Governor Mills: Why I decided to sign LD 1313, known as the “Death with Dignity Act”

June 12, 2019

You know, it is difficult to speak about death on days such as this, where spring is lifting up dormant life and summer is inviting us to such happier times.

Some say that dusk is both the most beautiful and the most troublesome time of day. That is why the subject of impending death, the dusk of our days, is so difficult. 

Good morning, I am Janet Mills, Governor of the State of Maine, and I thank you for listening.

This week we dealt with a bill -- commonly called “physician assisted suicide” or “death with dignity” -- that purports to address the decisions relating to end of life care, the dusk of our lives.

Basic principles for and against this bill are these:

First of all, those in the shadows of life — as all of us may be at some time — deserve the highest level of care, compassion and caution from those in charge of society’s resources; from those in charge of its rules, laws and mores.

For those people who are unable to care for themselves -- of whatever age, ability or capacity -- society has a great responsibility.

It is our role, both governmental and charitable, to lift people up, to give them the means to pursue the highest level of self-sufficiency, happiness and opportunity.

A law that permits the act of suicide by people nearing the end of life might be seen as an abdication of that responsibility.

On the other hand, there are those who say that what government provides — and all that it should provide — is the protection of personal liberty to the extent that the exercise of that liberty does not infringe on the rights and security of others.

The opportunity for someone of sound mind facing imminent death to avoid further suffering is viewed purely as an act of personal liberty by some, a decision with which government should not interfere. 

In the context of L.D. 1313, the pursuit of individual liberty beseeches us to authorize in law an act of suicide with the assistance of the medical profession. 

An individual would be free, without punishment of law, to ingest a lethal amount of a nonprescription drug, or to terminate one’s life in some other manner, were it not for the requirement of the prescribing of a lethal dosage of a drug.

The assistance of the medical professional presents a moral dilemma for many people in the health care profession and of course for spiritual leaders who caution against suicide in any form, or against government placing its stamp of approval on actions that may devalue life, and against the participation and assistance of government and licensed professionals in life-taking measures.

On the other side of the moral dilemma is the fact that medicine has found so many ways to prolong life way beyond the expectations and expectancies of the past. 

So what sometimes comes with that extended life, and extended disease, is extended suffering, pain, great physical and mental discomfort.

So what is the balancing of rights here when an individual, in the throes of suffering and facing certain death, but while still competent, dearly wishes to end life, denying death its ultimate pain? 

Some argue that the enactment of L.D. 1313 equates to the government authorizing taking life, or “playing god” with the lives of our citizens.

You know it is not up to the government to decide who may die and who may live, when they shall die or how long they shall live.

But it is our duty to provide the most comprehensive end of life care, a task we have only recently begun to recognize.  

And what is the responsibility of society when compassionate end of life care may be not be adequate or accessible?

We also have a duty to prevent people from being victimized, to prevent discrimination against persons with disabilities, to make sure others do not take advantage of our vulnerable citizens.

Despite the narrowest of votes in the House of Representatives, L.D. 1313 is favored by a majority of Maine people surveyed and it includes some, though not all, safeguards to protect the decision-making of competent terminally ill patients and to protect misuse and abuse of lethal medications and the diversion of dangerous drugs.

This right to decide the means of ending one’s life by lethal prescription might be seen as an extension of the right to decline life-sustaining care that was articulated in the Maine Supreme Court decision more than thirty years ago.

There the Court concluded that the law recognizes a previously competent patient’s “right of self-determination in matters of health care to be essential to the integrity and dignity of his person.” 

While I do not necessarily agree with the Court that the right of the individual is all that absolute, I do believe it is a right that should be protected by law- the right to make ultimate decisions- along with the protections for those who are unable to articulate their informed choices and those who do not have access to quality end of life care.

So, after weighing all these concerns, and perhaps for other reasons I am just not able to articulate today, I have decided to sign LD 1313.

For all of these concerns as well however, I have also issued Executive Order Number Nine, which requires the Department of Health and Human Services to engage in Emergency Substantive Rulemaking within the next few months.

The broad purposes of this Executive Order will be to provide a high level of protection for those in care and those who shall be in care; to track trends in the utilization of the law; to pursue our responsibility for end of life care; and to avoid the moral and social consequences of a law that in some way might facilitate the taking of life without the full authority of the individual.

It is my hope that this law, while respecting the right to personal liberty, will be used sparingly, that we will continue to respect the life of every citizen, with the utmost concern for their spiritual and physical well-being, and that we as a society will be as vigorous in providing full comfort, hospice and palliative care to all persons, no matter their status, location or financial ability, as we are in respecting their right to make this ultimate decision over their own fate of their own free will.

I know that there will be many who agree and disagree with my decision, but I thank you for listening this morning to hear directly from me about why I’ve made this important decision.

I am Janet Mills, Governor of the State of Maine, and I thank you for listening.