End of Life Medical Decisions: Assisted or Legal Suicide for the Terminally Ill

“Assisted suicide.” While the phrase itself may evoke strong emotions on each side of the issue, it is important that everyone affected (whether because you or a loved one face a terminal illness, or as a physician or estate planner you are advising patients or clients as to end of life decisions) be aware of the developments in this area. As the population ages and medical technology continues to advance, the conscious decision of those with terminal conditions and severe pain and/or the loss of quality of life, to choose whether to end their lives, will sadly occur more frequently.

Colorado passed Proposition 106, the End of “Life Options Act,” on November 8, 2016. This brought the number of states permitting this to a total of six. These states all permit what many refer to as “legal suicide.” Five states now have statutes that permit this: California, Colorado, Oregon, Vermont, and Washington. Montana has a court decision that is viewed as permitting similar actions.

What is legal suicide? This is when, after complying with strict procedures, the dying and suffering patient may obtain prescription medication to end his or her life. These states only permit this for terminally ill individuals who have less than a six-month life expectancy.

Common requirements of these laws may include:

·         You must make the request personally as the patient of your physician for self-administered aid-in-dying medication.

·         You must be a resident of the state permitting this. This requirement is an important part of planning that those living in other states should address, and preferably as early as possible after obtaining a diagnosis of the terminal condition (see below)

·         You must be an adult, which is generally age 18 or older.

·         You must be able to communicate an informed decision to health care providers (so that an agent under your health care proxy may not be permitted to do this for you)

·         You must have been diagnosed to have a terminal illness with a prognosis of six months or less to live.

·         Your dire health status must be confirmed by two physicians, including your primary physician and a second, consulting physician

·         You must be confirmed as being mentally capable to make this decision by two physicians. They must specifically conclude that you understand the consequences of his or her decision.

·         To confirm that your decision is deliberate, you must make two oral requests, at least fifteen days apart, and one written request, that are specific as to what you are requesting,  to your primary physician. The written request must also be witnessed by at least two other persons who meet certain requirements.

If you have been diagnosed with a terminal illness, face severe pain, and a loss of quality of life, and wish to avail yourself of the assisted suicide laws in one of these states it may be prudent to move to a state permitting assisted suicide o take advantage of this option. That move should be made while there is capacity to effectuate establishing residency in the chosen state.