8 years later, Ohio takes another look at 'medical aid in dying.' Will this time be different?

COLUMBUS, Ohio – Eight years after similar legislation stalled at the Statehouse, Ohio lawmakers are again weighing whether terminally ill residents should be able to determine the timing of their death.

Rep. Eric Synenberg this week introduced legislation to legalize “medical aid in dying” in Ohio, allowing mentally competent adults with a terminal diagnosis and six months or less to live to hasten their deaths by taking a lethal dose of medication prescribed by a physician.

 The proposal follows reporting by cleveland.com and The Plain Dealer, on Ohioans who sought the option out of state, including David Hollister of Chagrin Falls. Hollister urged lawmakers to act shortly before his death in September, and Synenberg introduced the bill one day before what would have been Hollister’s 65th birthday.

 “He wanted a dignified end-of-life option that would not require him to leave his home to receive that care,” Synenberg said. “Sadly, David is no longer with us today, and one day before what would have been his birthday … I want to recognize David for his advocacy.”

 Synenberg, a Beachwood Democrat, knows that it won’t be an easy fight. When similar legislation was introduced in 2018, it received one hearing and failed to advance out of committee.

 Recent public polling has shown that most Americans are open to medical aid in dying, and advocates say that public education on the subject has improved since the last legislative battle.

 Yet opposition to such legislation is also strong, particularly among the religious.

 Opponents say that built-in safeguards are insufficient, even though state oversight reports in Oregon, where medical aid in dying has been legal since 1997, have not identified documented cases of prosecuted coercion.

 Others fear that the law could be further expanded or argue that medical aid in dying clashes with the medical principle of “do no harm.”

 Synenberg and other supporters hope that despite the challenges ahead, the new bill can move the conversation forward.

 “I know we will get some pushback on this bill in the legislature, but my ask today is that my colleagues on both sides of the aisle consider having civil discourse on this bill,” Synenberg said during a press conference on Thursday.

 “Let us allow people from all perspectives to come to committee and testify and be part of this conversation.”

The 2026 Ohio Medical Aid in Dying Act
 
The proposal, cosponsored by Democratic Reps. Crystal Lett and Anita Somani of Columbus and Tristan Rader of Lakewood, would require patients to meet the same eligibility standards used in other states where medical aid in dying is legal.

 Eligible individuals would be adults with a terminal illness and a prognosis of six months or less to live, mentally capable of making medical decisions and physically able to self-administer the medication, with eligibility confirmed by both their attending physician and a second independent consulting physician.

 Unlike Oregon and Vermont, which allow nonresidents to participate, the Ohio bill would limit access to state residents. Patients would be required to make two oral requests to a physician, separated by at least five days unless death is imminent, and submit a written request witnessed by two people, including one independent of the patient.

 Physicians would be required to discuss alternatives such as hospice and pain management, and a mental health assessment could be required. Participation would be voluntary for providers and facilities and patients could rescind their request at any time. Deaths would be attributed to the underlying terminal illness.

 The bill now awaits a number and committee assignment.

 Past and present challenges
 In 2018, then-state Sen. Charleta Tavares, a Columbus Democrat, championed legislation that featured no substantive differences to the effort today.

 Like many advocates for medical aid in dying, she was inspired by her own experiences caring for loved ones. During a conversation about end-of-life decisions, her mother confided in her that she wished medical aid in dying was legal in Ohio.

 “I loved and trusted my mother … that was enlightening to me,” Tavares said.

So, in early 2018, Tavares introduced Senate Bill 249 knowing that it faced long odds. At the beginning of that year, only five states and the District of Columbia had “death with dignity laws,” and Montana had permitted it through a court ruling.

The comparative novelty of the laws at the time – combined with the what she called the political “tone and tenor” of the Republican-controlled General Assembly made even having conversations about the legislation difficult.

Ultimately, the bill received only one hearing — Tavares’ sponsor testimony.

Tavares expects lawmakers to face similar challenges this year. Republican lawmakers in leadership positions all openly hold “pro-life” positions which oppose these laws. What’s more, influential groups in the state such as Ohio Right to Life and Catholic Conference of Ohio have already come out in opposition.

One of Tavares’ co-sponsors, then Democratic state-Sen. Joe Schiavoni, now a judge in Mahoning County, said that for this time to be different, supporters must find lawmakers from both sides of the aisle who are willing to have a conversation.

“Whenever I was dealing with a bill that affected people’s lives, you would think that legislators would talk to the people that it would affect. Unfortunately, some legislators don’t do that,” Schiavoni said.

Supporters’ silver linings
 Over the last eight years, seven more states passed laws to legalize medical aid in dying. Thirteen states and the District of Columbia have now legalized the practice.

Public polling on medical aid in dying has also shown widespread support for the option both in Ohio and nationally.

A 2018 Public Policy Polling survey found that 71% of Ohioans supported giving terminally ill patients the right to control the end of their lives, which was true across party lines. More recent polling from Pew Research Center has similarly shown that most Americans support the option.

Lisa Vigil Schattinger, the founder of Ohio End of Life Options, said that her experience championing the legislation in 2018 opened her eyes to how much public education was still needed on medical aid in dying.

Over the last eight years, she and her organization have taken the opportunity to speak with individuals throughout the state and hear their thoughts and concerns. Those conversations are still needed today, she said.

“We clear up misunderstandings every time we have an audience with anyone in any setting, health care professionals, legislators, you know, just out in the community, it’s so important to engage in conversation about this,” Vigil Schattinger said.

As public understanding continues to grow – and more states pass laws of their own – advocates say there is reason to hope that someday Ohio could be among them.

“I know Ohio is unique. We are independent thinkers, but we also have to have movement on this as an issue,” Vigil Schattinger said.

Schiavoni said there is wisdom to playing the long game.

“I’ve seen things that I’ve proposed in 2016 or 2014 that are passing today,” Schiavoni said. “That’s a win … the groundwork that you laid as a legislator was meaningful and impactful later on, even if it didn’t have your name on it.”

Editor’s note: cleveland.com and The Plain Dealer will publish a continuing series involving the multitude of issues involving end-of-life decisions, including hospice care, the costs of care for the terminally ill, ethics, legal issues and more. If you’ve experienced these issues in your family and are willing to discuss your experiences and thoughts, please email Mary Frances McGowan at mmcgowan@cleveland.com.