Both sides of medical aid in dying bill emphasize respect for human lives
George Michael Vasiloff loved music, his family and barbecues. The native Minnesotian played saxophone and clarinet and performed in the Marine Corp. band. He shared his love of music with his daughter, and they played in the church choir together. It’s a fond memory, said his daughter Kate Vasiloff.
George Vasiloff was diagnosed with Lou Gehrig’s disease in September 2013. Amyotrophic lateral sclerosis, or ALS, is a progressive disease that attacks nerve cells that control muscles. The condition can result in the loss of movement, speech, eating and breathing, according to the ALS Association.
Kate Vasiloff and her father stayed up late to talk the night he was diagnosed. George Vasiloff was terrified of what the disease would do to their family, and what his family would watch him go through.
His daughter assured him it was OK to pass on his terms. “I wanted to give him any slice of peace I possibly could,” Vasiloff said. Her father slept well for the first time since his symptoms started because he felt he would have control if things got bad, she said. He passed in his sleep 18 months after his diagnosis.
Vasiloff believes people should have a choice in their death. “Why don’t we give people the autonomy to make decisions about their own body when their body is failing them?” Vasiloff said. Vasiloff has lobbied since 2020 for physician-assisted death with the organization Compassion & Choices.
Physician-assisted death is being discussed more as states introduce legislation, including Virginia, Illinois, Michigan, Minnesota, Missouri, North Carolina, and Tennessee, among others. People are polarized around the procedure; divided by the concept of a person’s free will versus accepting their fate.
Many physicians oppose it on the principle of their oath to heal. Faith leaders believe it goes against the will of God. But, people on both sides of the issue say it is about respecting human lives.
The process is legal in California, Colorado, Hawaii, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont, Washington, and Washington, D.C., according to Compassion & Choices. Several states have pending amendments.
Legislation on physician-assisted death was recently voted down in Virginia; there have been attempts to legalize the procedure since 2019.
Sen. Ghazala Hashmi, D-Richmond, sponsored Senate Bill 280 this year, which would allow an adult diagnosed with a terminal disease to seek a physician’s approval to end their life. Hashmi worked with Compassion & Choices to draft the bill, in response to constituent requests, she said.
“They want to die in Virginia and they want to be able to have ownership over their final decisions in that regard,” Hashmi said.
Physician-Assisted Death, Explained
Physician-assisted death is when a life-ending prescription is given to a patient by a physician. The patient takes the dose on their own. The process differs from euthanasia, when a doctor administers the drug and causes the death directly, which is legal in some countries but not the U.S.
“This is a bill that expressly is concerned with terminal illness, and disability is not a terminal illness, depression is not a terminal illness — and we have those safeguards in place to protect the individuals in making the right decision for themselves,” Hashmi said.
SB 280 required that to be eligible for physician-assisted death, an individual must be a mentally competent adult and have a terminal illness with a diagnosis of six months (or less) left to live. Two oral statements and a written statement must be given to a medical provider, according to Hashmi.
The Virginia legislation created a Class 2 felony for anyone who interfered with a patient’s end-of-life request, or coerced a patient to request the procedure.
Former Virginia congresswoman Jennifer Wexton could be considered the face of the legislation, Hashmi said. Wexton was diagnosed in 2023 with progressive supranuclear palsy, which affects motor functions and has no cure. Wexton will not seek reelection in the fall.
Wexton issued a statement of support for Hashmi’s bill that was read ahead of the final vote in the Senate. “Prohibiting willing physicians and their terminally ill patients and our families from working together to create an end-of-life plan that is peaceful, humane and allows us to maintain our dignity is needlessly cruel,” Wexton stated.
The Oregon Death with Dignity law in 1997 was the first to be enacted in the U.S. and has similar safeguards as Virginia’s proposed legislation.
Hospice and Palliative Doctor View
About 1.7 million Medicare beneficiaries receive hospice care each year, and Medicare pays about $23 billion annually for hospice care, according to the U.S. Department of Health and Human Services. In Virginia, 46.2% of Medicare beneficiaries used hospice care in 2020, according to figures from a National Hospice and Palliative Care Organization report.
The American Medical Association says the process directly goes against the role of a physician to heal. Dr. Andy Arwari is a hospice care worker and palliative care physician who warned against legalizing physician-assisted death.
Dying patients receive specialized care through hospice to make life as comfortable and peaceful as possible before a natural death. The core philosophy of hospice is not to speed up or delay death and a hospice care worker is not going to end a life prematurely, according to Arwari.
Under current law, a licensed health care provider would have their license revoked, or suspended, for providing or administering life-ending drugs.
Medical care has an interdisciplinary approach that treats physical ailments but also focuses on psychosocial, and spiritual elements to ensure a patient is cared for on many levels, according to Arwari. “Are we sure that we have explored all the possibilities and explain why that patient is suffering,” Arwari said. “Did we exhaust every possible avenue to resolve that suffering before getting to that option of medical assistance in dying?”
Religious Opposition
Jeff Caruso, executive director of the Virginia Catholic Conference, lobbies for hospice and palliative care for end-of-life patients. Quality, affordable health care is seen as a right within the Catholic Church, Caruso said. The Catholic Church teaches that every suicide is a tragedy, regardless of if it is approved by a physician.
The government should advocate for the common good and respect life, according to Caruso. “The government still has an obligation to do everything that it can to prevent suicide rather than promote suicide,” Caruso said.
End-of-life Care, or Doulas
Reamey Belski is an end-of-life doula, also known as a death doula. They are nonmedical professionals who provide specialized care for the dying, which can include spiritual, emotional and logistical care. Death doulas are often mediators between family members with caregiver fatigue and hospice care workers, according to Belski.
Belski estimated she has served as an end-of-life doula for approximately 25 people.
A patient’s quality of life and environment is important to a death doula. If someone with a terminal illness is suffering greatly and wishes to end their life, they should have a right to do so in every state, said Belski.
A person chooses physician-assisted death when they wish to live but their body will not allow it, and she does not consider it suicide, Belksi said. “I think people who get caught up with the issue of medical aid in dying start blurring the lines between the two and they’re very, very different things,” Belski said.
Vasiloff also does not consider it suicide, saying “people with terminal illnesses desperately want to be here.” The first sign of her father’s ALS happened when he could not lift his foot. The actual diagnosis took months, but his decline came on fast, putting him in a wheelchair just a month after his diagnosis, Vasiloff said.
She was thankful that up until his death he could still talk, eat and drink — three of his favorite things. Those memories, just like their time in the church choir, stay with Vasiloff as she finds herself advocating for a change in state law.
“I never thought that I would be sitting here talking to you about this, and being involved in this issue,” Vasiloff said. “I’m grateful that I have somewhere to put my energy and do this work in my dad’s name.”
By Shelby Warren, Capital News Service
VCU InSight journalist Chelsea Brooks-Giles contributed to this report.