In 10 other states, doctors are allowed to prescribe life-ending treatment for terminal patients. Illinois could become the 11th.
First legalized by Oregon in 1994, the treatment would become legal in Illinois under a new bill proposed by lawmakers in the Illinois House and Senate. It would only extend to patients who have six months or less to live as prognosed by a physician. Patients would also have to be 18 or older and be able to communicate that they want treatment.
The treatment comes in the form of a pill; it is a higher dosage of a medicine that is commonly used to treat insomnia. It can take from one minute to two days for a patient to die after taking it.
For some advocates, medical aid in dying is seen as an option for loved ones who are suffering with no hope of recovery.
Sarah Breeden of Normal has advocated for the bill after her father got a fast-moving cancer and died in 2015.
Breeden said her father tried everything to prolong his life but knew it was terminal. He had exhausted all other treatment options.
Breeden's father had moved to Oregon in 2003. She said he saw one of the benefits of moving there was Oregon was the first state to pass a medical aid in dying law. Breeden said that ended up giving him a choice he wouldn't have had otherwise once cancer struck.
Breeden said sharing her father's story with others has convinced them that it's a good option to have.
“I have received nothing but support for the idea that he had that option,” Breeden said. “Again, people may not choose it for themselves, individually, and I wouldn't want anybody to do something that they didn't want to do, but the idea that that option is available is something that I have seen tremendous support for.”
Disability advocates in Illinois don’t see it that way. Rickielee Benecke is director of the LIFE Center for Independent Living in Bloomington. Her organization is a part of the Illinois Stop Assisted Suicide Coalition.
Benecke said the bill is dangerous due to a fear that it could extend to the disabled community in multiple ways.
Firstly, she said a patient could be manipulated by family members due to feeling like a burden.
“It's not the person with the disability who's choosing to end their life,” Benecke said. “It's their caretaker or their doctor or a family member who are pretty much forcing them to do this because they're tired of taking care, taking care of this person, or helping this person.”
There is no language in the bill that applies to those without terminal illness. Regardless, Benecke shares a concern with many advocates that the bill could eventually be expanded to include disabilities.
“And I've been following these different laws that have passed in the different states for quite some time, and I have to say no,” Benecke said. “Because I've seen them do it, but they always take make amendments later to expand access to getting the life-ending drugs. We still see the abuse.”
Benecke pointed to Oregon as an example of this. In 2023, the bill was expanded to remove Oregon residency as a requirement for treatment.
Republican state Rep. Bill Hauter from Morton, who is a physician himself, is also against medical aid in dying. Hauter said it goes against what a doctor is meant to do.
“It’s kind of dangerous because we're talking about physician-assisted suicide,” Hauter said. “So, you're going to change the very heart of medicine. Heart of medicine is, and it's always been, do no harm first. Do no harm.”
Hauter is also worried physicians will be more prone to suggest medical aid in dying rather than life-saving care.
“And you're changing the whole dynamic of the patient relationship with the physician,” Hauter said. “If there's at some point the physician feels like he should say, have you ever thought about committing suicide? I mean, this is terrible.”
As part of the bill, doctors would be able to choose whether they want to offer medical aid in dying. They wouldn’t be forced to.
Hauter is also concerned about the possibility of health insurance companies exploiting patients by cutting life-prolonging care and incentivize medical aid in dying to save costs.
“The least expensive care is that you're dead and that they don't have to pay for your expensive cancer treatment or whatever chronic disease you may have that's very expensive to the insurance company,” Hauter said.
The bill addresses this claim. It would be illegal for an insurance company to deny life-prolonging care to incentive medical aid in dying.
Advocate Sarah Breeden said there are several misconceptions about what the law would allow. For example, there would be safeguards put in place to avoid prescription abuse.
"So it's not a case of a doctor saying, 'Here's your one and only option you have to do this,'" Breeden said. "This is a choice for someone who's got a terminal diagnosis with six months or left to live, and then they must inform them that they can change their mind at any time."
Supporters point to several safeguards in the bill. A patient must have a terminal diagnosis from at least two doctors, they have a waiting period before the get a subscription and the patient must be determined to have sufficient mental capacity to make the decision.
Democratic state Rep. Sharon Chung of Bloomington supports the bill after talking with advocates like Breeden.
Chung acknowledged the bill is controversial and will lead to hard conversations but said it is necessary.
“This might be some of the more serious conversations we've had about it in recent memory,” Chung said. “But it's sort of one of those things that there's a lot of education that probably needs to be had, and a lot of just thorough discussion.”
Chung also said talking with Breeden and other advocates helped change her mind.
“I probably would have been opposed to this,” Chung said. “But, again, talking with advocates and people who have been very directly impacted by something like this, I think it's time for our state to really take a very close look at something like this.”
The bill is in both chambers of the Illinois General Assembly waiting for amendments after the sponsors talked with Gov. JB Pritzker's office and the Illinois Health and Hospital Association.
The advocacy group Compassion & Choices published a survey from WedMD which shows Illinois doctors support the medical aid in dying by a more than 2-to-1 margin. About 4 in 10 physicians said they would be willing to write a prescription for it.
