NEW JERSEY
Assisted Suicide is Legal
2024—Separate bills that either increase or reduce safeguards for protecting those with the disability of terminally illness from accessing assistance with suicide.
A407 which would repeal New Jersey’s assisted suicide law (“Medical Aid in Dying for the Terminally Ill Act”) is introduced to the Assembly Judiciary Committee.
A406 a bill that would increase penalties for fraud or coercion “with the intent or effect of causing the patient’s death” via assisted suicide from a second to a first degree offense.
A1880 /S3588 are companion bills that would allow waiving the second oral request and reducing the 15-day waiting period to 48 hours between the first oral request/ written request and writing a prescription for lethal drugs if it is thought the patient will die within the waiting period.
Why waiving the waiting period is medically dangerous and unethical: Determining that death is near is difficult for experts (1), as is evaluating capacity of the terminally ill. This bill allows one practitioner, without stated expertise or second opinion to assess prognosis of near death and decision-making capacity and waive the second request requirement. Patients often begin to lose both mental capabilities and swallowing function a few weeks to several days before death with 90% lacking these functions within two days of death. Obtaining a valid consent and ingesting the lethal concoction are both unlikely the closer a patient is to death. Patients take anti-nausea drugs and mouth-numbing popsicles before drinking a bitter tasting, burning lethal drug cocktail. Risks include painful ingestion, nausea, vomiting, aspiration, seizures, prolonged death, and not dying. Complications, such as dying from choking on vomit, are more likely when patients are close to death. Supplying lethal drugs near death may be worse than natural death and demonstrates reckless disregard for patients. In addition, patient autonomy is violated by removing a chance for mind changes. Palliative care can do far better.
Lethal drugs are never necessary for pain or symptom management, and shortening or eliminating the waiting period should never be done for this reason. Even a physician who advocates for lethal drug prescriptions admits this (2). Patients rarely seek lethal drugs for inadequate pain control, but usually for psychological distress over new onset disabilities associated with terminal illness. Testimonies about patients with excessive pain or other symptoms at the end of life indicate that these patients had inappropriate palliative care. Unfortunately, studies show that doctors often lack knowledge about palliative care possibilities and fail to refer to specialists (3,4) It is unethical to get consent for lethal drugs from patients in severe pain which compromises a person’s decision-making capacity. Terminally ill patients frequently have psychological, spiritual, emotional, social, and family struggles, and they may find their pain and other issues reduced when these issues are addressed.
(1) White N, Reid F, Vickerstaff V, Harries P, Stone P. Specialist palliative medicine physicians and nurses accuracy at predicting imminent death (within 72 hours): a short report. BMJ Supportive & Palliative Care 2020; 10(2): 209-12.
(2) Shavelson, Lonny. Medical Aid in Dying: A Guide for Patients and Their Supporters. American Clinicians Academy on Medical Aid in Dying, 2022. (p. 36)
(3) Enguidanos S, Rahman A, Hoe D, Meyers K. Provider-Identified Barriers To Palliative Care For Medicaid Patients. Innovation in Aging 2019; 3(Supplement_1): S689-S.
(4) Kavalieratos D, Mitchell EM, Carey TS, et al. "Not the 'grim reaper service'": an assessment of provider knowledge, attitudes, and perceptions regarding palliative care referral barriers in heart failure. J Am Heart Assoc 2014; 3(1): e000544-e.
2022-2023—A4921 would allow the 15-day waiting period to be reduced to 48 hours between the first oral request/ written request and writing a prescription for lethal drugs if it is thought the patient will die within the waiting period. The bill was introduced in 2022 and placed in the Assembly Health Committee and stalls there with no action by the end of 2023.
2022—A1415 which would repeal New Jersey’s assisted suicide law (“Medical Aid in Dying for the Terminally Ill Act”) is introduced to the Assembly Judiciary Committee but stalls.
A1414, which would increase penalties for fraud or coercion “with the intent or effect of causing the patient’s death” via assisted suicide from a second to a first degree offense, dies in the Judiciary Committee.
2020—A577 which would repeal New Jersey’s assisted suicide law (“Medical Aid in Dying for the Terminally Ill Act”) is introduced to the Assembly Judiciary Committee but stalls.
A576 , which would repeal New Jersey’s assisted suicide law (“Medical Aid in Dying for the Terminally Ill Act”) is introduced to the Assembly Judiciary Committee but stalls.
2019—“Medical Aid in Dying for the Terminally Ill Act,” which legalized physician-assisted suicide, passed and goes into effect.
A5525, which would repeal New Jersey’s assisted suicide law (“Medical Aid in Dying for the Terminally Ill Act”), is introduced to the Assembly Judiciary Committee but stalls
A5469, which would increase penalties for fraud or coercion “with the intent or effect of causing the patient’s death” via assisted suicide from a second to a first degree offense, dies in the Judiciary Committee.