Minnesota's end-of-life options bill clears its first legislative hurdle

A woman with glioblastoma, the most aggressive form of brain cancer, pleaded with Minnesota lawmakers Thursday to pass an End-of-Life Options Act quickly so she can choose when she dies in the hope of avoiding a gruesome, painful death.

A mother of an adult son with quadriplegic cerebral palsy, both wearing T-shirts saying "NOT DEAD YET," told legislators of her fears that such a law could introduce a slippery slope and degrade the lives of people with disabilities — that people could be coerced, or that the law could eventually be opened to people with serious, chronic physical conditions that aren't life threatening.

Hours of searing testimony on both sides of the issue became the opening salvo for what promises to be one of the most controversial battles in the upcoming legislative session: Should terminally ill Minnesotans have the option to use medication to end their life? The proposed law's supporters believe it has its best chance this session, after a decade of not getting much traction under divided government.

The House Health Finance and Policy Committee voted 10-5 in favor of the bill in a rare committee session held weeks before the legislative session opens Feb. 12. It was the first legislative hurdle for the proposal, which will have to clear other committees before a full vote on the House floor. It must also pass the Senate, which Democrats control by a single vote.

Rep. Mike Freiberg, DFL-Golden Valley, said the bill is consistent with an agenda supporting abortion rights that Democrats passed last session.

"We prioritize bodily autonomy, and that's what this does — at the last moment people can exercise their bodily autonomy," he said. "I don't think anything is guaranteed in this process, but we are going to push this as far forward as we can. ... Republicans support this as well. Sometimes, I think it takes a little while for elected officials to catch up to where the public is."

The difference in worldviews of the dozens testifying at Thursday's hearing was stark, with supporters in yellow shirts, opponents in red. Supporters framed the bill as a simple question of bodily autonomy and said society ought not to force terminally ill patients to suffer through pain before inevitable death. A man with extensive small cell lung cancer, the same cancer that killed his older brother 15 years ago, said he feared the same ugly, painful, drawn-out death.

Opponents expressed fury at "death legislation," and fear that opening the door to a narrowly defined law will lead to an expansion of who can access life-ending medication. A woman, paralyzed for decades from a car crash, said she is grateful physician-assisted suicide wasn't an option in the immediate aftermath of her life-altering accident.

The nearly 100 Minnesotans who showed up for public testimony didn't even agree on what the legislation is called. Supporters called it medical aid in dying, while opponents called it physician-assisted suicide.

Jeff McComas, 54, a retired 3M chemical engineer from Woodbury, never thought about medical aid in dying until last year, when he was diagnosed with stage 4 metastatic adenocarcinoma — incurable and inoperable, he said. He's had 26 chemotherapy sessions since then. He's already outlived his initial prognosis.

In the meantime, he's trying to live life to its fullest with his wife and two kids. "We really blew out the vacation budget," he said. There have been recent trips to England, France and Canada, a month at a cabin up north, upcoming trips to Belize and Florida. He's moved from denial to anger to acceptance. He hopes to live until 2025.

"This is not a partisan issue. I'm a lifelong Republican, and my Republican friends agree with my position," he said. "Every one of us is going to die. I'm not here to convince anybody that my way of thinking is more right than theirs. I just want the freedom to decide for myself without the government interfering."

Religious figures spoke against the act on religious grounds, and some disability activists argued the proposal could increase disability discrimination.

"It weaponizes the medical community to express, with action, their already deeply held bias that disability is a fate worse than death," said Kathy Ware, a registered nurse who testified alongside her son Kylen, who has a seizure disorder and quadriplegic cerebral palsy. "My son's Kylen's life has value. He uses a wheelchair, he has pain, we treat it. He relies on some medical technology to help him stay healthy. That doesn't mean his life is undignified."

Ten states and Washington, D.C., have legalized medical aid in dying. Oregon became the first state to allow the practice in 1994.

Under Minnesota's proposed legislation, adults 18 and older and those determined to be mentally capable of making an informed health care decision are eligible. Two health care providers, including at least one physician, must confirm that a person is mentally capable with a prognosis of six months or less to live. There would be criminal penalties for anyone who attempts to coerce someone into ending their life. Once a patient receives a prescription, they would have to administer it themselves.

The bill was introduced last session but didn't get a hearing in either chamber. The issue has also faced intense pushback from some doctors who believe helping end life is antithetical to their mission.

The practice "will turn the practice of medicine on its head by undermining the trust between doctor and a patient, endangering vulnerable populations and exacerbate health care and financial inequities, and at the same time risk eroding decades of suicide prevention efforts," said Nancy Utoff with the Alliance for Ethical Healthcare.

The Minnesota Medical Association is neutral on the issue.

Gov. Tim Walz has said he welcomes the discussion on the issue after watching his father spend weeks on life support before dying of lung cancer. It took his mother 25 years to pay the medical bills.