On March 25, 2019, New Jersey lawmakers approved legislation allowing physician-assisted suicide. Assemblyman John Burzichelli (a Democrat representing New Jersey’s 3rd Legislative District and the Deputy Speaker of the Assembly) has been one of the bill’s key sponsors, along with Senator Nicholas Scutari, and has supported this important issue for more than six years. In a recent conversation with MDAdvisor staff, Assemblyman Burzichelli shared his perspective and his thoughtful point of view on the Medical Aid in Dying for the Terminally Ill Act.
On March 25, 2019, the state Assembly voted 41-33 with four abstentions to pass the Medical Aid in Dying for the Terminally Ill Act.1 On the same day, the state Senate approved the bill 21-16. This legislation grants “the right of a qualified terminally ill patient, protected by appropriate safeguards, to obtain medication that the patient may choose to self-administer in order to bring about the patient’s humane and dignified death.”1 Governor Murphy is expected to sign this measure into law soon, and the law is anticipated to take effect on August 1, 2019.
As the prime sponsor of this legislation and someone who has worked on this issue for more than six years, I am proud to say that the legislative process has been thoughtful, respectful and sound, and has produced a well-researched bill. The legislators listened to all perspectives and asked careful questions before coming to a conclusion on where the law should come down on this issue. I feel that this legislation is just and represents what the majority of New Jersey residents want. I am proud of the process and the ultimate decision.
New Jersey is poised to become the eighth state permitting physician-assisted suicide, behind Oregon, California, Colorado, Hawaii, Vermont, Washington and Montana (where the “right-to-die” was established under a court ruling that provides physicians a legal defense or immunity from prosecution). Additionally, the practice is also legal in Washington, D.C. The legislation, which is based on Oregon’s Death with Dignity Act enacted in 1997, would give an adult New Jersey resident who has the capacity to make healthcare decisions and who has been determined by that individual’s attending and consulting physicians to be terminally ill to obtain medication that may be selfadministered to terminate his or her own life. Under the bill, terminally ill is defined as “a patient who is in the terminal stage of an irreversibly fatal illness, disease or condition with a prognosis, based upon reasonable medical certainty, of a life expectancy of six months or less.”1 (Disabilities are not considered terminal illnesses according to the legislation.)
This legislation places a high value on personal autonomy and relies on personal responsibility. It is packed with redundant safeguards to prevent abuse. For example, terminally ill patients must have a six-month prognosis, confirmed by two doctors, and go through a multi-step process to request the prescription. When a patient initially makes a request for medication, the attending physician is required to provide the patient with information and recommend a consultation regarding alternative treatments, palliative care, comfort care, hospice care and pain control options. Patients would need to be able to take the drugs themselves, and prescribers can decline to participate in the program. Anyone seeking to coerce a patient would face criminal prosecution with severe penalties. It is important to note that in the other states that have existing physicianassisted suicide laws, there has been no evidence of abuse.
This legislation also protects participating physicians by providing immunity from civil and criminal liability and professional disciplinary action when they act in compliance with the bill. This includes being present when a qualified terminally ill patient takes the medication prescribed to the patient under the bill’s provisions. This immunity also applies to any refusal to participate in a request for medication made under the bill. Any action undertaken in accordance with the bill will not be deemed to constitute patient abuse or neglect, suicide, assisted suicide, mercy killing, euthanasia or homicide under any state law, and the bill expressly exempts actions taken pursuant to the bill from the provisions of N.J.S.2C:11-6, which makes it a crime to purposely aid a person in committing suicide.
The New Jersey law (commonly called Aid in Dying) provides patients nearing the end of life with peace of mind by providing ultimate control over their final days. There is absolutely no intention to force anyone’s hand or pressure anyone to do something that he or she does not want to do. This is a very individual decision. Those who make the request are free to change their minds at any time, and those who obtain the medication don’t have to use it. Those who feel morally compelled to fight to the very end are able to make that choice as well.
I am confident that New Jersey’s Aid in Dying legislation can benefit our citizens by providing more choices and more control for those with terminal illness, and I consider it a positive step for the citizens of New Jersey.
Janet S. Puro, MPH, MBA, is Vice President of Business Development and Corporate Communications at MDAdvantage Insurance Company.