The issue of allowing terminally ill, mentally competent individuals to choose to end their lives will be debated once again in the Maryland General Assembly.
While a number of legislators, including the lead sponsor, and advocates who support the option are Jewish, the community is all but united on the issue leading into the start of the legislative session on Jan. 13.
This year’s bill will be called the End of Life Option Act, a name change reflecting that some felt Death with Dignity implied that other deaths were undignified. While there is no debate that choosing to end one’s life goes against halacha, those who support the legislation say it’s about compassion and respect for the ill, and they draw on their Jewish identities in their support.
“It’s not, to me, a matter of being Jewish or not being Jewish, it’s a matter of respecting people to make their own decision at end of life,” said Del. Shane Pendergrass (D-District 13), a Howard County politician and the bill’s lead sponsor. “Do I think that’s a Jewish value? Actually, I do.”
Pendergrass and advocates who support the bill were upset with the Baltimore Jewish Council’s testifying against the bill during last year’s session and at a workgroup meeting in the fall. The BJC plans to revisit the issue when a new bill is introduced. Executive director Art Abramson said he doubts the council would ever support the bill, but it’s possible the organization could step back and not lobby heavily against it.
This year’s End of Life Option Act, modeled partly after California’s law, will be similar to last year’s Death with Dignity Act. It would allow patients with a six-month prognosis to obtain a prescription for a lethal drug from a physician. The patient must be the one making the decision to take the drug and must be able to take the drug without assistance.
A workgroup convened this fall to make changes to the bill. Some of those proposals include changes to documenting witnesses, requiring that one of two witnesses not be a relative or beneficiary, and to some other reporting requirements. Other proposals include listing the cause of death as “pharmacologically accelerated imminent natural death,” and sponsors want to include a mandatory private consultation between the patient and his or her doctor to ensure there is no coercion.
Pendergrass said a large number of Jews testified in favor of the bill last session.
“The quote that stays with me and will continue to stay with me, hauntingly, is, ‘Everyone is one bad death away from supporting this bill,’” she recalled.
The quote that stays with me and will continue to stay with me, hauntingly, is, ‘Everyone is one bad death away from supporting this bill.’
— Del. Shane Pendergrass
Pendergrass said she was “personally discomforted” by the experience of the Baltimore Jewish Council testifying against her bill last session and stopped contributing to The Associated: Jewish Community Federation of Baltimore because of that experience.
“I think this was a place where if you believe in your religion that this is the wrong thing to do, then don’t do it,” she said. “But if you want government to not be run by religion, then let the government be run by secular rules, and use your religious energy for other things.”
For Ruth Goldstein, Baltimore-area coordinator for Compassion and Choices, a nonprofit that advocates for end-of-life choice, supporting this legislation is consistent with her Judaism.
“This is completely consistent with how Reform Jews practice and interpret Judaism, and there is no conflict. The Bible says you should stone people to death if you commit adultery, and we don’t do that today,” Goldstein said. “I think compassion is sort of the prime directive for my brand of Judaism, and this doesn’t conflict in any way.”
But for the Baltimore Jewish Council, it does conflict.
“We’re not going to support it. We can’t for halachic reasons,” Abramson said.
The BJC’s position was adopted in 1997. In the spring of 2015, the BJC called a group of rabbis from across the denominational spectrum, some of whom were executive committee members, who unanimously agreed to oppose the bill. Abramson said when the new bill is introduced, the executive committee will take a look at it and may ask the full board to make a decision on how the BJC should proceed.
“I haven’t had any rabbi call me and say to me, ‘Well, we should support this bill,’” Abramson said. “What I’ve had [is people asking], ‘Is there a way we can deal with the issue without going [into] full-hearted testimony?’ …I wouldn’t be surprised if it goes in that direction.”
Abramson said he is aware that people were upset with the council over last session’s testimony.
Ron Halber, executive director of the Jewish Community Relations Council of Greater Washington, said his organization opposed the law last year and will again this year.
“It’s not going to be the primary item on our legislative agenda, but we would be willing to participate in broad coalitional efforts or testify,” he said, adding that the council has a longstanding policy that asserts its position on the upcoming legislation and that it is consistent with different denominations. He has not personally heard from Jews who support the legislation, but he doesn’t rule out that they exist.
“These issues are obviously highly emotionally charged and extraordinarily personal and complex, but we still feel [opposing the legislation is] where the Jewish community maintains a pretty strong consensus,” Halber said.
Norma Cohen, a Mount Washington resident who is active with Compassion and Choices, wants the BJC to put the issue to a full board vote. She authored a column in the Nov. 6 Jewish Times, “Baltimore Jewish Council Doesn’t Represent Me.”
“Times have changed, medicine has changed, and laws have changed,” she wrote. “It is time for the full board of the Baltimore Jewish Council, not just its executive committee, to revisit this very important issue and reach a consensus that reflects the entire spectrum of the Jewish community, not just a segment of it.”
Rabbi Rhoda Silverman of Temple Emanuel, a Reform congregation in Owings Mills, agreed that Jewish perspectives can be updated for the times.
“Judaism values life. The laws that were created that talk about this, extending life and doing anything to pursue life, could not even imagine the medical technology that we have today, and I don’t believe those rabbis would have made those same decisions as they would have today,” she said. “When somebody is in an unbearable amount of pain and they know where this is going … I feel like the Jewish response should be to allow them to die with dignity. To me there’s no other response.”
Rabbi Ariel Sadwin, director of Agudath Israel of Maryland, disagreed.
“We are not in charge of when we live and die, that is something that is decided from upon high,” he said. “Wherever you’re going to look in the text that shapes our observance, there’s no place for something like that.”
Del. Shelly Hettleman (D-District 11), who co-sponsored the bill last year, said this was an issue that was brought up at her first community meeting at someone’s home when she was campaigning.
“It was really very, very important to the people there,” she said. “They impressed upon me — and many of them were older adults — how important this issue was to them, and that stayed with me.”
She said numerous constituents have expressed their support to her as well on the issue.
“I think it gives people a lot of peace of mind to know that they have an option if they are terminally ill,” she said. “I firmly believe people should have the ability to make those choices for themselves at the end of life.”
She was present for a film screening of “How to Die in Oregon” presented by Compassion and Choices, which she recommends people watch to see how it actually works. The documentary, which explores how the state’s Death with Dignity Act has played out, will be screened for free at 1 p.m. this Sunday at Har Sinai Congregation.
Del. Dan Morhaim (D-District 11) will be present for the Har Sinai screening. A practicing ER physician, Morhaim has researched and written extensively on the issue of elderly care and authored a book, “The Better End,” on the subject.
He said people should take advantage of advanced illness and end-of-life care options that are available such as advance directives, hospice and palliative care, the support of family and health professionals and medical cannabis when it becomes available in Maryland.
“If we did so, a significant number of end-of-life care issues would be better managed,” he said. “However, there will always be outlier cases and circumstances that are not addressed by the above. But by using these tools (advance directives, hospice, etc.), these cases will be minimized.”
He said he looks forward to reviewing this year’s legislation and hearing from constituents.
For those pushing for the bill, the feeling is positive this year. With the workgroup amending the bill, 25 bills being introduced in 25 states in 2015 and the support of House Speaker Michael Busch, 2016 may be their year.
“I think the climate is a little bit different this year,” Goldstein said, “and we’ve had time to do some outreach and education and let people know what this really is as opposed to what it’s not.”