Deep Dive: Public Testimony About Dying With Dignity Legislation

The End-of-Life Options Act (SF 1813/HF 1930), which would make it legal for terminally ill, mentally capable adults to be prescribed and take a medication to end their life, is poised for another attempt to pass in Minnesota this year, led in part by Sen. Kelly Morrison (D-Deephaven). Ten states, and Washington D.C., have passed similar bills. A five-hour pre-legislative session committee meeting was held January 25, with 75 people giving testimony for or against the measure.

The bill is authored by Reps. Mike Freiberg (D–Golden Valley) and Heather Edelson (D–Edina).

If the bill passes, a terminally ill person would have to get clearance from two health care providers who verify that they have a prognosis of six months or less to live. They would need to be found to be mentally capable of deciding if they want to take the medication. If either provider has doubts about a patient’s ability to decide, there could be a separate mental health assessment. If a patient meets all the criteria, a physician could provide them the medication and the patient can choose whether or not, and when, to take it.

Rep. Freiberg opened the session by saying, “The main criteria for medical aid in dying have remained unchanged since I first introduced the bill in 2015,” which includes being eligible for hospice, being able to self-administer medication (injections and infusions are prohibited), and it is patient requested. An updated bill includes amendments emphasizing that “people do not qualify if they are subject to guardianship or conservatorship. Healthcare providers have no duty to participate. Criminal penalties are established for coercion.”

Nancy Uden testifies in a Minnesota legislative committee meeting about the End-of-Life Act

The first person who testified was Nancy Uden, of Corcoran, who is diagnosed with an aggressive form of malignant brain cancer. She had been in a car accident in 2022 caused by a first-ever seizure and woke up in North Memorial Hospital, where it was discovered that she had a brain mass. “It has a very grim prognosis with a median survival of 15 months,” she said. “My family and I have endured brain surgery, radiation, chemotherapy, and I currently use the Optum device, 99 percent of the time, to target cancer cells. But this is all treatment, it is not a cure.”

She says that after she runs out of treatment options, “then I deserve more death options. I’m not afraid of death, but I am afraid of how I will die. I walked my brother and my mother to the end of their lives over the past few years. They both died beautiful, painless deaths and that’s what I want. I had no choice over the cause of my death and currently I have no choice over the slow and painful death most glioblastoma patients endure. Our organs will slowly shut down and experience seizures, painful headaches, delirium, blindness, and paralysis.”

Uden added, “I don’t have time for long debates. This bill has been in front of the Minnesota Legislature for ten years already. It’s time to act. … As a terminally ill patient, I beg you to do something now to provide compassionate choices to those who qualify — the ability to end their life peacefully and painlessly surrounded by their loved ones. The safeguards of this bill are significant. There have been zero reports of abuse in the ten states and Washington, D.C. where this law has passed. The Minnesota Legislature has made bodily autonomy a priority. Well this is the final act of autonomy that any of us will have.” 

Dr. Cory Carroll testified as a Colorado doctor who works with Compassionate Choices, an organization aimed at mentoring and supporting doctors across the country wanting to incorporate “medical aid in dying” into their clinical practices. He said the three most common prognoses of people choosing medical aid in dying are: cancer, neurological disease, and coronary disease. “These patients do not want to die, but they are dying. They are seeking relief from suffering.” 

He added that one third of individuals who qualify for the medicine choose not to take it, which “demonstrates clearly that patients are in control and make the decisions for themselves. What we do know is having the medication, even having the potential option for medical aid in dying, relieves fear and anxiety. … I appreciate what medicine can do, but medicine cannot stop the inevitable. I took an oath to do no harm, but harm is also partially defined by the patient. My role as a healer is to provide comfort and support. Death is a part of life and part of my job as a physician is to make that transition as peaceful as possible.”

Carroll concluded, “In my view, withholding medical aid in dying, especially with well-tested, well-delineated parameters, causes harm.” He said medical aid in dying does not increase number of deaths, but it does decrease the amount of suffering for dying people. 

Kevin Bradley, a communications Director for the Libertarian party of Minnesota, is an ordained minister and has worked as a hospital and hospice chaplain. He indicated that most Democrats should support the bill because of respect for bodily autonomy, and most Republicans should support the bill because it would allow government to have less control over a person’s life.

Laurie Engel has incurable leukemia, and testified that she wishes the bill could help her, but, “unfortunately I’m probably going to pass before this happens. I’m lending my support because I feel it is so important that this bill move forward.” 

Mona Henkels testified that a good friend of hers was a longtime Minnesotan who moved to Washington State to have the choice to die “with her dignity still intact,” gathering her family and beloved dogs as she “kindly and humanely” left this world after four years suffering from pancreatic cancer.

Dr. Joanne Roberts is a retired palliative medicine doctor from Washington State, suffering from a terminal illness, who originally opposed her state’s Death With Dignity Act in 2008. “I was wrong. The Washington experience, and my own experience, have changed my mind. I stand in support of this bill, which is much like the Washington bill.” 

Eileen Weber, a nursing ethics professor, has had students debate the legislation in her University of Minnesota classes. “They questioned why such a flawed healthcare system as the one we have should insist that people suffer instead of having the control they rightfully and reasonably request.” She added that nurses advocate for patients’ autonomy and do not abandon patients at the end of their lives.  “Among the most unfair and, frankly insulting, arguments pushed by opponents of this end of life option is to call it suicide. Patients who want this end of life option are not suicidal in the honest sense. They would rather live, but they are sadly dying, terminally ill.”

Michelle Witte, director of the League of Women Voters of Minnesota, said she was speaking on behalf of her mother, who died after years of treatment for Parkinson’s Disease and months of seizures and panic attacks. “Most every day she would ask: when is this going to end, why don’t you just take me outside and shoot me?” Her mother eventually died after refusing all food and water for 11 days.

James M. Hamilton indicated he is dying of extensive small cell lung cancer, with less than a year to live — “the same incurable disease that killed my brother and devastated my family 15 years ago. I spent his final weeks at his bedside, doing what little I could to alleviate the suffering of suffocating as the disease ate away what remained of his lungs and wreaked havoc on his other organs. I do not wish the prolonged death he experienced. Nor do I wish my wife, my son, my siblings, my extended family, and my friends to” be scarred by witnessing the same.

Ellen J. Kennedy, director of World Without Genocide, said she watched her husband die of advanced multiple myeloma, an incurable blood cancer that eats away the bones. The Mayo Clinic helped him try to stop the disease for three years, until he “no longer had any psychological or physical strength left. … He wanted to choose to die when the essential elements of his life, as he defined them, were no longer sustainable and viable. And he wanted to die then. But for 16 days he endured the erosion of his personhood.” 

CeeAnne Becker said she suffers from a permanent, debilitating disability, “so I know the difference between a disability and a terminal illness.” Her father was in home hospice. She doesn’t know if he overdosed on his morphine, “but if he did, I cannot say that I blame him. He had suffered for far too long.”  

Merle Greene of Saint Paul said her mother died at age 60 of brain cancer. Referring to opposition testimony, she said, “It’s very unfortunate and unacceptable that people get inadequate hospice care, that proper equipment isn’t available to people with disabilities, or that a health care plan would not cover wound care. Those are awful, but these shortcomings, and the passage of an End-of-Life Options Act, have nothing to do with one another. They are not mutually exclusive.” 

Margaret Oibrekken said her 97-year-old father was a devout Christian, retired farmer, and World War II veteran. He chose to stop eating and drinking until he died. “It took him a week. I’m here because I would have liked to see him be able to see him do this by drinking something and be done in a couple hours instead of suffering more.” 

Melinda Mattson said her mother asked for two years to have help dying, indicating: “I don’t fear death. I fear the process of dying, of having nothing to look forward to in my life, uncontrollable pain, of drooling and wearing diapers that somebody else has to change.” 

Louise Bonach shared an image of the house she shared with her husband, who would have preferred to die there. “But there were no provisions for medical aid in dying, so he died instead in a cold sterile hospital room.”

Rosie Gaston, a hospice clinical social worker, said: “I believe in what hospice and palliative care provides. A vast majority of the time we’re able to manage the physical symptoms and support the emotional and physical journey that comes along with death and dying. I have also had a front row seat when this does not happen.”

Michael Tedford, a head and neck surgeon at Abbott Northwestern, treats patients who have cancer above the collarbone, and described the tumors they experience. He said he wants legislators to consider the suffering beyond pain that patients suffer at end-of-life. “As much as we wish we could manage all of this stuff, it just doesn’t happen.”

On the Other Hand

Jean Swenson was paralyzed in a car accident, fell into a deep depression, and learned how to live as a quadriplegic. She says she has “grave concerns” about the legislation, as a person with a disability. “I’m so grateful that assisted suicide was not available, and that those around me listened compassionately to my longing to die … and then gave me what I really needed – good medical care, counseling, access to disability services, and lots of prayer and loving support.”

She added, “I know all of you want to do the compassionate thing, so I respectfully ask that we pause and ask ourselves, once we open the door to this type of legislation, what will keep it from expanding [to include people with disabilities]?”

Kathy Jo Ware has been a registered nurse for 25 years and has a son with a disability. “Assisted suicide re-weaponizes the medical community against people with disabilities. You are asking us to trust the medical community to dole out prescriptions for suicide without discrimination and to never stray from the guidelines.”

Chris Massoglia, of Blaine, spoke on behalf of Americans United for Life, which opposes the legislation. “Suicide is not health care, and it’s completely unnecessary due to the advancements of palliative and end-of-life care.”  

Charles Dennis O’Hare, a doctor who works in an assisted living and memory care unit, says he has never had a patient request this option. He opposes the legislation because “it requires the physician to become the gatekeeper of which suicides are supposedly acceptable.” There are  patients who cannot get wound care covered by insurance, he says, “but now will pay for them to get narcotics to commit suicide. Once you open this door, it becomes uncontrollable.” 

Karin Charron, a nurse from Rochester and mother of four, said, “People are a gift from God, from the unborn to the aged, the healthy and the sick. The catechism of the Catholic Church says we are stewards, not owners, of the life that God has entrusted to us. It is not ours to dispose of. House File 1930 is horrific because it is not healthcare, it is deathcare. We cannot claim to be concerned with the mental health crisis and the rise in suicides and at the same time promote helping someone die on purpose.” 

Cathay Blaeser, co-director of  Minnesotan Citizens Concerned for Life, said, “This bill would move Minnesota from a community of compassion to one of active, callous, abandonment of our most vulnerable patients. When we move towards offering death as the solution to problems, we turn our backs on an actual cry for help and lose our incentives to solve the real root causes of that cry. Instead of improving palliative and hospice care, Minnesota will simply offer a deadly cocktail.” 

Rae Parker, of Rochester, said the legislature is “opening a Pandora’s box of evil. You’re trying to play God. You’re not God, so stop with the death suggestions, trying to make suicide normal, acceptable, easy, and embraceable.”

Caryn Addante of Mendota Heights said, “The bill is not compassion and it does not provide a so-called peaceful death. I’m concerned for our most vulnerable including the disabled. This is not care and this is not how a civilized society treats people.”

Blessing Griswold asked, “Can a life, even a remainder of a life, be considered expendable? Can government really decide that the last six months of life are irrelevant?” 

Jerry Kyser, a Vietnam War veteran, said he believes the legislation will hurt the veteran community. Someone in Vietnam committed suicide after receiving a break-up letter. He said the bill will increase suicide among veterans suffering from post-traumatic stress disorder.

Near the end of the 3.5 hours of public testimony, Dr. Lisa R. Mattson testified, “Please remember that this bill only applies to people with terminal, irreversible, incurable diseases who are likely to die within six months. It does not apply to people with chronic illness or people with mental health disease or the disabled. This bill also only applies to people who are mentally competent, who ask for this option of their own free-will … and does not negate the benefits of palliative care or hospice.”

Legislators  discussed the bill for at least an hour. There was a motion to re-refer the bill to the House Committee on Public Safety Finance and Policy, but there will be no further movement until the legislative session resumes February 12.