Debate continues on Virginia bill to legalize physician-assisted death (2024)

RICHMOND— George Michael Vasiloff loved music, his family and barbecues. The native Minnesotian played saxophone and clarinet and performed in the Marine Corp. band. He shared his love of music with his daughter, and they played in the church choir together. It’s a fond memory, said his daughter Kate Vasiloff.

George Vasiloff was diagnosed with Lou Gehrig’s disease in September 2013.Amyotrophic lateral sclerosis, or ALS, is a progressive disease that attacks nerve cells that control muscles. The condition can result in the loss of movement, speech, eating and breathing, according to the ALS Association.

KateVasiloff and her father stayed up late to talk the night he was diagnosed. George Vasiloffwas terrified of what the disease would do to their family, and what his family would watch him go through.

His daughter assured him it was OK to pass on his terms.

“I wanted to give him any slice of peace I possibly could,” Vasiloff said.

Her father slept well for the first time since his symptoms started because he felt he would have control if things got bad, she said.

He passed in his sleep 18 months after his diagnosis.

Vasiloff believes people should have a choice in their death.

“Why don’t we give people the autonomy to make decisions about their own body when their body is failing them?” Vasiloff said.

Vasiloff has lobbied since 2020 for physician-assisted death with the organization Compassion & Choices.

Physician-assisted death is being discussed more as states introduce legislation, including Virginia, Illinois, Michigan, Minnesota, Missouri, North Carolina, and Tennessee, among others.

People are polarized around the procedure; divided by theconceptof a person’s free will versus accepting their fate. Many physicians oppose it on the principle of their oath to heal. Faith leaders believe it goes against the will of God.But, people on both sides of the issue say it is about respecting human lives.

The process islegalin California, Colorado, Hawaii, Maine, Montana, New Jersey, New Mexico, Oregon, Vermont, Washington, and Washington, D.C., according to Compassion & Choices. Several states havependingamendments.

Legislation on physician-assisted death was recently voted down in Virginia; there have been attempts to legalize the procedure since2019.

Sen. Ghazala Hashmi, D-Richmond, sponsoredSenate Bill 280this year, which would allow an adult diagnosed with a terminal disease to seek a physician’s approval to end their life. Hashmi worked with Compassion & Choices to draft the bill, in response to constituent requests, she said.

“They want to die in Virginia and they want to be able to have ownership over their final decisions in that regard,” Hashmi said.


Physician-assisted death explained

Physician-assisted death is when a life-ending prescription is given to a patient by a physician. The patient takes the dose on their own. The process differs from euthanasia, when a doctor administers the drug and causes the death directly, which is legal in some countries but not the U.S.

“This is a bill that expressly is concerned with terminal illness, and disability is not a terminal illness, depression is not a terminal illness — and we have those safeguards in place to protect the individuals in making the right decision for themselves,” Hashmi said.

SB 280required that to be eligible for physician-assisted death, an individual must be a mentally competent adult and have a terminal illness with a diagnosis of six months left to live. Two oral statements and a written statement must be given to a medical provider, according to Hashmi.

The Virginia legislation created a Class 2felonyfor anyone who interfered with a patient’s end-of-life request, or coerced a patient to request the procedure.

Former Virginia congresswoman Jennifer Wexton could be considered the face of the legislation, Hashmi said. Wexton was diagnosed in 2023 with progressive supranuclear palsy, which affects motor functions and has no cure. Wexton will not seek reelection in the fall.

Wexton issued a statement of support for Hashmi’s bill that was read ahead of the final vote in the Senate.

“Prohibiting willing physicians and their terminally ill patients and our families from working together to create an end-of-life plan that is peaceful, humane and allows us to maintain our dignity is needlessly cruel,” Wexton stated.

The Oregon Death with Dignitylawin 1997 was the first to be enacted in the U.S. and has similarsafeguardsas Virginia’s proposed legislation.


View from hospice and palliative doctor

About 1.7 million Medicare beneficiaries receive hospice care each year, and Medicare pays about $23 billion annually for hospice care,accordingto the U.S. Department of Health and Human Services.

In Virginia, 46.2% of Medicare beneficiaries used hospice care in 2020, according tofiguresfrom a National Hospice and Palliative Care Organization report.

The American Medical Association says the process directly goes against the role of a physician toheal.

Dr. Andy Arwari is a hospice care worker and palliative care physician who warned against legalizing physician-assisted death.

Dyingpatientsreceive specialized care through hospice to make life as comfortable and peaceful as possible before a natural death. The core philosophy of hospice is not to speed up or delay death and a hospice care worker is not going to end a life prematurely, according to Arwari.

Under currentlaw, a licensed health care provider would have their license revoked, or suspended, for providing or administering life-ending drugs.

Medical care has an interdisciplinary approach that treats physical ailments but also focuses on psychosocial, and spiritual elements to ensure a patient is cared for on many levels, according to Arwari.

“Are we sure that we have explored all the possibilities and explain why that patient is suffering,” Arwari said. “Did we exhaust every possible avenue to resolve that suffering before getting to that option of medical assistance in dying?”


Religious opposition

Jeff Caruso, executive director of the Virginia Catholic Conference, lobbies for hospice and palliative care for end-of-life patients. Quality, affordable health care is seen as a right within the Catholic Church, Caruso said.

The Catholic Church teaches that every suicide is a tragedy, regardless of if it is approved by a physician. The government should advocate for the common good and respect life, according to Caruso.

“The government still has an obligation to do everything that it can to prevent suicide rather than promote suicide,” Caruso said.


End-of-life care or doulas

Reamey Belski is an end-of-life doula, also known as a death doula. They are nonmedical professionals who provide specialized care for the dying, which can include spiritual, emotional and logistical care.

Death doulas are often mediators between family members with caregiver fatigue and hospice care workers, according to Belski.

Belski estimated she has served as an end-of-life doula for approximately 25 people.

A patient’s quality of life and environment is important to a death doula. If someone with a terminal illness is suffering greatly and wishes to end their life, they should have a right to do so in every state, said Belski.

A person chooses physician-assisted death when they wish to live but their body will not allow it, and she does not consider it suicide, Belksi said.

“I think people who get caught up with the issue of medical aid in dying start blurring the lines between the two and they’re very, very different things,” Belski said.

Vasiloff also does not consider it suicide, saying “people with terminal illnesses desperately want to be here.”

The first sign of her father’s ALS happened when he could not lift his foot. The actual diagnosis took months, but his decline came on fast, putting him in a wheelchair just a month after his diagnosis, Vasiloff said.

She was thankful that up until his death he could still talk, eat and drink — three of his favorite things. Those memories, just like their time in the church choir, stay with Vasiloff as she finds herself advocating for a change in state law.

“I never thought that I would be sitting here talking to you about this, and this involved in this issue,” Vasiloff said. “I’m grateful that I have somewhere to put my energy and do this work in my dad’s name.”

VCU InSight journalist Chelsea Brooks-Giles contributed to this report.

Capital News Service is a program of Virginia Commonwealth University’s Robertson School of Media and Culture. Students in the program provide state government coverage for a variety of media outlets in Virginia. VCU InSight is the capstone broadcast news program.

Debate continues on Virginia bill to legalize physician-assisted death (2024)


Debate continues on Virginia bill to legalize physician-assisted death? ›

Legislation on physician-assisted death was recently voted down in Virginia; there have been attempts to legalize the procedure since 2019. Sen. Ghazala Hashmi, D-Richmond, sponsored Senate Bill 280 this year, which would allow an adult diagnosed with a terminal disease to seek a physician's approval to end their life.

What is the end of life bill in Virginia? ›

RICHMOND, Va. (AP) — Virginia lawmakers on Monday defeated for another year legislation that would allow certain adults facing terminal illness to end their own lives with a self-administered controlled substance prescribed by a health care provider.

What is the End of Life Option Act? ›

California's End of Life Option Act (EOLA) became effective on June 9, 2016. The EOLA allows terminally ill adults living in California to obtain and self-administer aid-in-dying drugs. 1,2 The EOLA requires the California Department of Public Health (CDPH) to provide annual reports under strict privacy requirements.

How does medical aid in dying work? ›

Medical aid in dying (MAID) is a practice in which a physician provides a competent adult with a terminal illness with a prescription for a lethal dose of a drug at the request of the patient, which the patient intends to use to end his or her life.

What is the definition of physician-assisted death? ›

In this context, physician-assisted death—also referred to as physician-aided death, physician aid-in-dying, or physician-assisted suicide—refers to a physician providing a patient who requests aid-in-dying a prescription that the patient can self-administer to end his or her life.

Can nurses call time of death in Virginia? ›

The nurse, licensed practical nurse, or physician assistant shall have the authority to pronounce death in accordance with such procedural regulations, if any, as may be promulgated by the Board of Medicine; however, if the circ*mstances of the death are not anticipated or the death requires an investigation by the ...

What is the death benefit in Virginia? ›

The death benefit is a one-time payment made to a beneficiary or the beneficiaries of deceased eligible employees or volunteers: It is paid based on the will of a deceased employee or volunteer. If there is no will, the benefit is paid according to the order of precedence as defined in the Code of Virginia.

What medications are given for the end of life? ›

Common anticipatory medicines include the following:
  • Medicine for pain in palliative care – an appropriate opioid, for example, morphine, diamorphine, oxycodone or alfentanil.
  • Medicine for breathlessness – midazolam or an opioid.
  • Medicine for anxiety – midazolam.
Jul 6, 2022

How long does an end of life plan last? ›

End of life care should begin when you need it and may last a few days or months, or sometimes more than a year. People in lots of different situations can benefit from end of life care. Some of them may be expected to die within the next few hours or days. Others receive end of life care over many months.

What is the difference between end of life care and euthanasia? ›

Palliative sedation is medication used to ease pain for terminally ill patients. 1 Death may follow the administration of these drugs, but the medications are not given with the intent to end life. This makes palliative sedation different from euthanasia or physician-assisted suicide.

What are the cons of medical assistance in dying? ›

Four Problems with Physician-Assisted Suicide
  • Endanger the weak and vulnerable,
  • Corrupt the practice of medicine and the doctor–patient relationship,
  • Compromise the family and intergenerational commitments, and.
  • Betray human dignity and equality before the law. [3]
Mar 30, 2015

Why medical assistance in dying should be legal? ›

6. Medical Aid In Dying helps family members cope with loss. Studies show that family members of those who request Medical Aid In Dying feel better prepared and are more accepting of the death, and that there are no negative effects.

What are the arguments against medical aid in dying? ›

Lay Summary: Presented here are four non-religious, reasonable arguments against physician-assisted suicide and euthanasia: (1) “it offends me,” suicide devalues human life; (2) slippery slope, the limits on euthanasia gradually erode; (3) “pain can be alleviated,” palliative care and modern therapeutics more and more ...

What symptom is commonly seen at the end of life? ›

Confusion or Withdrawal from Others

State of mind is different for every person approaching death. Hallucinations, confusion, and reduced responsiveness are common near the end of life.

What is another name for medically assisted death? ›

Euthanasia – that is, an assisted death carried out by a health care professional – is not available in the U.S. but is legal in Canada, Belgium, the Netherlands, Luxembourg and Colombia.”

How much does physician-assisted death save? ›

Extrapolating from the Medicare data, one can calculate that a typical uninsured patient, by dying one month earlier by means of physician-assisted suicide, might save his or her family $10,000 in health care costs, having already spent as much as $20,000 in that year.

What is the Natural death Act in Virginia? ›

The Virginia Natural Death Acf' allows a competent adult to make a written declaration49 directing the withholding or withdrawal of life-prolonging procedures in the event such person should have a tenninal condition.

Who is responsible for debt after death in Virginia? ›

It is the role of the executor of the estate to pay the deceased person's outstanding bills. If you are the executor, you may want to consult with a lawyer about your state's probate process and laws. There may be specific regulations on the order that the debts should be paid.

Does power of attorney end at death in Virginia? ›

In Virginia, all powers of attorney are durable, meaning they last until you die. Your durable power of attorney will end if: You revoke it. You can do this at any time as long as you're mentally competent.

What are end of life medical costs? ›

The average end-of-life spending per person for this population will be $10 000. Now imagine another 200 sick people in Minneapolis, whose average health care expenditures are $5000 per person, but 150 of those people die.


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