People with terminal illnesses advocate for physician-assisted death: ‘It’s my way of having control’
On a brisk day at a restaurant outside Chicago, Deb Robertson sat with her teenage grandson to talk about her death. She’ll probably miss his high school graduation.
Death doesn’t frighten her much. The 65-year-old didn’t cry when she learned two months ago that the cancerous tumors in her liver were spreading, portending a tormented death.
But later, she received a call. A bill moving through the Illinois legislature to allow certain terminally ill patients to end their lives with a doctor’s help had made progress. Then she cried.
“Medical aid in dying is not me choosing to die,” she says she told her 17-year-old grandson. “I am going to die. But it is my way of having a little bit more control over what it looks like in the end.”
That same conversation is happening across the country as Americans who are nearing life’s end negotiate the terms with themselves, their families and, now, state lawmakers.
Deb Robertson kisses her wife, Kate Koubek, as they prepare for a meal with family and friends at their home in Lombard, Illinois, on 23 March 2024. Photograph: Charles Rex Arbogast/AP
At least 12 states currently have bills that would legalize physician-assisted death. Eight states and Washington DC, already allow it, but only for their own residents. Vermont and Oregon permit any qualifying American to travel to their state for the practice. Patients must be at least 18 years old, within six months of death and be assessed to ensure they are capable of making an informed decision.
Two states have gone in the opposite direction. Kansas has a bill to further criminalize those who help someone with their physician-assisted death. West Virginia is asking voters to enshrine its current ban into the state constitution.
That patchwork of laws has left Americans in most states without recourse. Some patients choose to apply for residency in a state where it’s legal. Others take arduous trips in the late stage of disease to die in unfamiliar places and beds, far from family, friends and pets.
Opponents have moral objections with the very concept of someone ending their life. Even with safeguards in place, they argue, the decision could be made for the wrong reasons, including depression or pressure from family burdened by their caretaking.
“It’s normalizing suicide, and it’s incentivizing individuals to end their lives,” said Danielle Pimentel of Americans United for Life. Pimentel raised concerns that pain isn’t the top reason people choose an early departure, adding that policy should focus on bettering end-of-life care.
Two national organizations lobbying for the bills argue it’s about autonomy and compassion, and some power over one’s preordained exit.
Deb Robertson reacts to a card made for her by a student of her daughter, Shannon Rodriguez, in Lombard, Illinois, on 23 March 2024. Photograph: Charles Rex Arbogast/AP
“It comes down to the right of an individual to control their own end-of-life decisions free from government intervention or religious interference,” said Goeff Sugerman, national campaign strategist for Death With Dignity.
Even though it’s illegal in most states, a 2018 Gallup poll showed more than two-thirds of Americans support the practice.
Only a small fraction of Americans across the country, about 8,700, have used physician-assisted death since Oregon became the first state to legalize it in 1997, according to the advocacy group Compassion & Choices.
Typically, two doctors must confirm that a patient has six months to live. The patient must verbally request it twice with a waiting period that varies by state, and submit a written request with witnesses.
At three meetings, a physician assesses the patient to ensure they are able to make an informed decision. The patient can be referred to a psychologist for an assessment if there are concerns. Patients must take the medication themselves. They lose consciousness quickly.