Health

HEALTH • Spring 2018 19 practice. In 1951, just 36 percent of Americans were favorable, according to Gallup. That percentage climbed to 53 percent by 1975, before peaking at 75 percent in 1999 and 2005. For the last 13 years, favorability has ebbed and flowed but remained relatively steady. A survey of MMS members con- ducted in September showed the majority, or 60 percent, of Bay State doctors favor the option, and 62 per- cent say they favor the pending legis- lation. However, only 13 percent of the MMS' roughly 25,000 members responded to the survey. Coalition rejects new position As Dorkin noted in his interview, there are many physicians who are staunchly opposed to the idea of legalizing assisted suicide. They maintain it directly contra- dicts the moral obligation of physi- cians to care for their patients, and that it makes patients vulnerable to a host of issues that proponents might not anticipate, such as problems get- ting coverage for treatment if insur- ance companies believe patients will not survive an illness, or being taken advantage of by family members who stand to gain in the event of the patient's death. One of those physicians is Dr. Mark Rollo, a Fitchburg-based family prac- tice physician and MMS member who is among about 25 doctors who have banded together in opposition of the MMS's new position of neutral engagement. The doctors announced their position during a press confer- ence at the Massachusetts State House in January. Rollo, who has been involved in pro-life causes in the Fitchburg area over the years, including opposing the opening of a Planned Parenthood clinic on Main Street in Fitchburg because the organization provides abortion services, said the MMS' "neutral engagement" position is a euphemism. "It's a cop out, and it is wimpy, weak wording," Rollo said. According to Rollo, his opposition and that of other doctors transcends religious affiliation, and there are non-religious people behind the same cause. "It's much broader than that. It's a moral issue that affects people's lives," Rollo said. Rollo cited two well-known cases in Oregon where Medicaid patients Barbara Wagner and Randy Stroup were denied coverage for drugs that doctors thought might extend their lives because the state-run health plan determined that survival odds weren't great enough. Instead, Wagner and Stroup were reportedly told that they could receive coverage for prescrip- tions to end their life. Assisted-suicide has been legal in Oregon since 1994, making Oregon the earliest adopter of the practice. Since then, Washington, Montana, Vermont, California, Colorado and Washington, D.C. have legalized it, in that order. Is Mass. the new frontier? Rollo said the national end-of-life options advocacy group Compassion & Choices has been promoting pas- sage of an assisted-suicide law in Massachusetts for years, but he said despite changing public opinion, advocates still face an uphill battle in Massachusetts. "I don't think it's a slam dunk that either side is going to prevail," Rollo said. Rollo believes that legalizing assisted suicide will make low- income and minorities vulnerable, actually decreasing their end-of-life options rather than adding one more Dr. Mark Rollo of Fitchburg addresses a crowd at the State House in Boston in January, announcing the opposition of a coalition of Bay State doctors to the legalization of physician-assisted suicide. to the list. He said the focus should be on treatment to improve quality of life and palliative care for those nearing the end, and he doesn't think the proposed bills being con- sidered by legislative committees have adequate safeguards to protect people from coercion into assisted suicide. On the other side of the issue is Rep. Louis Kafka (D-Stoughton) a longtime proponent of legalizing assisted suicide and the sponsor of the House bill. "I look at it as [an option] for the person who chooses to end their life because of an illness that is terminal, and in their minds could be very painful, and under best circum- stances will only allow them six more months," Kafka said in an interview in March. Kafka has been trying to get a bill legalizing assisted suicide passed since a terminally-ill constituent brought the issue to him eight years ago. Kafka said he hasn't been made aware Rollo's concerns that some may be coerced into choosing assist- ed suicide, and he said if that became a reality, he would respond. "If that should happen, I would immediately file legislation that would fine any insurance company that would make that decision," Kafka said, though he added to write that into the bill now may confuse the issue. Both the House and Senate bills have been referred to the Committee on Public Health. This spring, they are expected to either be sent for fur- ther study by a committee or go to the floor for a vote. According to Rollo, the opposing doctor, there are also rumors the issue will go to the ballot in 2020, if it doesn't pass in the Legislature. American opinion of whether physician-assisted suicide should be legal for terminally ill patients who seek it has been relatively flat over the last two decades, peaking in 2005. Source: Gallup Public opinion on assisted suicide 2001 60% 70% 80% 2005 2008 2011 2014 2017 Percent with favorable opinion 75% 73% 65% 68% 67% 69% H

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