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Why Mass. 'Death With Dignity' Ballot Initiative Isn't Back This Year

In this Oct. 26, 2015, file photo, right to die advocates rally outside the New Mexico Supreme Court in Santa Fe, N.M., after a lawyer asked justices to allow terminally ill patients to end their lives. (Russell Contreras/AP)
In this Oct. 26, 2015, file photo, right to die advocates rally outside the New Mexico Supreme Court in Santa Fe, N.M., after a lawyer asked justices to allow terminally ill patients to end their lives. (Russell Contreras/AP)
This article is more than 3 years old.

It was a squeaker, and a dramatic reversal. Poll after poll had found that a majority of Massachusetts voters would support the 2012 "Death with Dignity" ballot measure allowing terminally ill patients to get doctor-prescribed medications to end their own lives.

But in the final days, amid a well-funded opposition TV ad campaign, the picture changed. The measure went down to defeat, 51 percent against to 49 percent in favor. Opponents, including Catholic groups, outspent backers by about $5 million to $1 million.

The outcome deeply disappointed my octogenarian dad, a Massachusetts resident who believes strongly in his right to die as he wishes. Not to worry, I consoled him; it was so close, surely you'll have another chance to vote for it in the next election.

Wrong. It wasn't on the ballot in 2014. The deadline just passed for 2016 ballot measures in Massachusetts, and there is no similar measure on the roster. There can't be.

"By Massachusetts law, you need to wait five years to put the same issue on the ballot," says Marie Manis, Massachusetts campaign manager for Compassion & Choices, a group that backed the 2012 ballot measure spearheaded by Death With Dignity. "So that would come up in 2017, which is not an election year. So 2018 would be the first year it could go back onto the ballot."

A "death with dignity" bill, as proponents call it, has been gathering momentum in the state Legislature, she said. But it has repeatedly been defeated — seven times, at latest count.

The bill had 15 co-sponsors in the 2013-'14 session, Manis says; it was reintroduced in the 2015-'16 session, this time garnering 39 co-sponsors. But last month it failed to make it out of committee.

"We will reintroduce it — Rome wasn't built in a day. We move closer and closer each time," Manis says. To get a measure onto the 2018 ballot, the filing deadline is August of 2017, so "It will either move forward in the Legislature or we'll put it on the ballot."

Meanwhile, as of June, our giant neighbor to the north has begun allowing doctors to help terminally ill patients die nationwide — and even, in Ontario, providing the prescriptions for free.

That means Canada joins five American states — Oregon, Washington, Montana, Vermont and California — and several other countries — Switzerland, Belgium, the Netherlands — in legally allowing doctors to help terminally ill patients end their own lives.

A sweeping review just out in the journal JAMA rounds up the state of the issue thus far. (Its lead author, Dr. Ezekiel J. Emanuel, has written skeptically about assisted suicide.) It notes that it's mainly cancer patients who take advantage of the new laws. Among its findings:

• In the United States, less than 20% of physicians report having received requests for euthanasia or physician-assisted suicide, and 5% or less have complied.

• In Oregon and Washington state, less than 1% of licensed physicians write prescriptions for physician-assisted suicide per year.

• In the Netherlands and Belgium, about half or more of physicians reported ever having received a request; 60% of Dutch physicians have ever granted such requests.

• Between 0.3% to 4.6% of all deaths are reported as euthanasia or physician-assisted suicide in jurisdictions where they are legal. The frequency of these deaths increased after legalization.

• More than 70% of cases involved patients with cancer.

• Typical patients are older, white, and well-educated.

• Pain is mostly not reported as the primary motivation.

• In no jurisdiction was there evidence that vulnerable patients have been receiving euthanasia or physician-assisted suicide at rates higher than those in the general population.

Overall, it concludes: "Euthanasia and physician-assisted suicide are increasingly being legalized, remain relatively rare, and primarily involve patients with cancer. Existing data do not indicate widespread abuse of these practices."

What does all this mean for possible passage in Massachusetts? We'll see soon — but not this year.

Clarification: Updated to clarify that the group Death With Dignity led the 2012 campaign.

Carey Goldberg Twitter Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.

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