I have stage 4 metastatic breast cancer. I continue to get weaker every week. I have lost 40 pounds from cancer and chemotherapy treatments. I am nauseous, constipated, have severe daily headaches, and bone pain in my back and head. The brain radiation left me with blurred vision in my right eye and very loud ringing with limited hearing in my right ear. The chemo has left me with neuropathy in my fingers and toes.
But I continue to fight, for myself, and to spend as much time as I can with my 29-year-old son. I know my bone and brain tumors are highly likely to cause me to suffer from intense pain at the end of my life. I am dying. Not today, not tomorrow, but that day is soon approaching.
That’s why I’m spending my limited time and energy trying to get this compassionate law passed. I walked the halls of the General Assembly speakng to lawmakers, I have been sending emails and calling lawmakers and I testified three weeks ago before the Maryland Senate Judicial Proceedings Committee and House of Delegates Health and Government Operations Committee in support of the Maryland End-of-Life Option Act. This compassionate legislation would provide mentally capable, terminally ill patients with six months or less to live with the option of medical aid in dying to peacefully end their suffering if it becomes unbearable. The stakes for me couldn’t be higher because if lawmakers fail to pass this bill this year, I probably won’t be able to use it, as am not likely to be around next year.
I support medical aid in dying because I have seen how the end of life can be so painful, even with the best hospice care and medications. If you have ever sat with a dying patient for hours at a time, then you know how difficult it can be for the patient and the family.
I have vast knowledge about dying patients because I worked for 35 years as an occupational therapist, and for 23 years in homecare and hospice care.
I also took end-of-day/night care of my mother who also had metastatic breast cancer. Over the last two months, she had no quality of life and a great deal of pain, and she was in hospice care. The pain medicine was helping her but even upping the dosage, or changing the medication, did not cover the pain she had when we had to roll her side to side or bathe her, moving any limb for any movement.
I can still hear her moan. And her breathing was difficult as her lungs were filling with fluid. During the last six days of her life, she slipped into a coma-like state from cancer. Even in hospice care, she, like many of my patients, did not have a peaceful or gentle death. In fact, while the use of hospice care among Medicare recipients has more than doubled over the past two decades, studies estimate that 65% to 85% of patients with advanced cancer experience significant pain that can be attributed to the disease itself or to treatment.
This is a very time-sensitive issue: the terminally ill individuals who desperately need this end-of-life care option are likely to die with needless suffering this year if the Legislature continues to punt this issue to next year, as it has done for the last eight years. Meanwhile, neighboring Washington, D.C., and six other states have authorized this option since 2015. Today, 10 states nationwide allow it. There are no more excuses for Maryalnd’s legislative inaction. Gov. Hogan’s vague position on the issue during his two-term tenure made some lawmakers hesitant to vote yes on the bill because he might veto it. In contrast, Gov. Wes Moore endorsed medical aid in dying in January, concluding:
“…[W]e as a state have to make sure that we are protecting that ability for people to be able to make those clear mind, clear-hearted, independent decisions about the suffering that they are enduring…”
In addition, a record-high of 71% of Maryland voters support medical aid in dying, including 65% support or higher among voters in every area of the state, according to a January poll by Gonzales Research & Media Services, compared to 62% statewide support in a 2019 Goucher poll. The Gonzales survey also showed majority support for medical aid in dying across the political, racial and religious spectrums, including 58% of Catholic voters, 70% of African American voters, and 82% of “pro-choice” voters.
And when Gov. Moore, House Speaker Adrienne Jones, and Senate President Bill Ferguson announced their support for a constitutional amendment to protect the right to abortion in Maryland, Sen. Ferguson proudly said the amendment: “affords the highest level of protection against attacks on reproductive liberties and bodily autonomy.” For these reasons, it upset me to read a Washington Post story last month in which Senate President Ferguson, who cosponsored and voted for the End-of-Life Option Act in 2019, was quoted as follows:
“It is very much an art and not a science and trying to get a feel for what people are willing to take on and how many big issues we can take up,” said Ferguson. While I understand he is worried about how it may inconvenience some legislators to “take on” this issue, I must remind them that their inconvenience pales in comparison to their terminally ill constituents who are fighting to ensure we have a peaceful death at the end of our lives. There is no bigger, more urgent issue than medical aid in dying for terminally ill Marylanders. This too is an issue of bodily autonomy, which Senate President Ferguson said should be afforded “the highest level of protection.” We cannot afford for lawmakers to postpone passing the End-of-Life Option Act until next year. And so I will fight on, pleading with our lawmakers to put themselves in my shoes and do the right thing for dying Marylanders like me.
After eight years of debate on the End-of-Life Option Act, the time is now to end the debate and pass this long-overdue, urgently needed legislation.
Diane Kraus lives in Baltimore.