At the end of our lives, some of us will endure terrible pain and a quality of life we find unendurable and without dignity. In Rhode Island we are not legally permitted to evade that fate. We are compelled to suffer and endure.

Representative Edith Ajello (Democrat, District 1, Providence) introduced legislation that would provide a choice to those facing such a fate. The Lila Manfield Sapinsley Compassionate Care Act, upon passage, would provide a mechanism for terminally ill patients to choose to end their life using physician prescribed drugs.

Lila Manfield Sapinsley was a Republican Rhode Island State Senator. Ajello has introduced the bill for the last three years.

Here is Ajello, introducing the bill:

For some, the idea of choosing death in the face of end-of-life pain challenges their beliefs about God and morality. They believe that suffering is an inevitable blessing that should not be avoided even if the limits of palliative care have been reached. If presented with the choice of death or suffering, they feel compelled to choose suffering. They also seem to believe that their choice should be the only choice allowed by law.

For instance, the first person to testify Wednesday evening on Representative Ajello’s bill was Dr Timothy Flanagan, who identified himself as “an HIV and infectious disease doctor” who provides end-of-life care at Rhode Island Hospital and Miriam Hospital.

Flanagan is an impressive person. He went to Liberia to utilize his knowledge of infectious disease during the recent Ebola outbreak.

Flanagan gave testimony opposing the bill, saying that pain medication has advanced in the last few years, making pain manageable, though he admits that there are still times where pain is “intractable.” In those cases, Flanagan says there is “palliative sedation” now available.

As for loss of dignity and an unacceptable quality of life, Flanagan sees this as another form of pain, “reactive depression,” that can arise at the end of life. “It’s normal,” said Flanagan. It’s normal to want to give up, to want to end their life, “to short circuit this process [dying] and end it early.”

Flanagan argues that offering physician assisted suicide, when a patient is suffering, is destructive to patients and families. It takes advantage of their vulnerability

What Dr Timothy Flanagan did not tell the committee is that he is not only a Doctor, he is also a Deacon in the Roman Catholic Church.

Perhaps Flanagan’s insistence that that suffering patients must endure pain or be pumped full of drugs, even to the point of “sedation,” doesn’t wholly stem from his medical knowledge, but also from his Catholic faith.

Debbie Flitman spoke in favor of the bill on behalf of the Humanists of Rhode Island (Full disclosure: I am a co-founder of that group, and Debbie Flitman is my friend.)

“I am also here as a Humanist Jew, because I feel that at the end of my life, my choices should be mine, and not based on someone else’s religious convictions,” said Flitman.

Humanists are strong believers in the separation of church and state, and also belive that we all must make decisions about our own lives and deaths according to our own beliefs.

Flitman told the emotional story of watching her mother die, in pain, from pancreatic cancer. Her mother did not want to die that way.

Ending one’s life when in severe pain when there is no hope of recovery does not go against Flitman’s principles or morals. “This bill will give me the freedom to choose,” said Flitman.

Emily Titon did not speak from the position of religious faith. Titon is a disability rights activist whose objection to the idea of physician assisted suicide is rooted in the disparity of care available under our “broken” for profit health care system. She is associated with the group Not Dead Yet, a disabilities rights group “that has long opposed euthanasia and assisted suicide.”

“A lot of people can’t access the care that they need, to have dignity” said Titon, “when Medicaid and Medicare dictate what care they can have.”

Titon said that in Oregon, where physician assisted suicide is available, there were people who could have been treated with chemotherapy, but Medicare would not pay for chemo, only euthanasia drugs.

Margaret Dore is “a lawyer from Washington State, where assisted suicide is legal.” She is president of Choice is an Illusion, which has fought assisted suicide and euthanasia legalization efforts throughout the United States.

She maintains that the law in Washington, and the legislation in the bill introduced by Edith Ajello, allows euthanasia “in the fine print.” It does not.

People were limited to two minutes of testimony. Dore spoke for 17 minutes, because various legislators asked questions and allowed her ample time to speak in answer to the questions. Dore is a traveling national activist against physician assisted suicide who worries that unscrupulous persons may use physician assisted suicide to grab inheritances.

Cranston resident Joyce Smith will soon be 88 years old. ” I think every person my age fears the possible development of a terminal disease which result in a long, drawn-out and possibly painful death,” said Smith. “I do not want to exist in any manner that robs me of what I believe to be a quality life. I do not want to leave my family with memories of a dying woman writhing in pain.”

Barth Bracy of Rhode Island Right to Life opposes the bill, of course.

Representative Joseph McNamara (Democrat, District 19, Warwick), who chairs the House Committee on Health, Education and Welfare, warned his fellow representatives that the hearing is for asking questions, not making comments.

Marie Mannis is the Rhode Island campaign manager for Compassion & Choices, which advocates for physician assisted dying. She spoke in favor of the bill.

Speaking in favor.

Bradley Kehr, from the religiously based Americans United for Life, spoke against the bill.

Dorothy is a Rhode Island resident who gave powerful testimony in support. “I don’t want to move to Vermont, to do myself in, should the need arise. I am for this legislation. My body, my choice.”

Randall Rose is in favor of the legislation. It should not be a crime to assist a loved one suffering from a painful end of life disease who has chosen to die.

Marylin Brennan is a retired nurse who has worked with the elderly for a long time. She opposes the bill.

I couldn’t catch her name, but she is the services director at Rhode Island Right to Life. She opposes the legislation.

This is her mother, who also opposes the bill.

Middletown resident Karen LeBlanc spoke in favor of the legislation.

Speaking in opposition.

Father Christopher Marr is a priest in the Roman Catholic Diocese of Providence. Note the chummy way the Father is greeted by the chair and co-chair of the committee.

Victor Bergeron spoke against the legislation.

David Finnegan was the last to testify. A member of the Humanists of Rhode Island, David said, “I’m getting older. I’m past the halfway point. I’m healthy, I’ll probably have a long life. But one of the most important things to me is to be able to have choices, to be able to have free will to decide for myself how I’m going to handle any situation in my life. I’m a humanist. I’m an atheist. I believe that this is the only life I have, I see no evidence of another one.

“I therefore would like to have the opportunity to make my own decisions about how I live and how I die. I would like to end with a quote. ‘Enforced uniformity confounds civil and religious liberty and denies the principles off Christianity and civility.’ Roger Williams.

“I think what he was getting at is that for anyone’s beliefs to be meaningful, they must have the free will to act on their own. And I just ask that you give me the opportunity to make my own choices.”

• 11 people spoke in opposition
• 2 people who spoke in opposition were out of state activists
• 8 people who spoke in opposition were apparently motivated by religion
• 8 people spoke in favor, all Rhode Island residents

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