State lawmakers send firm message that Indiana remains ‘opposed’ to assisted suicide

(Indiana Capital Chronicle) — As more than a dozen states contemplate “death with dignity” laws, Indiana lawmakers are making clear they’re staunchly opposed to any policy allowing physician-assisted suicide. 

A Senate resolution penned by Sen. Tyler Johnson, R-Leo, emphasizes that the legalization of assisted suicide “sends a message that suicide is a socially acceptable response to aging, terminal illnesses, disabilities, and depression” and subsequently imposes a “duty to die.”

Further, it states assisted suicide “is a direct threat to human dignity, patient rights, and the disabled when the medical goal must be to eliminate suffering rather than the person who suffers.”

Alternatively, the resolution preferences ongoing advancements in palliative care that can relieve pain and allow a person “to die naturally, comfortably, and in a dignified manner without a change in the law.”

The Senate health committee approved the resolution in a 9-2 vote, along party lines, on Wednesday.

“You cannot compassionately kill a patient, and you cannot care for the patient that you are comfortable killing,” said Johnson, who works as an emergency physician. “Physician-assisted suicide is contrary to everything I have as a physician and my duty to my patients, as a healer, and it clearly undermines the physician-patient relationship.”

Strong opposition against assisted suicide

The arguments in the resolution are similar to those held by other critics of physician-assisted death, including some religious groups, disability rights advocates, and the American Medical Association. They maintain the practice is at odds with physicians’ responsibility to care for patients and can open the door to more suicide.

Last year, the AMA’s legislative body voted against changing its stance on physician-assisted death, which its code of ethics describes as “fundamentally incompatible with the physician’s role as healer.”

Advocates, on the other hand, say giving terminal patients more control of end-of-life decisions brings more dignity to death.

Assisted suicide is already banned in Indiana. Current statute states that a person who “participates” or “provides the physical means” for another person to attempt or commit suicide commits assisting suicide, a Level 5 felony. Those who have knowledge of an assisted suicide can also face the felony charge.

Exempt from the law are medical professionals who provide care “to relieve a person’s pain or discomfort, even if the medication or procedure may hasten or increase the risk of death, unless such medications or procedures are intended to cause death.” Health care providers are additionally permitted to withhold or stop life-prolonging treatments.

Johnson clarified that end-of-life and palliative care are not the focus of his resolution, however.

“People call it medical assistance in dying, or paid physician assistance in dying, or physician-assisted suicide, or euthanasia. Really, at its core, we’re discussing the act of a physician taking steps to end a patient’s life,” Johnson said, noting that he regularly works in his hospital’s palliative care settings.

“Frankly, medicine is really hard. It’s not an easy thing. It gets tougher as we get more advanced. We don’t always get it right,” he continued. “But I can’t fathom what it feels like to stop trying. We strive every day to take great care of people — even in the toughest of situations, even when it’s hard, even when it’s hard for the patient to keep going.”

Legal in other states

On the opposite side of the issue, House Bill 1011, introduced earlier in the legislative session by Rep. Matt Pierce, D-Bloomington, sought to allow terminally ill patients to voluntarily end their lives. The bill was never heard in committee however.

Pierce has filed similar proposals in years past without success. 

Still, support for such legislation is growing.

Assisted suicide has so far been legalized in 10 states — Maine, Vermont, Oregon, New Mexico, Hawaii, Colorado, California, Montana, Washington and New Jersey, as well as the District of Columbia — either through legislation or court decisions, according to Death with Dignity, an organization promoting end-of-life options.

Pierce’s proposal mirrored Oregon’s Death With Dignity Act, which took effect in 1998 and has since been used as a model in several other states.

The Oregon law allows physicians to assist with death if and only if the person is over the age 18, terminally ill with a life expectancy of six months or less, capable of making their own medical choices, and is choosing assisted suicide voluntarily.

Under Pierce’s bill, a patient’s doctor would supervise the process and be required to refer the patient to another physician for a second opinion. Both must agree that the patient is terminally ill.

The patient would eventually be prescribed medication, which they must self-administer, that renders them unconscious before death ensues.

According to a 2020 study from the Journal of American Geriatrics Society, 5,329 patients died by “medical aid in dying” (MAID) and 8,451 received a prescription between 1998 and 2020 in states that had such laws and publicly available records. Roughly 74% of those deaths had a diagnosis of cancer, per the study.

Sen. Shelli Yoder, D-Bloomington, who voted against the resolution, pointed to national polling that shows broad support for assisted suicide legalization. 

She called the resolution “problematic at best,” and said the General Assembly should have instead held public hearings on a bill like Pierce’s “so we could at least have a discussion, a grown-up conversation, to bring in experts, to listen to Hoosiers — all while honoring the sacredness of life.” 

“Suicide is preventable, as long as the person has access to the appropriate suicide prevention resources. But equating (physician-assisted suicide) with suicide is irresponsible. It does a disservice to people and families who need medical aid in dying, and people who are in families who are impacted by suicide,” Yoder said. “We provide, in this state, access to helping families and those giving birth. We have induced labor. We have C-sections — and we do that sometimes just out of convenience. But why are we so resistant to being able to have this conversation around the process of dying, when someone has less than six months to live, and wants to have this conversation?”