do a good job with opioids and now there is a stigma attached to their use when they could be helpful in making patients more comfortable.

“I would rather see the focus be more funding of palliative care,” Eddinger said, “rather than a pill to off somebody.”

To give a pill to a patient to kill somebody is “changing our culture, starting to move the needle to change society, an acceptable move toward more suicide,” he said.
He said he battles with insurance companies every day over what is the most effective therapy for a patient. “It all comes down to cost, I don’t want that to be an option,” Eddinger said. 

Dr. Brian Lombardo of Lebanon said he became involved in end-of-life care after treating a Vermont patient with advanced cancer while sitting in his living room and seeing he had a number of guns.

Lombardo said he had three elderly male patients who committed suicide and asked the man if he had ever thought of it and his patient replied of course.

Lombardo said he then thought of the Vermont law and told the man there may be an alternative and he responded “tell me all about it.”

Since that time he has been involved with nine patients who want to control their death and not have their disease determining when they would die, he said.

“In my 30 years of medical practice, I have never seen (a group) so appreciative of the care they receive, that the family also receives,” Lombardo said. “Instead of the inevitable progression to a death without dignity, they have found this to be an incredible solace to their soul.”

A number of religious organizations turned out to oppose the bill, including the Roman Catholic Diocese of Manchester, whose director of public policy Bob Dunn said assisted suicide has been presented as an issue of individual autonomy, but you have to look at the constitutional principle of common good despite the good intentions.

“The remarkable diversity of the coalition that has come together to oppose this bill,” Dunn said, “speaks to the breadth of dangers this assisted suicide law proposes.”

He urged the committee to take the advice of the Red Cross to people leaving burning buildings. “Never open a door that is warm to the touch,” Dunn said.

A coalition including the NH Hospital Association, Disability Rights Center NH and the Roman Catholic Diocese of Manchester have joined to oppose the bill.

But Melissa Stacey, Regional Advocacy Manager Northeast for Compassion and Choices, said if New Hampshire passes the law terminally ill patients will be able to obtain medication to die peacefully in their sleep if the pain becomes unbearable.

She said the medically assisted option is entirely voluntary for providers if they have moral or religious objections.

Stacey said 37 percent of the people who obtain the medication never take it.

“Decisions about death belong to the dying,” Stacey said. “They can focus on the present and the time they have left.”

Armand Soucy, chaplain to a number of veterans organizations, said all the organizations oppose the bill, noting suicide is an issue for veterans like his nephew who spent three years in Iraq.

“Assisted suicide is murder,” he said. “Suicide is simple. It is a choice to do it yourself, the state does not have to assist.”

The state should not be authorizing someone to help a person commit suicide, he said. “That is very questionable.”

Under the bill, a person who interferes to try to stop someone who wants to use assisted suicide to end their suffering would be guilty of a felony.

Health care providers who participate in the medically assisted process are given indemnity under the bill, and two state representatives who are pharmacists asked that pharmacists also be given indemnity as they would have to dispense the drugs.

The bill also has penalties for those who would try to coerce someone who may not want to use medical assistance in dying.

Smith said soon after she and her husband moved to New Hampshire many years ago, their 23-year-old niece suffered a debilitating stroke, but taught them all about the rights of the disabled in the two years left in her life.

Smith said 25 years ago when she came to a hearing on a bill much like the one she introduced this session, she was shocked to hear physicians talk about feeling powerless to help their patients who were suffering and in extreme pain, but were afraid to prescribe the drugs their patients needed.

She noted the other attempts over the years to pass an end-of-life bill, and the opposition, particularly from the religious community.

“We do have separation of church and state to protect the rights of individuals to make religious-based choices for themselves,” Smith said, “but not to use the power of government to impose those choices on others.”

The committee will work on the bill before it makes a recommendation to the full House.

Garry Rayno may be reached at garry.rayno@yahoo.com. Garry has been a reporter in New Hampshire for 40 years.