PENNSYLVANIA SB 405 Analysis
2021-2022 “End of Life Options Act”
The Pennsylvania “End of Life Options Act” would give doctors the power to prescribe a deadly overdose of drugs for patients to take to end their lives.
The “End of Life Options Act” would permit a prescription for “end-of-life medication” that the patient may “self-administer to bring about death.”
Thus, it would permit prescriptions for a deadly overdose of drugs that could be taken by mouth, by drinking drugs that have been mixed into liquid.
Doctors in the same medical practice could diagnose a patient as having a terminal illness or condition and then confirm the diagnosis on the same day.
Under the bill, one doctor called the “attending physician,” could diagnose (or misdiagnose) a person as having a terminal illness or condition. On the same day, a second doctor, called the “consulting physician,” could confirm that diagnosis. Nothing prevents the two physicians from being in the same medical practice.
An individual with a controllable medical condition could be considered terminal for purposes of the Pennsylvania bill.
To qualify for assisted suicide under the bill, a person is to have a “terminal illness,” defined as “an incurable and irreversible disease that has been medically confirmed and will within reasonable medical judgment, produce death within six months.” However, the illness could be controllable and, yet, the patient would still be eligible for the life ending drugs.
This is similar to the situation in Oregon, on which the Pennsylvania bill is fashioned.
Examples of eligibility due to having a “terminal disease” in Oregon:
Official Oregon reports state that the “terminal diseases“ that qualified some patients for the lethal overdose included diabetes and arthritis.
Also, in Oregon, patients who refuse treatment are eligible for the lethal prescription. Dr. Charles Blanke, an oncologist and professor of medicine diagnosed a young woman with a condition that gave her a 90 percent chance of survival with recommended treatment. The woman, however, refused the treatment. In an interview, Blanke said, “Why doesn’t that patient want to take relatively non-toxic treatment and live for another seven decades?” He ended up prescribing the deadly overdose. In only one year, Blanke wrote about 15% of prescriptions for the lethal drug overdose in Oregon.
Patients who are severely depressed or mentally ill are not required to have any counseling for their mental conditions.
“Counseling,” defined as “one or more consultations as necessary … for the purpose of determining that the person is capable and not suffering from impaired judgment.“ “Capable” is defined as the “having the ability to make and communicate informed health care decisions without impaired judgment.”
A referral for “counseling” is not required even if the physician knows the patient is mentally ill or severely depressed, as long as the physician believes that the patient knows what he or she is requesting. Thus, even patients who are severely depressed or mentally ill can still be given the prescription as long as they know what they are requesting.
Assisted suicide would be transformed from a crime into a “medical treatment.”
This would cause emotional and financial pressure on patients. It would give insurance programs the opportunity to cut costs since they could deny payment for treatments that patients need and want while approving payment for the far less costly lethal drug overdose prescription.
This has happened in states that permit doctor-prescribed suicide.
Referring to payment for assisted suicide, the Oregon Department of Human Services explains, “Individual insurers determine whether the procedure is covered under their policies, just as they do any other medical procedure.”
There is documented information about terminally ill patients in Oregon and California who were denied coverage for treatment by insurance providers and, instead, were told that doctor-prescribed suicide would be covered.
In California, after finding that her insurance company would not cover the chemotherapy her doctor had prescribed, a woman asked if assisted suicide was covered under her plan. She was told, “Yes, we do provide that to our patients, and you would only have to pay $1.20 for the medication.”
California pays for assisted-suicide drugs obtained by MediCal patients under the state’s doctor-prescribed suicide law.
If the Pennsylvania bill becomes law, will insurance programs do the right thing – or the cheap thing?
Patients would have no protection once the assisted-suicide prescription is filled.
Like the Oregon law, the bill only addresses activities taking place up until the prescription is filled. There are no provisions to ensure that the patient is competent at the time the lethal drug overdose is administered or that he or she knowingly and willingly took the drugs.
Due to this lack of protection, the bill would put patients at enormous risk. For example, someone who would benefit from the individual’s death could trick or even force the person into taking the fatal drugs, and no one would ever know.
Why aren’t there any safeguards at the most important stage of the process – at the time the patient takes the drugs that will cause death?
 Section 54B02 – Definition of “self-administer.”
 Section 54B02 – Definition of “attending physician.”
 Section 54B02 – Definition of “consulting physician.”
 Section 54B02 – Definition of “terminal illness.” (Emphasis added.)
 Official report for 2016 deaths under Oregon’s Death with Dignity Act, Oregon Public Health Division, “Oregon’s Death with Dignity Act – 2016,” pg. 11, fn. 2. Available at: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year19.pdf. (Last accessed 12/7/19) and Oregon “Death with Dignity Data Summary,” Released February 2019, p. 13, fn. 3. Available at: https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year21.pdf. (Last accessed 12/7/19.)
 Tara Bannow, “Rural Oregonians Still Face Death with Dignity Barriers,” Bend Bulletin, August 14, 2017. Available at: http://www.bendbulletin.com/health/5512373-151/oregonians-can-choose-how-their-roads-end. (Last accessed 12/7/19.)
 Markian Hawryluk, “Bill reopens debate over assisted suicide in Oregon,” Bend Bulletin, April 27, 2019. Available at: https://www.bendbulletin.com/localstate/7117862-151/bill-reopens-debate-over-assisted-suicide-in-oregon. (Last accessed 12/7/19.)
 Section 54B02 – Definition of “counseling.” (Emphasis added.)
 Section 54B02 – Definition of “capable.”
 Section 54B09.
 Oregon Dept. of Human Services, “FAQs about the Death with Dignity Act,” p.4. Available at: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/faqs.pdf. (Last accessed 9/23/21.)
 See, for example: Bradford Richardson, “Assisted-suicide law prompts insurance company to deny coverage to terminally ill California woman,” Washington Times, October 20, 2016. Available at: http://www.washingtontimes.com/news/2016/oct/20/assisted-suicide-law-prompts-insurance-company-den. (Last accessed 9/23/21.)
 Bradford Richardson, “Assisted-suicide law prompts insurance company to deny coverage to terminally ill California woman,” Washington Times, October 20, 2016. Available at: http://www.washingtontimes.com/news/2016/oct/20/assisted-suicide-law-prompts-insurance-company-den. (Last accessed 9/23/21.)
 Kimberly Leonard, “Californians Can Choose to Die – With the Help of Taxpayers,” U.S. News & World Report, March 21, 2016. Available at: https://www.usnews.com/news/articles/2016-03-21/in-california-government-to-pick-up-the-tab-for-death-with-dignity. (Last accessed 9/23/21.)
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