January 10, 2019The Journal Record |
OKLAHOMA CITY – An Oklahoma lawmaker is reviving an attempt at legislation that would regulate death certificate listings when residents pursue physician-assisted suicides.
Last year, about a dozen Republican members co-authored a bill that would require additional reporting on death certificates when the patient underwent a physician-assisted suicide. Although the practice is not legal in Oklahoma, it could be at some point, supporters said. And in the event that it becomes legal, the state needs to be tracking the manner in which those patients die. Under this law, if medical examiners failed to report suicides correctly, they would face penalty charges. That legislation existed in House Bill 1495 in 2018, but that didn’t pass. This year, a similar law is pitched in Senate Bill 108.
State Sen. Gary Stanislawski, R-Tulsa, was an author on last year’s measure, and he filed this year’s bill. He said the measure would ensure a level of transparency that hasn’t existed in other states that have legalized, and it could create a layer of accountability for physicians.
States that have legalized the practice usually implement legislation called the Death With Dignity Act. In Oregon, for example, the law allows doctors to prescribe lethal medication to qualifying patients. Officials in that state differentiate euthanasia and physician-assisted suicide based on who administers the drug. If it is the doctor, it is euthanasia, but if it is the patient, it is a physician-assisted suicide.
Many of the states that have considered or implemented these laws contain provisions that require death certificates to omit the patient’s decision to die. In Washington, D.C., for example, the law requires the death certificate to list the patients’ underlying illnesses as their cause of death.
Stanislawski said that in the event Oklahoma legalizes, the death certificate should have to be explicit about whether the death was a physician-assisted suicide, but that the document could still list the underlying illness as a contributing factor.
“The intent is for transparency and to be honest,” he said.
He said it could help reveal behavior by bad actors, such as family members who pressure someone into the suicide or doctors who begin to abuse the program.
The legislation in 2018 and 2019 contains provisions that would have examiners or physicians who submit the reports face penalty charges if they knowingly omit the cause of death as suicide. That was one of the sticking points with critics in 2018. Stanislawski said that he would be open to dropping the severity of that charge.
Supporters of last year’s bill voiced concern that there is little information on the means the patients and doctors have used in other states that have legalized physician-assisted suicide. State Rep. Travis Dunlap, R-Bartlesville, was the House author on the measure last year. He won’t be returning in 2019 because he lost his primary last year.
One of the concerns he raised during the bill’s March 2018 hearing was that physicians and medical examiners were urged to omit the medical techniques used to end lives.
Dunlap said during the March 6, 2018, hearing that the bill had been requested by the National Right to Life chapter in Oklahoma.
When it went to the House floor, it passed 62-26, mostly along party lines. Five Republicans voted against. Democrats spent significant time to question the bill and debate against it. Much of their opposition hinged on the felony provision, in how it could incentivize certifiers to label more overdose deaths as intentional suicides out of fear.
State Rep. Eric Proctor, D-Tulsa, who didn’t run for re-election last year, debated against it. He said it had a freight-train-sized loophole in it because it could allow insurance companies to nix payments for beneficiaries after an accidental overdose was designated a suicide.
State Rep. Emily Virgin, D-Norman, argued against the bill for several reasons. She said the legislation lacked clarity, and it gave medical examiner only three days to decide whether someone intentionally died. It doesn’t lay out how to make that determination, and it penalizes medical examiners who fail to designate a suicide correctly with a felony charge.
“It is rather broad and doesn’t necessarily list physician-assisted suicide,” she said. “There are some situations like palliative care, where someone may be very, very close to the end, and some drugs are introduced. … This could lead to a lot of court battles.”
Former House Minority Leader Steve Kouplen made many attempts to pass so-called right-to-die legislationduring his tenure, but none of those attempts were successful. Kouplen didn’t achieve re-election in 2018.
Oklahoma’s suicide rate has been higher than the country’s overall rate for several years, and both are growing. Across the country, residents saw 13.9 deaths due to self-harm per 100,000 people, according to the United Health Foundation‘s 2018 America’s Health Rankings report. In Oklahoma, that number was 21.4. In 2012, Oklahoma’s rate was 16.7 per 100,000.