ROCHESTER — With Minnesota's 2023 legislative session in full swing, the DFL majorities in both chambers have advanced several health-related bills, from protecting abortion access to making nonprofit hospitals' financial assistance programs more accessible .
In the legislative mix this year are Senate File 1813 and House File 1930 , both known as the End of Life Option Act. The companion bills, introduced on Feb. 16, would let terminally ill adults have the option to choose medical aid in dying, also known as physician-assisted suicide.
"It's modeled after a similar law in Oregon that's been in effect for more than two decades," said Rep. Mike Freiberg, DFL-Golden Valley, who has led the effort to pass the End of Life Option Act since 2016.
The House version of the bill has 19 authors, including Rep. Andy Smith, DFL-Rochester. Sen. Liz Boldon, DFL-Rochester, is one of five Senate authors.
For Boldon, a nurse, the proposal underscores her belief that patients should have the autonomy to make their own health care decisions.
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"I think I can't separate my 20 years experience as a nurse from my work at the Legislature," she said. "I've taken care of patients at the end of their life. ... Their care goals should be determined by them, and that includes at the end of people's lives, including their death."
If made law, Minnesota's End of Life Option Act would be available to adults diagnosed with a terminal illness who have been given a prognosis of six months or less to live. The patient can request a prescription for life-ending medication, and two medical providers would work with the patient to ensure that they are fully informed and able to consent to the procedure.
"And they have to be able to self-administer the medication, so nobody can give it to them," Freiberg said. "If they meet all those requirements, then they are able to be prescribed a medication that will end their own life."
"The ultimate decision, even down to swallowing the medication that is given for the end of life, is given to the person who is dying," Smith added. "That's not something that the doctor would administer via syringe or anything like that."
Medical aid in dying is legal in 10 U.S. states and Washington, D.C. Oregon has permitted the practice since 1997, and a 2017 article published in the New England Journal of Medicine found that Oregonians were more likely than other Americans to die at home rather than at a hospital. In 2021, the Oregon Health Authority reported that 383 people received lethal prescriptions under the state's Death with Dignity Act that year, and 238 adults used the prescribed medication to end their lives.
A notable example of medical aid in dying is actor René Auberjonois, who died on Dec. 8, 2019 , after ingesting life-ending medication prescribed through California's End of Life Option Act. Auberjonois, who was 79, had been diagnosed with lung and brain cancer.
Though medical aid in dying is allowed in several states, the practice is controversial. Several medical organizations support or are neutral on this topic, but many others, including the American Medical Association , oppose the practice.
When the End of Life Option Act received a Minnesota House Health and Human Services Policy Committee hearing in 2019, several Minnesotans testified for and against the legislation. Those who oppose the practice cited religious beliefs, concern for the potential mistreatment of disabled adults and conflicts with a physician's oath to do no harm.
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Freiberg said the legislation includes precautions used in other states to prevent misuse and coercion.
"It's only a limited number of people who can use it, and the physician has to sign off on all of these conditions," Freiberg said. "There's liability protections for clinicians who follow the law — coercion would remain to be a felony."
The legislation also allows physicians and health care facilities to opt out of the program.
"If it's against the doctor's personal beliefs, they're not required to participate in the program," Freiberg said.
From a theological standpoint, Smith said he understands some people's religious oppositions to medical aid in dying.
"Death is scary, and it's also a very large moral issue that we all have to deal with," he said. "So I am certainly not at all offended or taken aback by people who have issues with this.
"This not a new idea or a new program," Smith continued. "We do have data ... (for) how this will work out. So a lot of the questions we have, we don't necessarily just have to wonder about. We do have some clear evidence to go (on)."
Smith said Minnesota's End of Life Option Act aligns with DFL legislators' health reform priorities because it is centered around compassion.
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"We're trying to put more compassion into the medical system that we have right now," he said. "We know that there are flaws in the system, and a lot of that comes from the difficulty of having a very expensive medical system, having the insurance system that we have. A lot of these simply cannot be solved overnight, so we're working on small ways that we can inject some compassion into the system."
Freiberg said having DFL majorities in both legislative chambers improves the odds that the End of Life Option Act will make it to Gov. Tim Walz's desk this year.
"I'm certainly hopeful that we can get hearings in the House and Senate and advance the bill," Freiberg said. "I guess we'll just have to see how it goes."
"I'm hoping it will get a hearing," Boldon added. "It's a conversation that we should have and work that should continue."
The companion bills have been referred to the Senate Health and Human Services Committee and the House Health Finance and Policy Committee.
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