Illinois Legislature Approves Medical Aid in Dying Bill for Review

The Illinois legislature has passed a significant bill that would allow terminally ill adults to access life-ending medication prescribed by a physician. The bill, known as Senate Bill 1950, received approval during the fall session, marking a pivotal moment in the state’s approach to end-of-life care. Supporters argue that the legislation offers compassion and autonomy to those in their final stages of life, while critics raise concerns about potential risks to vulnerable populations.

The Senate voted 30-27 to pass the bill in the early hours of October 31, 2023, following a 63-42 vote in the House earlier in May. The legislation now awaits the signature of Governor J.B. Pritzker, who has indicated he is reviewing its provisions. If signed, the law would take effect nine months later.

Advocates of the bill include Suzy Flack, who has campaigned for this legislation in memory of her son, Andrew Flack, who passed away from cancer at the age of 34 in 2022. Andrew utilized California’s medical aid in dying options, which were not available in Illinois at that time. Flack emphasized the importance of having control over one’s death, stating, “I am just comforted every day by the way his death was so peaceful. He had some control over things.”

Details of the Legislation

Senate Bill 1950 stipulates specific eligibility requirements for patients seeking end-of-life medication. Applicants must be Illinois residents aged 18 or older with a terminal illness that two physicians determine will result in death within six months. A diagnosis of major depressive disorder alone does not qualify for this option.

Patients must submit both oral and written requests for assistance in dying. A physician must assess the patient’s mental capacity and explore any potential coercion before prescribing the medication. Importantly, patients must be capable of self-administering the medication, and they retain the right to withdraw their request at any time.

The bill also specifies that death certificates for individuals who utilize this option will list the underlying terminal illness as the cause of death rather than suicide. Senator Linda Holmes, the bill’s sponsor, highlighted the safeguards included in the legislation, noting that there are “over 20 guardrails in place” to prevent coercion and abuse. She referenced Oregon’s long-standing experience with similar legislation, stating, “In the years that this has been in effect in Oregon, starting in 1997, there have been no substantiated cases of coercion or abuse.”

Concerns from Opponents

Despite the support, critics of the bill express concerns about its potential implications. Senator Jil Tracy raised alarms regarding the six-month prognosis required for eligibility, arguing that advancements in medicine could allow patients to outlive their diagnoses. Holmes countered this point, asserting that medical professionals often overestimate patients’ prognoses and that a minority of patients ultimately choose to take the medication prescribed.

Tracy also voiced concerns about the safety of powerful drugs intended for self-administration, suggesting they could be misused by young people. “There’s no control over who might access it besides the patient,” she stated, citing concerns over mental health among youth.

Supporter Brian McCurdy, who began advocating for this legislation after the loss of his life partner, argued that the risks associated with this bill do not exceed those already present in current medical practices. He noted that medications prescribed to hospice patients are often not closely monitored in home settings.

Another point of contention is the potential for coercion among elderly and disabled populations. Critics argue that heirs should not be allowed to serve as witnesses when patients request end-of-life medication.

The American Medical Association has historically opposed physician-assisted dying, labeling it “fundamentally incompatible with the physician’s role as healer” and expressing concerns about broader societal implications.

Senator Chris Balkema referred to the bill as a “slippery slope,” cautioning that states with similar laws have expanded their provisions over time, potentially leading to unintended consequences. He stressed the importance of not introducing a “culture of death” in Illinois.

Supporters of the bill counter that it is not about promoting death but rather providing agency to those facing inevitable mortality. Flack expressed her disapproval of the term “assisted suicide,” stating, “People with terminal illness want to live.”

Senator Laura Fine emphasized the personal nature of this issue, affirming that the legislation is about choice and compassion. “This is not suicide, it is compassion,” she stated, highlighting the importance of having options at the end of life.

As the bill awaits the governor’s review, Pritzker has acknowledged the gravity of the situation faced by those with terminal illnesses. “I know how terrible it is that someone who’s in the last six months of their life could be experiencing terrible pain and anguish,” he remarked during a recent news conference in Glen Ellyn. He noted the need for thoughtful consideration of how to alleviate such suffering.

Should Governor Pritzker sign Senate Bill 1950 into law, Illinois would become the first Midwestern state to offer medical aid in dying, joining ten other states and the District of Columbia that have enacted similar legislation. The outcome of this legislation could set a precedent for discussions on end-of-life care in the region and beyond.