Senate committee to take up assisted suicide bill April 24

EDITED to reflect venue change announced on General Court website.

New Hampshire’s latest assisted suicide bill will have its hearing at the Senate Health and Human Services committee on Wednesday, April 24, at 10 a.m. in room 103 of the State House in Concord. HB 1283-FN passed the House earlier on a 179-176 vote.

Here are some reminders about the bill and the policy behind it, followed by the details you’ll need in order to weigh in on the measure.

Points to ponder

• HB 1283-FN relies on dishonest language that doesn’t belong in New Hampshire law.
• It would turn suicide into a form of medical care, giving insurers and other third-party payers an incentive to favor it over authentic care, which is likely to be more expensive.
• It reinforces an attitude of “better dead than disabled.”
• It undermines suicide prevention outreach to vulnerable individuals.
• No amendment can “fix” this bill. HB 1283-FN needs to be voted “inexpedient to legislate.”

“An act relative to end of life options,” says the title of the bill. The last assisted suicide bill in New Hampshire, in 2020, used the words “patients’ rights.” Then and now, sponsors and supporters are not happy to hear the term “assisted suicide” used instead. Suicide is the deliberate taking of one’s own life. Prescribing and dispensing a drug with the intention of facilitating that act is assisting suicide. Hence, the act so carefully authorized in HB 1283-FN is indeed assisted suicide.

HB 1283-FN has a provision (“Death certificate” section, paragraph II) that the death certificate for a person whose suicide is committed with medical assistance shall not list “suicide” as cause of death. HB 1283-FN is a mandate to health care providers to falsify death certificates.

It’s also a gilt-edged invitation to insurers to treat assisted suicide as medical care. Compare the cost of palliative care for a patient – possibly a complex regimen of which pharmaceuticals are only one element – with the cost of a lethal dose of drugs. The insidious financial pressure toward the cheaper option would be overwhelming for insurers and patients alike.

It’s no coincidence that among the most passionate opponents of HB 1283-FN are people living with chronic debilitating diseases or irreversible disabilities. They know they are the patients who are most vulnerable to pressure. Lisa Beaudoin, longtime advocate in New Hampshire for the rights of disabled persons, wrote about the bill in an op-ed published in February. “Physician-assisted suicide is insidiously becoming normalized as a legitimate option instead of doing the hard work of creating safe, equitable end-of-life care….In April 2023, four disability rights groups filed a CA lawsuit alleging California’s 7-year-old End of Life Option Act, originally designed to allow terminally ill people to end their life, puts people with disabilities at greater risk of being coerced into seeking assisted suicide because we know from the research that healthcare providers undervalue life with a disability.”

Representatives of veterans’ groups were among more than a thousand people who registered opposition to the bill before its House hearing. Recall the words of a representive of the State Veteran’s Advisory Committee: “this bill scares our members right out of their socks.” We’re all familiar with efforts to reduce the appalling rate of suicide among veterans. Those efforts arise from the belief – the fact – that each human life is valuable and worth caring for. HB 1283-FN would turn that belief on its head. It would establish as a matter of public policy that the value of life is situational and subjective.

And this is what the bill’s chief sponsor at the House hearing called a “conservative” measure.

No, thanks.

Preparing for the Senate hearing

The goal is a committee recommendation of “inexpedient to legislate” (ITL).

You can refer to this blog’s Legislative Tool Kit page for more information about contacting elected officials and about procedures for hearings. Always be polite, and never let them say they didn’t hear from you.

Your presence at the hearing will make an impression. We saw at the House hearing what can happen when people show up to try to stop bad legislation. Let’s keep up the effort. Expect a crowd. Seating may be limited. If you can’t stay for long, try to be there for the first hour, beginning at 10 a.m.

This hearing’s scheduled to be in room 103 of the State House.

The members of the Senate Health and Human Services committee are Sens. Regina Birdsell (R-Hampstead), Kevin Avard (R-Nashua), Jeb Bradley (R-Wolfeboro; also Senate President), Rebecca Whitley (D-Hopkinton), and Suzanne Prentiss (D-West Lebanon).

You can sign in at the hearing on sheets that will be available near the door of the hearing room. You’ll be asked to provide your name, address, the name of any group you’re representing – and don’t forget to put a check mark in the “opposed” column. Even if you don’t give any oral or written testimony, your name on that sign-in sheet will have an impact.

You can sign in online to register your opposition to the bill right now. The online form will be available through the day of the hearing. Go online to the Senate’s “remote sign-in” page and follow the instructions. You may attach a written statement if you wish, but you don’t need to provide one in order to sign in. You may also email testimony to the committee members via the link on the committee’s page.

Links to my earlier coverage of HB 1283-FN: Assisted suicide bill draws a crowd, Assisted suicide bill scheduled for House vote, House passes assisted suicide bill

New Hampshire House passes assisted suicide bill; next stop: Senate

Assisted suicide proponents scored a victory as the New Hampshire House today passed HB 1283-FN on a 179-176 vote, The measure will now go to the Senate on a date yet to be determined.

The ill-named “end-of-life options” bill was characterized by co-sponsor Rep. Marjorie Smith (D-Durham) as “a toe in the waters” at the bill’s House hearing. Apparently, 179 representatives are fine with that.

Supporting this bill meant rejecting the voices of more than a thousand people who signed in online against it when the Judiciary committee held its hearing. It meant ignoring the New Hampshire Coalition for Suicide Prevention (zerosuicidesnh.org), a broad alliance of veterans’ groups, advocates for the rights of Granite Staters with disabilities, mental health professionals, and faith-based providers of human services.

Fortunately, the coalition’s participants don’t get discouraged easily. Already, they’re preparing to appeal to senators.

Breakdown of the vote

Details of the vote are on the General Court website. (Look on the left side of that page for Roll Calls; the relevant one is “OTP/A.”) The motion was Ought to Pass with Amendment, which included the Judiciary Committee’s recommended amendment leaving the substance of the bill unchanged.

I see that seven of my town’s reps voted Nay, and that means I have seven thank-yous to write. Please do the same for your own reps who opposed the bill.

Party affiliations

It wasn’t a straight party-line vote. While most Democrats supported the bill, 33 opposed it. On the other hand, while most Republicans opposed the bill, 36 supported it.

Republican Speaker of the House Sherman Packard handed the gavel to Deputy Speaker Steven Smith in order to cast a Nay vote.

Unexcused absences: a few more votes would have changed the outcome

Twenty-four representatives had excused absences, which means they reported to the House Clerk that they missed the session due to illness, important business, or death in the family.

But how about the 16 reps marked “Not Excused” in the official roll call? Where were they? I don’t know their circumstances; let their constituents ask them. What’s indisputable is that on a bill with a three-vote margin of victory, these reps could have made a difference. The roll call posted on the General Court website as of 9:20 p.m. on the day of the vote lists the following reps as being “not excused” (name, party, town, county/district):

Richard Beaudoin (R-Gilford, Belknap 6), Amy Bradley (D-Manchester, Hillsborough 41), Jacob Brouillard (R-Nottingham, Rockingham 1), Gerri Cannon (D-Somersworth, Strafford 12), Matthew Coulon (R-Pike, Grafton 5), Linda DiSilvestro (D-Manchester , Hillsborough 17), Sean Durkin (R-Northumberland, Coos 1), Jason Gerhard (R-Franklin/Northfield, Merrimack 25), Heidi Hamer (D-Manchester, Hillsborough 19), David Huot (D-Laconia , Belknap 5), Cassandra Levesque (D-Barrington, Strafford 4), Nikki McCarter (R-Belmont, Belknap 8), Andrew Prout (R-Hudson, Hillsborough 13), Jeffrey Rich (D-Somersworth, Strafford 12), Jared Sullivan (D-Bethlehem/Franconia, Grafton 2), Linda Tanner (D-Georges Mills, Sullivan 5),

I hope their constituents will reach out to them and open up some lines of communication. Tell your stories. Perhaps those stories will prompt a constructive vote someday.

Next steps

The Senate hearing for the assisted suicide bill will be announced in the Senate calendar and online in the coming weeks. As there was on the House side, there will be an online sign-in form, which will be available as soon as the hearing is scheduled. It’s not too early to contact your own senator and express your opposition to the bill.

Resources to view and share

The Concord Monitor published an op-ed from Lisa Beaudoin, longtime New Hampshire advocate for the rights of people with disabilities: “Physician-assisted suicide is insidiously becoming normalized as a legitimate option instead of doing the hard work of creating safe, equitable end-of-life care.”

Robert Dunn, public policy director for the Diocese of Manchester, testified to the House Judiciary committee on how assisted suicide legislation is inconsistent with our state constitution’s affirmation of the common good. The two-minute video is on YouTube.

Steven Wade of the Brain Injury Association of New Hampshire has a short blog post at zerosuicidesnh.org that outlines briefly the major problems with HB 1283: “Assisted Suicide Open the Wrong Door.“

Lori Safford wrote about her Christian faith and how it guides her approach to HB 1283: “As tempting as it is to try legislating pain away, I hope Granite State Christians will look at this issue through the lens of faith and join me in affirming the value of human life.” (linked at nhcornerstone.org)

header image: pexels.com

Assisted suicide scheduled for House vote March 21

After the Judiciary Committee voted 13-7 on an “ought to pass with amendment” motion for the assisted suicide bill, HB 1283-FN will get a vote in the full House on March 21. The time is now to contact your state representatives to vote “inexpedient to legislate” (ITL). The bill’s amended version is at this link.

There will definitely be a debate before the vote, with a minority of the committee recommending ITL.

You can find your representatives’ names and contact information at the General Court website (https://www.gencourt.state.nh.us/house/members/). Contact all of your reps, regardless of party. Make no assumption that a party affiliation will tell you how a rep will vote.

Voices against assisted suicide

In one way or another, more than a thousand people went on record opposing HB 1283.

Readers of this blog won’t be surprised by my own take on the bill: it’s about normalizing suicide, turning it into a medical procedure. I’m sure insurers – third-party payers – are watching with interest. Via costs alone, the availability of assisted suicide will undermine the development and use of authentic palliative care and pain control. One lethal prescription will surely be cheaper than a holistic regimen of care.

I can’t forget hearing the testimony of a member of the State Veterans Advisory Committee, who said “this bill scares our members right out of their socks.” It should. Veterans are aware of programs to reduce the number of veteran suicides, and here comes a bill that would make suicide a perfectly acceptable thing. It’s enough to make a person wonder if there’s some sort of hierarchy of lives, with some more worthy of protection than others.

A longtime advocate for the rights of people with disabilities isn’t wondering about such hierarchies; she knows for sure they exist. She has taken note of the effect of assisted suicide laws in other jurisdictions. Lisa Beaudoin of Strategies for Disability Equity wrote in the Concord Monitor on February 12, “Physician-assisted suicide is insidiously becoming normalized as a legitimate option instead of doing the hard work of creating safe, equitable end-of-life care….In April 2023, four disability rights groups filed a CA lawsuit alleging California’s 7-year-old End of Life Option Act, originally designed to allow terminally ill people to end their life, puts people with disabilities at greater risk of being coerced into seeking assisted suicide because we know from the research that healthcare providers undervalue life with a disability. It’s a data-driven lawsuit.”

The written testimony from Robert Dunn on behalf of the Roman Catholic Diocese of Manchester echoes these concerns and raises others. “the mere existence of a cheap alternative to often costly types of health care will almost surely result in a diminishing of the resources and funding that should be available for people in need. If you believe that the poor and the vulnerable get the short end of the stick in today’s health care world, how do you think it will go for them when assisted suicide is introduced into the mix?”

No need “to travel under a pseudonym”

Attorney Dunn can’t let the bill’s abuse of language slip by unnoticed: “…HB 1283 – which uses the euphemism ‘medical aid in dying’ and makes the astonishing declaration that the taking of one’s own life is not suicide – is utterly wrong in its claim of what death with dignity is. We all know what death with dignity really is because we see it every day in the way the dying are cared for by New Hampshire families and in hospitals, nursing homes and other settings. This is care which allows even the frailest and neediest of our citizens to live and to die in a truly humane and dignified way. This is care that does not feel the need to travel under a pseudonym.”

Committee chairman is co-sponsor, ranking minority member is chief sponsor

The chairman of the Judiciary Committee, Rep. Robert Lynn (R-Windham), together with Rep. Marjorie Smith (D-Durham), the ranking Democrat on Judiciary, released an op-ed published in the New Hampshire Union Leader on March 13 headlined “Death is non-partisan: Help pass the End of Life Options Act.”

In it, they take to task Granite Staters who recognize that a decision to end one’s own life is suicide. They are determined to torque the English language in whatever way is necessary to get votes for HB 1283. From their op-ed: “The conflation – intentional or accidental – of medical aid in dying with suicide traumatizes the loved ones of people with an unresolved mental health crisis who actually died by suicide.” Excuse me, Honorables, but my sister died by suicide – an intentionally self-destructive act. That’s traumatizing. Recognizing that your bill seeks to normalize a particular type a of suicide doesn’t traumatize me further. It spurs me to action.

Rep. Smith, chief sponsor of the bill, said at the hearing that HB 1283 would let New Hampshire put its “toe in the waters,” as though there’s further to go with assisted suicide (as has proven to be the case in jurisdictions where it’s legal). In the op-ed co-written with Rep. Lynn, she avoids that toe-in-the-waters metaphor in favor of calling HB 1283 “conservative.”

A voice to remember

I wrote about the late Maggie Karner ten years ago when I heard her speak at an east coast conference against euthanasia. She spoke while suffering from the cancer that would take her life only a few months later. I included her story in my Pro-Life Journeys anthology because she deserves to be remembered long after blogs fade away. Her words remain timely as assisted suicide gains traction in our legislature.

Ms. Karner spoke with calm urgency. “Proponents of assisted suicide and euthanasia want to capitalize on emotions, and more importantly, they want to change our vocabulary….We have to come to terms with what this really is – with the fact that assisted suicide, let’s call it what it is, affects others, and not just those close to the self-appointed victims. It affects especially the weak, the disabled, and the most vulnerable. Because how long will it be before the right to die quickly devolves into the duty to die? What does this mean for all who are elderly, or disabled, or just wondering if they’ve become a burden to the family?

“Don’t you ever let anyone tell you that you can’t have an opinion on this because you haven’t been through [a terminal illness]….This topic of assisted suicide needs to be about every single one of us. It’s about all of us in our society. It’s about you.”

I can still remember how she looked when she told us that. Ill as she was, she stood up to speak to us. Her voice was gentle but firm. She made eye contact with her listeners. She didn’t read from a script. She spoke from the heart. And I know she was right: it’s about all of us.

Assisted suicide bill draws a crowd

_{Front page headline, Manchester Union Leader, 2/8/24}

New Hampshire’s assisted suicide bill, HB 1283-FN, got its House Judiciary Committee hearing on February 7. For hours, the committee heard passionate testimony for and against. Supporters insisted that the “end-of-life options” bill was about something called “medical aid in dying” (MAID). They were countered by Granite Staters who refused to accept Orwellian language. Instead, they stood by the fact that an act of deliberate termination of one’s own life is suicide, facilitating that act is assisted suicide, and that killing in the name of compassion isn’t compassion at all.

Both the Union Leader and WMUR led their reporting later in the day with the accurate language: “assisted suicide bill.”

According to the House calendar, the Judiciary Committee will vote on HB 1283-FN on Thursday, February 15. End-of-life bills, unlike abortion bills, seldom break down along the party lines. How this bill will come out is anyone’s guess.

An old topic, a familiar theme

It’s been more than thirty years since I attended my first hearing on a New Hampshire bill, which happened to be a piece of end-of-life legislation. I just looked it up to refresh my memory: 1989, a durable power of attorney (DPA) for healthcare bill, sponsored by the late Sen. Susan McLane (whose daughter now represents New Hampshire’s Second Congressional District). All about patient autonomy and choice, said the sponsors. Opponents weren’t buying that; they were concerned that the document, and its cousin the living will, were more about relieving doctors of liability for non-treatment of terminally ill patients. The debate was an eye-opener for me, illuminating the fact that care for terminally and chronically ill people is very much a pro-life issue.

Even then, speaking to a committee as my two toddlers squirmed in the chair beside me, I knew there was something that just didn’t ring true in all the talk about “choice.”

Since then, DPAs and living wills have become routine. The outlines of the policy debates on end-of-life issues haven’t changed much. What we have now that we didn’t have in 1989 are assisted suicide laws in several states and foreign countries. Those laws, ostensibly written to apply only to people with a terminal illness, have a history of being expanded bit by bit. (Check out “The Danger of Assisted Suicide Laws” by the National Council on Disability for more on this.)

NH House Judiciary Committee hearing on HB 1283-FN, February 7, 2024. Photo: NH Coalition for Suicide Prevention (Facebook page).

A “toe in the waters”

So here we are in 2024, and HB 1283-FN has brought an assisted suicide debate to New Hampshire. It was a lively hearing at the House Judiciary Committee, and many people who couldn’t attend expressed their opinion online (641 in favor, 1112 opposed).

My notes on the hearing are disjointed and sketchy, since I was unable to remain for the whole time. Anyone who wants to listen to the hearing can do so on the House Judiciary Committee’s YouTube channel. The recording is nine hours long, and HB 1283’s hearing was split into two sessions that were at the beginning and end of the committee’s workday.

I was present to hear this, however: chief sponsor Rep. Marjorie Smith (D-Durham), in a moment of candor, noted that HB 1283 was only the beginning. “This is a very narrow and conservative bill….[to] put [NH’s] toe in the waters.” That “toe in the waters” line has stayed with me ever since. I wonder what the figurative deep end of the pool looks like to Rep. Smith. Fellow sponsor Rep. Steven Woodcock (D-Center Conway) said he was there “on behalf of all the citizens of New Hampshire.” I’ll receive him of at least some of his burden: he wasn’t there for me.

It was standing-room-only for the hearing. A crowd that would have done justice to Representatives Hall filled a large committee room in the Legislative Office Building even before the 10 a.m. starting time. Seeing the turnout, House staff quickly set up a video feed in a smaller room down the hall to accommodate the overflow crowd. Even that wasn’t enough, as people stood in the hallway hoping to hear. 

People on both sides spoke of caring for loved ones near death. Some urged the committee to legalize suicide as a medical treatment. They cited opinion polls and safeguards to bolster their arguments. Opponents of the bill warned that any assisted suicide law in New Hampshire would surely go the way of such laws in other states, which have been expanded despite “safeguards.” People spoke of their religious beliefs about the value of life, doing so even after those beliefs were dismissed and discounted by some of the bill’s supporters.

“Safeguards” aren’t persuasive

There were purely secular arguments against the bill, too.

Disability-rights advocates were blunt about the ableism inherent in such legislation. It creates an option that tends to steer medically-vulnerable individuals to non-treatment. No matter the “safeguards” written into assisted suicide laws, killing is always cheaper than caring. When third-party payers and overburdened health care providers consider assisted suicide a form of medical care, that’s bad news for anyone dealing with a chronic condition

A few days before the hearing, the New Hampshire Coalition for Suicide Prevention (zerosuicidesnh.org) held a 30-minute Facebook Live press conference with representatives of various groups who oppose the bill. If you can only listen to one part of it – and it’s all worth hearing – listen to the statement of Lisa Beaudoin of Strategies for Disability Equity. She was at the hearing and she delivered the same message: medical ableism is all over assisted suicide legislation, and it’s a threat to anyone who’s medically vulnerable..

I couldn’t help but think as I listened to the testimony that the sponsors of the bill were tiptoeing very carefully around the issue of third-party payers. For many people, out-of-pocket medical costs are dependent on the provisions of health insurance including Medicaid and Medicare. Once assisted suicide is authorized as a medical treatment, there’s no safeguard to prevent an insurer from refusing to cover treatment for a disorder while being willing to cover suicide drugs for the same condition.

Of course the third-party payers won’t call it “suicide.” None of the supporters of HB 1283-FN wants the word “suicide” used to describe the direct intentional termination of one’s own life. As with earlier assisted suicide bills in New Hampshire and similar laws elsewhere, the bill calls for falsification of death certificates. The cause of death for anyone committing suicide pursuant to the bill would be listed as the underlying terminal condition, not suicide-by-drug.

“Lean into life.”

Representatives Glenn Cordelli (R-Tuftonboro) and Katherine Prudhomme-O’Brien, opposing the bill, each shared with the committee a difficult and moving account of supporting a family member through terminal illness. As best he could with a three-minute limit on oral testimony, Rep. Cordelli described how his sister, who died from cancer, relied on pain medication near the end of her life but did not seek to hasten her death. Representative Prudhomme-O’Brien lost her family member just last year, and her emotions were close to the surface as she said, “We can lean in toward life or we can lean against it. We should take every opportunity we can to lean into life.”

Physicians and other health care professionals weighed in on both sides. I’ll mention just a few. It was good to hear a Dr. Eddinger, a physician from Catholic Medical Center in Manchester, warn of how “diagnosis creep” seems to follow assisted suicide laws, making more and more patients eligible for prescribed death. Another doctor who testified – and I’m sorry I didn’t catch his name – took note of Rep. Smith’s toe-in-the-water remark. “This bill could be a Trojan horse, unintentionally.”

Kevin Grady, a member of the New Hampshire State Veterans Advisory Committee, told the committee “this bill scares our members right out of their socks.” No surprise there. As the mother of a veteran, I’m aware of (and grateful for) public service campaigns to raise awareness of the risk of suicide among military veterans. Those campaigns are based on the belief that suicide is something to prevent. An assisted suicide law would deliver precisely the opposite message.

And now, we wait for the committee’s vote.

Interim study on assisted suicide bill yields committee recommendation

The New Hampshire House Judiciary Committee voted 10-8 on September 1 to recommend that legislation addressing assisted suicide be considered in a future legislative session.

This is not the passage of any specific bill. It’s only a recommendation. This post is not a call to action, only a report. Here’s how we got here.