Doug Tsitouris suffers from advanced emphysema and says with certainty that he isn’t afraid to die. But when the time arises, he wants to go out on his own terms.
Tsitouris, 68, of Cape St. Claire in Anne Arundel County, was diagnosed with his terminal illness about seven years ago. But an oxygen tank with plastic tubes running through his nose to help him breathe led to him living longer than his doctors expected. Eventually, he said, his condition will get to the point where he wants “some measure of dignity” and comfort in how he will die.
That’s why Tsitouris backs the Richard E. Israel and Roger “Pip” Moyer End-of-Life Option Act, which would grant terminally ill Marylanders with six months or less to live the opportunity to request lethal medication to end their lives.
“I think we should treat ourselves with as much dignity and compassion as we treat our pets,” Tsitouris said. “For me, it’s all about quality of life. As an adult, I think the person doing the dying should have the last word if they are terminally ill.”
Members from the House Health and Government Operations Committee listened to hours of gut-wrenching testimony from those who both support and oppose the act in a hearing that drew more than 300 people to Annapolis on Feb. 16.
The bill, sponsored by Del. Shane Pendergrass (D-District 13) and Sen. Guy Guzzone (D-District 13), would require two doctors — including the patient’s primary care physician — to confirm that a patient meets all the requirements of the measure. A doctor would have to decide whether the patient has six months or less to live, has the mental capacity to make a sound medical decision and could administer the medication on his or her own.
“This is about personal autonomy,” said Pendergrass, a Jewish delegate from Howard County. “People should have the right to have a say over their bodies without any interference from the government. No one knows my own destiny better than me.”
This marked the third consecutive year the House has held a hearing for the measure, which remains one of the most polarizing issues in the Jewish community. In each of the two past years, previous versions of the bill failed to generate enough support to make it out of the Senate Judicial Proceedings Committee.
While proponents affirmed that sufficient protections would be carefully outlined for elderly, disabled and otherwise vulnerable patients, not everyone was persuaded patients couldn’t be coerced or manipulated into making a decision against their wishes.
Sheryl Grossman, 41, of Pikesville, has Bloom syndrome, also known as Bloom-Torre-Machacek syndrome, a rare autosomal recessive disorder characterized by short stature and predisposition to the development of cancer.
Grossman has beaten nine different forms of cancer and said she fears that if the bill were signed into law, she wouldn’t be alive today.
“As a disabled person, this bill scares me even more because I know the societal barriers, stigma and discrimination that [disabled people] face. Our lives are often seen as being the worse quality of life and less worthy than others,” said Grossman, who added that doctors told her parents she wouldn’t live past the age of 2. “It is far too easy to coerce someone into thinking of themselves as a burden to medical care staff or family members.”
Rabbis who have witnessed the painful death of loved ones say they think the bill could provide suitable closure for terminally ill patients.
George Driesen, an adjunct rabbi at Bethesda-based Adat Shalom Reconstructionist Congregation, said Jewish tradition clearly states that people are not obliged to suffer.
“People can’t take over God’s role and limitations of what they can do, but it is clear that suffering and Judaism is not a virtue, whereas among other faiths, it’s a sin,” Driesen said.
Tsitouris, who is of Greek descent, said he doesn’t consider himself a very religious person. But if he were, he said he would identify as Jewish because of the freedom he feels the religion allows for individuals to make their own choices, which he thinks the bill accomplishes.
“To Jews, what is important is that you lead a good, moral life, and that makes clear and complete sense to me,” Tsitouris said. “In every respect, this bill allows for people to do what’s right for them.”
Some rabbis took issue with the bill on religious grounds, citing Halachah. They also believe the legislation could lead to the premature deaths of individuals who have longer to live.
Rabbi Ariel Sadwin, director of Agudath Israel of Maryland, said he had doubts if any of the Jewish legislators supporting the bill took religious beliefs or values into account.
“We’ve never tried to influence public policy, because we feel that the way of Judaism should be accepted by the state. It’s pretty insulting to go ahead and say someone who is accepting their faith by God is considered to have a lack of dignity,” said Sadwin, who testified for the third time in as many years. “The greater dignity is when you go ahead and accept the fate that has been handed to you, even if it’s not easy. So to go ahead and hit the restart button and say ‘I can’t hack it anymore’ is insulting.”
In a letter of opposition, the Baltimore Jewish Council asserted “all life is sacred and that we are all created in the image of God. Suicide is a violation of Jewish law, as is assisting in a suicide.”
Del. Sandy Rosenberg (D-District 41), one of the bill’s 55 co-sponsors in the House, urged critics to keep an open mind.
“No one would be forcing anyone to take advantage of this law,” Rosenberg said. “In my mind, the individual choice takes precedent. The value of giving an individual the choice is a positive, not a negative.”
The practice is legally permitted in six states — Oregon, Washington, California, Vermont, Montana and Colorado — and Rosenberg said it’s Maryland’s turn to join them.
Dr. Michael Strauss, 63, of Montgomery County, is a retired internist and current health policy consultant who said there is greater optimism for passage this year.
He pointed to a Maryland State Medical Society (MedChi) poll that found 65 percent of Maryland voters support end-of-life measures and 60 percent of physicians either support it or are neutral.
“This is a decision that should be between a doctor and a patient, and we have seen that the majority have expressed those sentiments,” Strauss said. “For the small minority of patients who suffer with physical pain, why should they be denied this option?”