Massachusetts’s Compassionate Care for the Terminally Ill Act

Massachusetts is considering a death with dignity bill that would allow terminally ill patients to request life-ending medication.

Recently, there has been a dramatic increase in the number of states considering death with dignity laws. Sometimes called “assisted suicide” or “right to die” initiatives, these laws make it possible for terminally ill patients to use prescribed medication to end their lives peacefully rather than suffering a painful and protracted death.

The catalyst for greater national attention to this issue was 29-year-old Brittany Maynard, a woman diagnosed with terminal brain cancer who moved from California to Oregon to end her life in 2014. Oregon because California had not yet passed its aid-in-dying law, and Oregon is one of just a few states that allowed terminally ill patients to legally end their lives.

Spurred by Maynard’s decision and the resulting publicity, the Massachusetts legislature is now considering a death with dignity bill, HB 1991, called the Massachusetts Compassionate Care for the Terminally Ill Act, that would allow terminally ill patients who meet certain requirements to request life-ending medication.

This article first clarifies some confusing language related to death with dignity laws and then sets out the basics of Massachusetts’s proposed law.

Death With Dignity, Assisted Suicide, Right to Die: What’s In a Name?

“Death with dignity” is one of the most commonly accepted phrases describing the process by which a terminally ill person ingests prescribed medication to hasten death. Many people still think of this process as “assisted suicide” or “physician assisted suicide.” However, proponents of death with dignity argue that the term “suicide” doesn’t apply to terminally ill people who would prefer to live but, facing certain death within months, choose a more gentle way of dying. In fact, Massachusetts’s proposed law states that terminating one’s life under the law is not suicide. (See HB 1991, Section 15.)

Increasingly, health organizations are turning away from the term “suicide” to describe a terminally ill patient’s choice to reduce the suffering of an inevitable death. The phrase “aid in dying” is becoming a more accepted way to refer to this process. Massachusetts’s proposed Compassionate Care for the Terminally Ill Act uses the phrase “aid in dying” throughout the text of the bill.

You may also see the phrase “right to die” used in place of “death with dignity.” However, “right to die” is more accurately used in the context of directing one’s own medical care -- that is, refusing life-sustaining treatment such as a respirator or feeding tubes when permanently unconscious or close to death. You can provide your own health care directions by completing a Massachusetts health care proxy and living will. (See the end of this article for more information.)

An Overview of Massachusetts’s Compassionate Care for the Terminally Ill Act

Massachusetts’s proposed law is modeled closely on Oregon’s Death With Dignity Act, which took effect in 1997. If Massachusetts’s law passes, a patient requesting aid-in-dying medication will have to be:

  • at least 18 years old
  • a Massachusetts resident
  • mentally capable of making and communicating health care decisions, and
  • diagnosed with a terminal disease that will result in death within six months.

A patient who meets the requirements above will be prescribed aid-in-dying medication only if:

  • The patient gives a written request to the doctor, signed in front of two qualified, adult witnesses. (The law sets out the specific form that the patient must use.)
  • The prescribing doctor and one other doctor confirm the patient’s diagnosis and prognosis.
  • The prescribing doctor and one other doctor determine that the patient is capable of making medical decisions.
  • The prescribing doctor refers the patient to a licensed psychiatrist or psychologist for counseling to determine that the patient is not suffering from a mental disorder that could cause impaired judgment.
  • The prescribing doctor confirms that the patient is not being coerced or unduly influenced by others when making the request.
  • The prescribing doctor informs the patient of any feasible alternatives to the medication, including care to relieve pain and keep the patient comfortable.
  • The prescribing doctor asks the patient to notify their next of kin of the prescription request. (The doctor cannot require the patient to notify anyone, however.)
  • The prescribing doctor offers the patient the opportunity to withdraw the request for aid-in-dying medication before granting the prescription.

To use the medication, the patient must be able to ingest it on their own. A doctor or other person who administers the lethal medication may face criminal charges.

You can read the full text of Massachusetts Compassionate Care for the Terminally Ill Act on the Massachusetts legislature’s website.

Learn More

For more news and information about death with dignity in Massachusetts, visit Compassion and Choices Massachusetts.

To find out more about the history and current status of death with dignity laws in the United States, visit the website of the Death With Dignity National Center.

For information about appointing a health care agent and making known your own wishes for medical care at the end of life, see the Living Wills & Medical Powers of Attorney section of Nolo.com.

Updated: 11/8/2017

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