Advocates: End-of-life bill gives patients 'personal liberty and autonomy' in the face of terminal illness

an elder woman speaks at a podium
Nancy Unde, of Corcoran, Minn., who was diagnosed with an aggressive form of brain cancer in late 2022, speaks at a news conference about his bill to allow physician-assisted suicide in Minnesota, Thursday at the State Capitol in St. Paul.
Steve Karnowski | AP

Death with dignity — that’s what advocates of a controversial bill are hoping to codify into Minnesota law.

Ahead of the 2024 legislative session, the House Health Finance and Policy Committee voted 10-5 Thursday in favor of a bill that would allow mentally competent, terminally ill adults with a prognosis of six months or less to end their own lives with medication prescribed by a doctor.

It’s called the “End-of-Life Options Act.” Ten states and Washington, D.C., have similar policies in place called physician-assisted suicide. Lawmakers in Minnesota have been considering various versions since 2015. Its lead sponsor, Rep. Mike Freiberg, DFL-Golden Valley, said Thursday he’s confident the legislation will pass at least the House this session.

Testimony turned emotional as Minnesotans on both sides of the bill spoke Thursday. Dr. Joanne Roberts — a retired hospice director and palliative care doctor — was among those who testified. She’s now facing her own terminal illness, and told MPR News the intention is to preserve patient autonomy when interventions like hospice and palliative care aren’t enough.

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“It is the pain — physical, emotional, and spiritual. And when this bill came up in Washington in 2008, I believed that hospice could provide all of that,” Roberts said. “After the bill passed… I learned that actually there were a few people where hospice just came up a little bit short, people enrolled in hospice already just couldn’t get their suffering under control.”

Some end-of-life options already exist and are sometimes used in Minnesota like palliative sedation and voluntarily stopping eating and drinking, or VSED. However, patients who utilize those treatments are often already in hospitals, rather than at home.

“They’re surrounded by a lot of professionals, but not a lot of family. This issue to me is one of more personal liberty and autonomy,” Roberts said. “And it’s unfortunate that the government has to pass laws, but the government has a right to preserve life… But these are folks who… are trying to maintain their own agency and control in the face of their death.”

a man speaks at a podium
Rep. Mike Freiberg, DFL-Golden Valley, speaks at a news conference about his bill to allow physician-assisted suicide in Minnesota, Thursday at the State Capitol in St. Paul.
Steve Karnowski | AP

Nancy Unde of Corcoran was diagnosed with an aggressive form of brain cancer in late 2022. She told reporters that she wants the right to choose a peaceful, painless death on her own terms.

“This bill has been in front of the Minnesota legislature for 10 years already. It’s time to act,” Unde said. “As I imagine the end of my life, I would like to be able to say my goodbyes and go peacefully. I’m thankful that we have hospice as an option. I will use it for the maximum comfort I can. But if it’s not enough, in the end, I want the option to die gently in my sleep."

Angela Sovak told the story of her grandmother entering hospice care and telling her she was more afraid of the process of dying rather than death itself.

"We had the gift of being with her when her heart stopped beating, but a better gift would have been months of connection and shared laughter instead of relentless anxiety. And that could have been possible if she knew she could have a peaceful death,” Sovak said.

Opponents worry that medical aid in dying could endanger vulnerable populations and exacerbate healthcare and financial inequities.

“I believed in the slippery slope argument myself, and that’s why I opposed the bill in Washington. It did pass, and then I saw it play out. And even now, nearly 15 years later, fewer than one-half of 1 percent of people who die in Washington state die with this option,” Dr. Roberts said. “There are many many guardrails to prevent coercion by families or physicians. And the proportion of deaths just has not gone up.”

The proposed legislation in Minnesota requires two providers to confirm a patient is facing a terminal illness with six months or less to live; the patient must be mentally competent; and the patient must be able to administer the lethal medication themselves. Under the bill, doctors can opt out of prescribing the medication, but must refer their patient to another provider. The bill does not require patients to be Minnesota residents.

Freiberg is hopeful the bill will garner some GOP support. The Associated Press reported no Republican lawmakers were present at the start of Thursday’s hearing, but arrived later on to suggest amendments to soften the legislation.

a woman speaks at a podium
Nancy Utoft, president of the Minnesota Alliance for Ethical Healthcare, speaks at a news conference against a bill to allow physician-assisted suicide in Minnesota at the State Capitol on Thursday, in St. Paul.
Steve Karnowski | AP

“Intentionally ending a human life is wrong. It doesn’t matter what name we call it,” testified Chris Massoglia of Blaine, representing Americans United for Life. “Suicide is not health care. And it’s completely unnecessary due to the advances in palliative and end-of-life care.”

Roberts says she believes the Minnesota Medical Association has done a great job of taking a neutral position on physician-assisted suicide and supports the portion of the bill that allows physicians to opt out of prescribing lethal medication.

“Myself, I opted out. And the reason I did is as a palliative care doctor, I’m often giving drugs that actually cause death. But I’ve always been able to square it with I’m, I’m causing death, but I'm relieving suffering by causing death,” she said. “I think it's a personal decision for physicians as much as it is for patients and families.”

Roberts says her own terminal illness will be relatively painless and doesn’t plan to take an end-of-life option, but maintains it should be available to the dying who want it.

“I walked this journey with my family and we're ready,” she said. “I guess what I've learned as a patient myself is this issue of liberty. I just believe that should I be suffering unduly, I should at least have this option.”

This story includes reporting from MPR News senior politics reporter Clay Masters and The Associated Press.