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Lawmakers narrowly reject prohibition on medical aid in dying

SB 210 would have removed a legal shield for physicians who prescribe lethal medication at the request of terminally ill patients.

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HELENA — A bill that would have allowed criminal penalties for Montana physicians who provide terminally ill patients with medical aid in dying narrowly failed to pass a final vote in the Senate chamber Wednesday, spelling the likely fate of the bill this session.

Senate Bill 210, sponsored by Sen. Carl Glimm, R-Kila, passed an initial vote Tuesday by a two-vote margin, with 26 Republicans in favor and a bipartisan coalition of 24 lawmakers voting no. That margin flipped when lawmakers reconsidered the bill Wednesday, with one senator changing his vote in the affirmative and three others switching sides to oppose the bill.  

Glimm did not reply to a request for comment Wednesday afternoon about the bill’s outcome.

Appealing for lawmakers’ support on the Senate floor this week, Glimm described medical aid in dying as assisted suicide, a characterization opponents of the bill refuted during a January hearing. SB 210, Glimm said, would send the message that life is valuable. 

“We need to be consistent in our message. And we need to tell the citizens of Montana that suicide is not the answer,” Glimm said. 

The Senate’s decision to reject the bill squares with votes in preceding legislative sessions. Similar legislation to SB 210 has been brought consistently since 2009, the year the Montana Supreme Court ruled that physicians who prescribe lethal medications to a terminally ill person at the end of their life can use the patient’s consent as a legal defense to homicide charges. That decision in Baxter v. State created a legal loophole for physicians to prescribe aid in dying for patients. 

Though the state doesn’t collect data on how widespread the practice has been since the Baxter decision, the option of medical aid in dying appears to be popular among registered voters. 

A recent poll conducted by Susquehanna Polling and Research, Inc. on behalf of the national group Compassion & Choices found that between 70% and 80% of Montanans identifying with different political parties said that mentally sound adults with incurable, terminal illnesses, and less than six months to live, should be legally allowed to “obtain prescription medication to pass peacefully in their sleep.” Nearly three-quarters of the 601 Montana voters polled said they would want that option for themselves. 

Nine other states and the District of Columbia have legalized the procedure and created parameters for when certain patients can utilize that end-of-life choice. Montana is the only state that permitted the practice through a court ruling, leaving medical providers to follow best practices laid out by other states if they choose to prescribe that medication to patients who request it. 

Pamela Brown, an advanced practice registered hospice and palliative care nurse, told members of the Senate Judiciary Committee at the bill’s hearing in January that only eight out of her more than 300 patients in southwest and central Montana have opted to use medical aid in dying. In those circumstances, Brown said, she required the patient to be mentally sound, not suicidal or depressed, within their last six months of life, able to consume the medication on their own, and proceeding with the informed consent of their family.

“Each one had a completely gentle, pain free, peaceful death surrounded by loved ones,” Brown said. “I believe in the right of Montanans to choose their own paths as they face the end of life.”

More than a dozen others testified against the bill, including representatives of the Montana Hospital Association and the Montana Medical Association. Some opponents included family members of people who have died after being diagnosed with terminal illnesses who argued for privacy and personal choice in end-of-life medical care.

“This removes an element of privacy that we each hold dear to ourselves,” said Ron Waterman, whose late wife Mignon Waterman, a longtime Montana senator, died from pancreatic cancer in 2017. If faced with a terminal disease like that, he said, “I know my privacy entitles me to make a choice as to the degree of suffering, the amount of dignity and the time of my death.”

SB 210’s six supporters included the conservative Montana Family Foundation, Disability Rights Montana, the Montana Catholic Conference and Lt. Gov. Kristin Juras speaking on behalf of Gov. Greg Gianforte’s administration.

In her testimony to lawmakers, Juras agreed with Glimm about the need to firmly oppose suicide for any and all Montanans, including older adults and those with terminal medical conditions. 

“I think elder people are vulnerable,” Juras said. “I took care of my parents. My father on several occasions said, ‘I don’t want to be a burden. Is there a way that I can go?’ And it was our job as a society, as his children, to stand up and say, ‘You are valuable. You are valuable in the midst of suffering. We are going to get through this. Suicide is not the solution.’”

Lawmakers on the committee eventually voted to pass the bill along party lines, with seven Republicans in favor and four Democrats opposed.

SB 210 has little time to be reconsidered before the Legislature’s transmittal deadline on March 3, the date by which policy bills must pass from one chamber to the other in order to survive.

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