Minnesota could legalize physician-assisted suicide

[MUSIC PLAYING] CATHY WURZER: There's a news conference this afternoon at the State Capitol, where several Minnesotans with life-limiting illnesses, their supporters, and several DFL lawmakers will outline measures that would legalize medical aid in dying. Now, you may have heard it described as death with dignity or even physician-assisted suicide. The medical aid in dying bill called the Minnesota End-of-Life Option Act would allow terminally ill adults, 18 years of age or older with less than six months to live to get drugs from their doctor to help them end their life.

If it passes, Minnesota would join 10 other states plus Washington DC in medical aid in dying, where that is legal. DFL Representative, Mike Freiberg is the lead author of the House version of the bill. Krista Dorgan is with us. She's a marriage and family therapist who lives in Afton. She was diagnosed in 2019 with multiple myeloma, that's a rare incurable type of blood cancer. Representative and Krista Dorgan, welcome.

MIKE FREIBERG: Thank you, Cathy.

KRISTA DORGAN: Thank you. Thanks for being here.

CATHY WURZER: Representative Freiberg, I want to start with you. You've said this bill is modeled after the Oregon law. Can you briefly explain to folks what it would do?

MIKE FREIBERG: Sure. So this bill, to me, is about bodily autonomy and the freedom to make one's own personal medical decisions, yeah. So the Oregon law has been in place for over two decades. If a person meets the requirements of the bill-- and I'll say what those are in a second-- then they can be prescribed a medication by a doctor that they would-- that they have to self-administer to ultimately end their life.

So to qualify for it, however, they have to be 18 or older. They have to have a terminal condition-- a terminal disease or condition that has a six-month prognosis or less, they have to be capable of making their own medical decisions, be capable of giving informed consent, and be acting of their own free will. So if they have dementia or other cognitive disorders, they wouldn't qualify.

And they have to be able to ingest the medication, as I said. Delivery by injection or infusion is not permitted. So that's essentially what I did, you know what the bill would do. To clinicians, have to receive an independent request for medical aid in dying, they have to evaluate the patient, and they have to agree that the patient qualifies. If they have any concern, a mental health evaluation is requested.

CATHY WURZER: OK. Krista, you have an incurable cancer, as I mentioned, what does your future look like?

KRISTA DORGAN: Well, right now things are pretty good. I'm stable. I was on treatment for close to a year and a half, and then took a break. I was actually on two different treatments, and due to side effects, I took a break. And my cancer level in my body remained stable until about four months ago, and now it's increasing again, so I'm meeting at Mayo and looking at starting up treatment again.

At initial diagnosis, the Mayo oncologist said, some people live two years with this disease, and some people have lived 20. So there's really no way of knowing until you live it kind of which direction you're going to go. I've been very fortunate to have this break from treatment, but I'm going to start again soon, and hopefully, I will have years of being able to be around and have good quality of life. And that's what we're aiming for, but nobody knows for sure what's going to happen with multiple myeloma.

CATHY WURZER: I know you've experienced terminal illness from the point of view of being a caretaker. I know your dad died, and you were with him. How does that influence how you see this issue?

KRISTA DORGAN: Well, during the final days of my dad's life-- granted this was 30 years ago-- we had hospice care at home. But it is kind of burned into my memory, sort of, like, a nightmare experience because he was having a lot of pain. He had cancer that had spread to his brain and his other organs. So as his body was shutting down, they were trying to give him oral morphine, and he was very nauseous. And so it was-- he was vomiting it up, and I was the one sitting with him in that last day. And he was literally crying out in pain all day long. It was a really hard experience to go through.

And with that, that is kind of the image I have of my experience of seeing someone dying. Now, I know there's-- I work with an end-of-life doula, and I've gone through a lot of kind of therapy over the last few years, and know that in many cases it can be very peaceful and there's good pain management, but in the few cases that there is not, I am for having that option for people. And I think even for myself, one of the greatest fears is, is there something coming up physically that I'm not going to be able to handle? And it gets in the way of just relaxing and living with the life that we have.

And so to know that that was an option-- even if I'm not quite sure myself I would end up utilizing it because it's a very personal choice for everybody with spiritual and ethical and moral implications-- to know that it's there would allow me to relax and feel like I kind of have a safety net as I go on and live with the life that I have.

CATHY WURZER: Representative, you mentioned that for you this is an issue of bodily autonomy. But medical aid in dying isn't a completely autonomous act, it requires the help of another person who took an oath to do no harm, which means not hastening the death of his or her patient. And there are serious ethical concerns with this measure. How are they addressed in this bill?

MIKE FREIBERG: Yeah. Well, I mean, the experience-- as I said, this is modeled after the Oregon law which has been in place for over 20 years. And the experience there shows that it's not abused people to have to self-ingest the medication, and there are many doctors who support it. The chief author of the bill in the Senate, Senator Kelly Morrison is a doctor herself. The Minnesota Medical Association used to have a position opposed to it, now they have one of neutrality. Certainly, there are doctors who are opposed to this practice, and they will not be required to participate under the bill.

I mean, Krista-- I couldn't have put it better than Krista did. I mean, it's about people having this options. It's the End of Life Option Act. They're not required to use it, it may give some people peace of mind, other people may see peacefulness and dignity in not using this, and that is their choice. I think this is an area where the government shouldn't put artificial barriers in place.

CATHY WURZER: The terminally ill patients, of course, already have the right to die. They can refuse treatment. Patients can voluntarily stop eating and drinking. I mean, there are other ways to make an exit from this world beyond legislating this option. For people who are just still not quite understanding, why move to enshrine medical death under law?

MIKE FREIBERG: Well, I mean, not eating or drinking is a long and drawn out process, and there may be people in the condition exactly like what Krista was describing with her father who don't want to go through that difficult process. If they do, that's fine. That is their prerogative and the bill would not stand in their way from doing it at all. If they have moral objections, they don't have to participate. But this is an option for people who don't want to live that way at the end of their life and want the peace of mind that Krista described that this could provide.

CATHY WURZER: There, of course, is a slippery slope argument that some use, will this lead, do you think, to sanction euthanasia?

MIKE FREIBERG: No. I don't believe it will. This has been in place in Oregon for over 20 years. There's a very narrow-- I mean, the list of people who do take advantage of it have a very-- it's been a limited-- it's mostly ALS and certain types of cancer, I think, that the vast majority of people who use this option take advantage of. It hasn't been expanded in any way. I have had requests from people, for example, with Alzheimer's who want to be able to say in advance that they should be able to take advantage of this.

But I don't see a way to have the same protections in place. So the bill does not do that. I think there are people who think that those are under inclusive, but we want to be very precise in the language and follow the example that's been set in Oregon and the 10 other states you mentioned and just make sure that this is a very narrow category of people able to take this option. So the slippery slope argument has not come to pass in the states that have this option.

CATHY WURZER: Krista, as you know, there's a prevalence of depression in the chronically and terminally ill. Because you work in the field, should there be some kind of provision where an individual should get counseling from a mental health professional before taking this action?

KRISTA DORGAN: My opinion is, 100%, I think that should be a component of it. I know as the bill is written now, it is my understanding that if the medical professional thinks that there is a need for that, they will-- they have the obligation to refer to a licensed mental health professional. But I've had plenty of people in my own office who have been struggling with extreme suicidal thoughts. And if there was some sort of legal kind of socially acceptable, sanctioned way for them to leave the planet, I have people that I think would have probably taken that option. And I know for a fact some of those people are thriving today.

And when you mix depression with chronic pain, there is the phenomenon of things getting magnified. And the depression piece, I think it'd be important to sort out, what is the depression piece, what is the actual unbearable physical pain piece? And so that's-- in my opinion, I think that could be kind of a tricky thing to sort out. But I think having a team of people coming in and working with this person, and then doctors who know the history of the person, would be very important to have this bill go through.

CATHY WURZER: Representative, why not have a requirement in the bill that anyone receiving the medication has to talk with a mental health provider first?

MIKE FREIBERG: I just pulled up the bill language. There is a requirement that says the attending provider shall-- there's multiple things that the intending provider has to do, but one of them is specifically refer the individual to a licensed mental health provider if the attending provider observes signs that the individual may not be capable of making an informed decision. So it's already in there.

CATHY WURZER: And will doctors get mandatory training to prescribe the medications? They have training right now to prescribe opioids and other pain management drugs, would they get trained to prescribe life-ending medication?

MIKE FREIBERG: I assume it would-- I don't know if the bill requires it, but I assume it would fall under their general requirement to be familiar with how any medication is dispensed.

CATHY WURZER: And there have been versions of this bill in the past that have been introduced and they've not gone anywhere. Do you think it'll have success this session?

MIKE FREIBERG: I certainly hope so. I certainly hope so. I mean, it shouldn't be a partisan issue, as I said, it's about bodily autonomy. But I do think the fact that the Democrats-- unfortunately, it tends to be more supported among Democrats and supported less among Republicans, and I think just given the fact that the Democrats are in control of the House and Senate improves the chances. Certainly nothing is guaranteed in the legislative process, but we did-- I don't know that it's accurate to say it went nowhere. We did have a hearing on it a few years ago, and I'm certainly hopeful that we will have one again this year.

CATHY WURZER: All right. Representative, thank you very much. We've been talking to Representative Mike Freiberg. Krista Dorgan, really thank you, I'm so grateful for your time today, too, and best of luck to you.

KRISTA DORGAN: Thank you. Thank you for having me.

CATHY WURZER: Krista Dorgan's with-- she is from Afton, Minnesota. We've been talking about the medical aid in dying bills that are just introduced in the Minnesota legislature. Representative Freiberg and other advocates of these proposals are holding a news conference at 1 o'clock this afternoon. And for more news on what's happening at the legislature right now, of course, you can always tune in noon tomorrow. We're going to start Politics Friday again with host Mike Mulcahy.