By Maggie Dougherty
Capitol News Illinois
mdougherty@capitolnewsillinois.com
CHICAGO — Terminally ill adults in Illinois may have the option to take life-ending
medication prescribed by a physician under a bill passed by the Illinois legislature last
week during its fall session.
Advocates for the bill say it is rooted in compassion and will bring agency to already
dying people in the last stages of life, while opponents cite religious concerns and
potential harm to vulnerable populations.
The Senate voted 30-27 to pass Senate Bill 1950 in the early morning hours on Oct. 31
after the House passed it 63-42 in May. The legislation needs only the governor’s
signature to become law and, if signed, would take effect after nine months.
The bill received support from advocates like Suzy Flack, formerly of Chicago, who has
pushed for the legislation in honor of her son Andrew, 34 at the time of his death from
cancer in 2022. Andrew chose to live in California and utilize the state’s medical aid in
dying options, which were not available in Illinois at the time. He is one of several
advocates named in the bill text.
What’s in the bill?
The bill sets specific requirements for eligibility to receive end-of-life medication.
Patients must be Illinois residents 18 or older who have a terminal disease that is
determined by two physicians to result in death within six months.
A diagnosis of major depressive disorder does not alone qualify patients for end-of-life
medication.
Patients requesting treatment must make both oral and written requests for aid in dying.
A physician would then need to evaluate the patient’s mental capacity and evaluate
potential sources of coercion or undue influence and inform the patient of alternative
hospice care and pain control options before writing a prescription for life-ending
medication.
Those who qualify must be able to self-administer the medication, as no one else is
permitted to administer it to them. Patients who qualify and receive medication have the
right to withdraw their request at any time or choose not to ingest the medication.
Death certificates of those who take end-of-life medication under the bill will attribute
their cause of death to the underlying terminal disease, not suicide.
Bill sponsor Linda Holmes, D-Aurora, said on the Senate floor that there are “over 20
guardrails in place” to prevent coercion and abuse, pointing to Oregon’s 28-year history
of providing medical aid in dying care.
“In the years that this has been in effect in Oregon, starting in 1997, there have been no
substantiated cases of coercion or abuse,” Holmes said.
Including Oregon, 10 states and the District of Columbia have legalized medical aid in
dying. Illinois would be the first Midwestern state to do so.
Guardrails explained
Critics of the bill felt there were not enough safeguards in place to prevent harm. Jil
Tracy, R-Quincy, raised concern about the six-month diagnosis window, saying that
advancements in modern medicine can allow people to outlive their diagnoses.
Holmes said this is not common, as doctors tend to overestimate patients’ prognosis.
“There aren’t that many patients that outlive what that prognosis ends up being,”
Holmes said. “Those that do are very likely not to take the medication until they get to a
point where the pain has gotten so bad.”
Only 62% of patients prescribed the medication end up taking it, Holmes added.
Tracy and other senators additionally voiced concerns about potent drugs, which
patients would bring into their homes to self-administer, falling into the hands of young
people struggling with mental health.
“There’s no controls over who might access it besides the patient,” Tracy said. “In this
day and age, we have young children that have suicidal thoughts.”
Brian McCurdy, who began advocating for medical aid in dying after the death of his life
partner Harriet, said the bill doesn’t introduce any risk that is not already there.
“Right now, there’s very little control over the medication, the morphine, that’s being
given to hospice patients in a home setting,” McCurdy said. “So, I don’t think this
legislation creates more opportunities for bad things to happen.”
After someone dies in hospice, the medication is collected by a hospice nurse or other
medical provider. McCurdy said he expected the same to be true for planned deaths
under this bill.
Tracy also raised concerns about coercion of disabled or elderly populations,
particularly that the bill did not prevent heirs from acting as one of the two witnesses
required to sign the patient’s request for end-of-life medication.
Impact on physicians, culture
Sen. Steve McClure, R-Springfield, quoted studies finding very high rates of death by
suicide among veterinarians, in part due to the toll of euthanizing animals. McClure
likened veterinarians to physicians who care for humans, suggesting the provision of
end-of-life care would create a mental health crisis among medical professionals.
The American Medical Association has long opposed the practice of physician-assisted
aid in dying, calling it “fundamentally incompatible with the physician’s role as healer”
and stating that it would pose “serious societal risks.”
The bill does not require physicians to prescribe end-of-life medication and protects
physicians from civil or criminal liability and professional discipline for either prescribing
or refusing to prescribe aid-in-dying care.
“One of the things I love about the legislation that we’ve passed in Illinois is that it’s not
going to require anybody who’s in opposition to be involved,” McCurdy said. “Not
patients, not family, not doctors, not pharmacists. Nobody who doesn't want to be
involved is going to have to be involved.”
Sen. Chris Balkema, R-Channahon, called the bill “a slippery slope” and pointed to
other states expanding options for medical aid in dying after what was initially
introduced, including Oregon removing its residency requirement.
“It’s not right to introduce a culture of death into Illinois,” Balkema said.
Advocates of the bill said it is not introducing a culture of death but rather giving agency
to those who are already actively dying.
“I don’t like the term assisted suicide, I feel that is very insulting because people with
terminal illness want to live,” Suzy Flack said of her son Andrew. “He fought for many
years; he wanted desperately to live.”
Balkema spoke from his experience witnessing both of his parents die in hospice in the
past three years. Both were at peace with their deaths, Balkema said, and both said
they were ready to go “when the Lord wants to take me.”
“Those are hard words to hear but also comforting to know that we are not in control,”
Balkema said.
But advocates of the bill say having that control is crucial.
Compassion, not suicide
Sen. Laura Fine, D-Glenview, thanked legislators for a heartfelt discussion on medical
aid in dying.
“This is a very personal issue and it’s an issue that is about choice,” Fine said. “This is
not suicide, it is compassion.”