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Assisted Suicide Ban Act passed with mixed reactions

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Alabama’s new Assisted Suicide Ban Act will make assisting in the death of others illegal in the state starting in August.

Some say the law was written in support of a patient’s right to live. Others, however, worry about the burden it places on those charged with providing pain medication to those patients.

Before the new law, which was signed by Gov. Kay Ivey in May, Alabama didn’t have a specific law dedicated to banning assisted suicides, according to Sen. Phil Williams, R-Rainbow City.

This law prohibits health care professionals and others from aiding in the death of a person under certain conditions. Those who aid in the death of another person can now be charged with a Class C felony, punishable by up to 10 years in prison.

Gregory Pence, a bioethicist at the University of Alabama at Birmingham, believes this could cause doctors to worry when giving ill patients pain medication because the dosage can speed up the dying process as a side effect.

“It can make doctors hesitate to aggressively treat the pain,” Pence said.

Pence thinks that the new law will hurt patients without affordable health care who can’t afford treatments. Furthermore, he said pain medication is not a viable option for every disease.

Despite this being the state’s first law directed against assisted suicide, Dr. Walter T. Geary Jr., assistant state health officer for regulatory affairs for the Alabama Department of Public Health, said medical codes of ethics have discouraged assisted suicide over the years. In addition, he said Alabama’s Natural Death Act covered issues around assisted suicide without specifically mentioning assisted suicide.

According to Alabama’s Natural Death Act, anyone who “falsifies or forges” a do not resuscitate order or advance directive, with the intent to withhold life-saving treatment against a patient’s wishes, faces a Class C felony. The law does not mention cases where a patient asks to die.

Geary worked at regular office practice for 20 years and then switched into hospice work for 10 years.

“I took care of a lot of people at the end of their lives, and our goal was to do whatever it took to make them comfortable ... not end their lives,” Geary said.

He thinks the law will have little effect on the medical field. He said there is a chance someone could judge a final dose of pain medicine as the cause of a death. Geary said if nurses and physicians document their treatments thoroughly in their reports, they should stay out of legal trouble.

“Even a very careful investigation will turn up nothing that can be used against you in court,” Geary said.

The Assisted Suicide Ban Act says that medical professionals following a patient’s wishes to withhold or withdraw life-sustaining treatment is not punishable by law. It also states prescribing pain medication or palliative care as an illness runs its course is not punishable by this law. It also said state executions “by any means” are not punishable.

Williams said the law will have no effect on hospice care, the prescription of pain medication or the decision to stop further treatment in a terminal illness situation. He said the law acts as a preventive measure in a growing trend of allowing assisted suicides.

According to the Death with Dignity national center, five states have passed statutes legalizing “assisted dying” and one state has made the right to die legal by a court decision. Efforts to reach the Death with Dignity officials were unsuccessful.

State Rep. Mack Butler, R-Rainbow City, sponsored the original bill, HB 96, stating that it acted as a preventive measure.

“Where the concern is for people that are maybe depressed,” Butler said.

Butler said he met with a hospice doctor in his district to ensure that the bill did not hurt the medical field. He said patients still have a right to refuse medical treatment.

Williams works as an attorney at his own practice in Gadsden. He said there have been cases across the country where people have been declared incompetent and their family members have made medical decisions ending their life for the insurance money. Though he personally hasn’t seen a case like this, he said it is feasible, and Alabama’s new law will prevent such cases.

“I see family members try to take advantage of family members all the time,” Williams said.

Anne Moses is a certified elder law attorney at Moses & Moses law firm in Birmingham. She said she’d never heard of an instance like the kind Williams described.

“I have never had that situation and I don’t know of anyone who had — not to say it couldn’t happen,” Moses said.

Moses said the new law places a huge liability on doctors, medical professionals and hospitals as a whole. She is concerned that if patients say they’re in pain or agony and don’t want to live, it leaves it up to doctors whether a patient is suicidal or just wanting to halt treatment.

“How do you know?” Moses said. “How do you prove it? It’s vague and overbroad.”

Moses said theoretically, a person’s advance directive and living will is protected, but there are nuances.

“While there are protections in this particular bill, I don’t think it eliminates the problem,” Moses said.

Though medical and legal implications were considered, Williams and Butler both said the HB 96 was meant to be a pro-life bill. Williams mentioned an incident in Massachusetts in which a girl texted her boyfriend and persuaded him to kill himself. He said this law would protect people in harm’s way and hold those responsible for any deaths that occur.

“It’s just not right,” Williams said. “The reality is we need to recognize the sanctity of life.”

Pence believes people should have the right to be put out of their misery.

“It’s not a patient-friendly bill because when it comes to your own death and what you can and can’t handle, I think people are the best judge of that,” Pence said.