Rep. Baumbach Introduces Delaware End of Life Options Act

DOVER – Lawmakers introduced a measure Thursday that would allow capable, terminally ill patients to choose to use medication to end their suffering.

Sponsored by Rep. Paul Baumbach, the Delaware End of Life Options Act would create a process and set of procedures for terminally ill adults nearing the end of their lives to request, receive and use medication to end their lives. House Bill 140 includes a physician’s evaluation, confirmation by a second physician, and two waiting periods before medication could be provided.

“This is a very delicate matter, which requires great sensitivity and care. The sensitivity of this issue, however, should not prevent us from addressing and discussing the need for this legislation,” said Rep. Baumbach, D-Newark North. “This is an issue about allowing adults facing a terminal illness to make critical decisions about their life. Many people in the last stages of life wish to retain their autonomy, including the ability to make decisions regarding their life and their suffering.

“The Delaware End of Life Options Act provides terminally ill adults an additional option to decide whether they wish to lessen their pain and suffering. But it is not a decision that they can make haphazardly, or without numerous safeguards.”

HB 140 includes several steps a Delaware resident must take before receiving medication to end his or her life, including: presentation of all end of life options which include comfort care, hospice care, and pain control; a physician’s evaluation; medical confirmation by a second physician; psychiatric/psychological counseling when indicated; passage of two waiting periods; and the completion of a formally witnessed request for prescribed medication.

A person making the request may rescind that request at any time, and can decide at any time not to use the medication.

The measure is vastly similar to a version introduced in the previous legislative session, but Rep. Baumbach said HB 140 includes several changes to clearly define processes that previously have been either accidentally or willfully misrepresented. Changes from the previous bill include:

  • Narrows definition of “terminal illness from “reasonable medical judgment” to “medical probability.”
  • Specifically requires and defines informed consent and the information a physician must provide to a patient about alternative treatments.
  • Prohibits anyone, including a guardian or authorized representative, from requesting medication under this chapter on behalf of another person.
  • Requires a physician to refer any individual who the physician believes may not have decision-making capacity to a psychiatrist or psychologist and that the psychiatrist or psychologist send a written report after the evaluation.
  • States specifically that a patient who lacks decision-making capacity cannot be a qualified patient and cannot be prescribed medication under this chapter.
  • Adds requirements regarding the safeguarding of medication and the safe disposal of unused medication.

In Oregon, which has had a similar law in effect since 1997, few patients who begin the process actually proceed to receive and fill the prescription, and more than one-third of patients who have the prescription filled choose to never take the medication. New Jersey passed a similar measure last month. According to the Associated Press, California, Colorado, Hawaii, Vermont, Washington and Washington, D.C., all have similar laws.

Under HB 140, a patient wishing to utilize this process must have “an incurable and irreversible disease that as a medical probability” will result in their death within six months.

The bill has been assigned to the House Health & Human Development Committee.