Assisted Suicide Battles after the 2020 Election
Bioethics in Law & Culture Spring 2021 vol. 4 issue 2
Skylar Covich, Ph.D.
This article is an overview of battles over assisted suicide legislation that are ongoing as of this article’s publication in April 2021, particularly the recent legalizations in New Mexico and Spain. Its most important source is the blog run by Alex Schadenberg of the Euthanasia Prevention Coalition. For battles where legislative votes have occurred, I have tried to conduct research on the extent to which these were party-line votes, though more needs to be done for future articles. While some efforts to legalize assisted suicide have slowed down, most notably in Maryland, where legalization narrowly failed in 2019, there have been significant battles in several US states, as well as several countries such as Spain. As Schadenberg has repeatedly noted, not only are new jurisdictions attempting to legalize assisted suicide but there are efforts to expand eligibility for assisted suicide in several US states and Canada where it is already legalized. With some exceptions, legislators on the left support assisted suicide while those on the right do not, as has been the case in the past; however, there are more significant divides on the Left about the expansion of legal assisted suicide where it is already legalized.
The most recent reputable poll on assisted suicide was conducted by Gallup in 2020, finding that 74% of Americans support euthanasia and 61% support assisted suicide. As the term is being used in polling, euthanasia is the refusal of treatment for people who are likely terminal and thus is seen as less extreme than assisted suicide. While this is up compared to 2019 polling, it is within the margin of error of record-high support for euthanasia in 1996 and 2005. Majorities of people identifying as weekly church attenders and conservatives still oppose assisted suicide. Regarding euthanasia, there is more support by whites (77%) compared to people of color (65%). 
There was a record level of legislative activity in favor of assisted suicide in the United States in 2019. Three states legalized the practice; Hawaii, Maine, and New Jersey, while there were significant battles in Maryland, Massachusetts, and New York. Assisted suicide was already legal in California, Oregon, Washington, Colorado, Vermont, Montana, and the District of Columbia. I covered most of this in my Sebastian's Point article early in 2020, and my article with Jacqueline Abernathy on partisanship for the Journal of Public Affairs. 2020 looked to be another active year legislatively. Bills were reintroduced in Maryland, with a pro-choice Republican governor and a heavily Democratic legislature, as well as in Florida, dominated by Republicans in recent years. However, the bills were withdrawn as legislative sessions ended early due to COVID-19.
By early 2021, the legislative activity around assisted suicide returned to a high level, especially but not exclusively in states with Democratic control of the legislature. This culminated in New Mexico officially legalizing assisted suicide on April 8, with the Democratic governor’s signature. As Schadenberg noted in early March, assisted suicide legalization bills excluding New Mexico’s were being debated in the following states; Arizona, Connecticut, Indiana, Iowa, Kansas, Kentucky, Massachusetts, Minnesota, Nevada, New York, North Dakota, and Rhode Island." It is worth noting that Maryland was not on this list. In addition, some states which had already legalized assisted suicide are now debating efforts to expand eligibility for aid in dying, specifically California, Hawaii, and Washington. States such as Indiana, Iowa, and Kansas are dominated in the legislature by Republicans. As is historically the case, bills in Republican legislatures on this topic do not get very far. Aside from New Mexico, only Connecticut’s bill appears to have made it out of committee, but it is very early in the legislative session in many relevant states. In the following paragraphs, I will more deeply analyze the situations in Connecticut and New Mexico.
In Connecticut, an assisted suicide bill passed the Joint Public Health Committee on March 5. One Democrat, 81-year-old Henry Genga, was opposed; three Republicans were in support. These Republicans were Robin Green, Tony Hwang, and Kathy Kennedy It is difficult to find information about what was behind these Republicans’ decisions, but Hwang has been described on his Wikipedia page as a centrist.
Connecticut is also facing a public split among advocates against assisted suicide. The disability rights group Not Dead Yet, which does not oppose abortion, criticized the Connecticut Catholic Conference’s messaging, which links the issues of preventing assisted suicide and protecting crisis pregnancy centers. Not Dead Yet claims that such messaging will alienate progressive Democratic legislators who may be convinced to vote against assisted suicide based on disability rights arguments. The Society of St Sebastian, for which this article is being written, is on record against abortion and in favor of crisis pregnancy centers. It is worth noting that some Democrats will listen to lobbying from the Catholic Conference on assisted suicide even if they are less likely to do so on abortion, at least on legal protections for the unborn as opposed to freedom of conscience bills. This was the case in Maryland in 2019, for example. However, the number of Democrats for whom this is true seems to be decreasing. There is potential that Not Dead Yet may have valid concerns about the practical politics as the bill goes before Connecticut’s legislative floors.
While Connecticut’s fight may be lengthy, New Mexico’s assisted suicide bill, HB47, has advanced the farthest and is definitely set to becoming law. Alex Schadenberg of the Euthanasia Prevention Coalition has argued that it is among the most extreme bills with a real chance of passage, as it has loose requirements on which professionals can confirm that a patient is eligible for assisted suicide and requires medical providers who will not provide assistant suicide to transfer a patient to a willing provider. Assisted suicide bills had previously been introduced in New Mexico in recent legislative sessions by the same Democratic legislature. This is further evidence for the argument that repeated introductions of assisted suicide result in advancement, especially considering that New Mexico, while it has a Democratic legislature and governor, is not extremely dominated by Democrats in recent history.
In the state Senate vote, three Democrats voted No. Republicans who voted were all opposed, with one abstention. The three Democrats against were Pete Campos, George Munoz, and Benny Shendo. Campos had indicated his opposition to assisted suicide in a campaign Q&A, arguing that pain management provides death with dignity. All three had been among seven Democrats who helped narrowly defeat a legalization bill in 2017, which had one Republican supporter. In the House, the following Democrats voted against the bill; Anthony Allison, Ambrose Castellano, Harry Garcia, Derrick Lente, Patricia Lundstrom, Rod Montoya, Candie Sweetser. Republican Kelly Fajardo voted Yay. It is hard to find information about what motivated these representatives to cross party lines, even Fajardo, who had declared in her campaign Q&A that she opposed assisted suicide.
Meanwhile, California’s Senate Bill 380 threatens the conscience rights of medical providers who oppose assisted suicide. According to the California State Legislature's website, it was passed by the Senate Judiciary Committee but has been referred back after amendments.
Assisted Suicide outside the United States
It is also critical to examine activity around assisted suicide in countries outside the United States. By 2020, assisted suicide was legal in Canada, Colombia, and the western European "Low countries" Luxembourg, Belgium, and the Netherlands. By early 2021, Canada’s Bill C7, expanding assisted suicide, had advanced, and Spain’s parliament passed an assisted suicide legalization bill. Legalization was narrowly avoided in Portugal after a ruling by the constitutional court, and in Latvia, where a citizens’ petition was defeated by the Parliament.
Canada legalized assisted suicide in 2016 when Bill C14 passed Parliament. There were significant limitations to make sure that only those with severe and terminal illnesses were eligible. In 2020, Bill C7 was introduced to expand eligibility to those with painful disabilities who are not terminally ill. After passing the House of Commons, it was amended by the Senate to clear the way for those with mental illnesses to request aid in dying. When the bill was returned to the House of Commons, the Conservatives were able to delay the bill with some assistance from across the political spectrum, as some New Democratic and Green MPs expressed concern about the Senate amendments. The Liberals received assistance from the Bloc Quebecois to bring up and pass the bill, with an 18-month moratorium on allowing those with mental illness to request aid in dying. Two of the three Green MPs and five liberal MPs joined the Conservatives and New Democrats in opposing the bill in the House of Commons during the March vote. The amendments were passed by the Senate and into law the following week.
It is worth examining the position of the Canadian conservatives and especially the New Democrats in more detail. Because Canadian conservatives had been divided over cultural issues around abortion and same-sex marriage, there was concern that the Conservative Party would become less opposed to assisted suicide as well. Still, in March 2021, the party reaffirmed its opposition. The New Democrats, as a more left-wing party than the liberals, are more apt to consider the concerns of activists in the disability rights community and thus opposed the expansion of assisted suicide. They had opposed C-14 legalization in 2016, though Prime Minister Justin Trudeau implied that the party would not be united on the issue if they had allowed a free vote. However, this does not mean that they remain staunch allies of disability rights activists who still oppose legalization entirely. The New Democratic MP quoted in the Globe and Mail story on the March 21 vote indicated that he supports aid in dying, and the NDP leader’s objection was primarily procedural.
Spain’s Parliament passed a law allowing assisted suicide in March 2021. There had been attempts to legalize assisted suicide since the current Socialist Party government took office in 2018. A bill was passed in the Lower House of the Spanish Parliament in December 2020 after which the Senate passed it with some amendments, which the Lower House accepted in March. While the bill requires people to have a serious illness to be eligible, it threatens to define those illnesses broadly, and also allows both assisted suicide and euthanasia, and was opposed by the Spanish Bioethics Committee unanimously in October 2020.
It is difficult to find partisan breakdowns in media coverage of this Spanish debate. Many stories refer to the governing coalition relying on “other parties.” The December Lower House vote resulted in 198 MPs in favor, while the March vote resulted in a slightly increased majority of 202. A Euronews story about the December vote revealed that Catalan nationalist parties and the centrist Ciudidanos party joined Socialist Party and Podemos in support of the bill, while the conservative Popular Party and far-right Vox were opposed. When the Popular Party was in government, there were no serious attempts to legalize assisted suicide. Still, the Euronews coverage and other coverage presents Vox, a much smaller party, as the main opposition to the law and the main party involved in legal challenges. The Popular Party is framed as objecting to the bill largely on procedure, though a Popular Party MP was quoted as advocating better pain management.
Latvia’s Parliament rejected a law allowing assisted suicide by a vote of 49-38. The debate occurred after a petition of at least 10,000 signatures, which according to Latvian law, mandates consideration. I have not yet completed research about the partisan breakdown of the vote, and the ideological composition of Latvian parties is more complex regardless.
This brief overview shows that the cultural changes around COVID-19 have not significantly changed the debate on assisted suicide. It is hard to find evidence of religious groups or disability rights groups having an impact on close votes. The conservative movement remains broadly against assisted suicide, but with some exceptions, especially among centrist politicians and rank and file Republicans who seem to want to allow people to alleviate pain even in morally concerning ways. There is potential that in some American states, the busy legislative session around economics and other matters, and lobbying by activists, may cause bills to die, but it is too early to tell. As Schadenberg has noted on his blog recently, with the parliamentary actions in Spain and Portugal and newer bills in France, Ireland, and Latvia, there is more action in favor of assisted suicide across Europe. Meanwhile, jurisdictions that have sought to legalize assisted suicide, invariably with left-wing governments, seek to expand access, though support is not universal among left-wing parties.
Skylar Covich, Ph.D., received a doctorate in political science from the University of California, Santa Barbara, where he has taught courses on American interest groups and politics in American religion. His dissertation, 'Christianity and the Politics of Poverty in the United States,' compared actions by Catholic, mainline Protestant and evangelical organizations on economic policy. He currently serves on the National Committee of the American Solidarity Party.