CHICAGO — Terminally ill adults in Illinois may have the option to take life-ending medication prescribed by a physician under a bill passed by the Illinois legislature last week during its fall session.
Advocates for the bill say it is rooted in compassion and will bring agency to already dying people in the last stages of life, while opponents cite religious concerns and potential harm to vulnerable populations.
The Senate voted 30-27 to pass Senate Bill 1950 in the early morning hours on Oct. 31 after the House passed it 63-42 in May. The legislation needs only the governor’s signature to become law and, if signed, would take effect after nine months.
The bill received support from advocates like Suzy Flack, formerly of Chicago, who has pushed for the legislation in honor of her son Andrew, 34 at the time of his death from cancer in 2022. Andrew chose to live in California and utilize the state’s medical aid in dying options, which were not available in Illinois at the time. He is one of several advocates named in the bill text.
“Inevitably, losing a child is the hardest thing that anyone could go through, I believe,” Flack said. “I am just comforted every day by the way his death was so peaceful. He had some control over things.”
See how the Illinois House voted on this issue in May.
What’s in the bill?
The bill sets specific requirements for eligibility to receive end-of-life medication. Patients must be Illinois residents 18 or older who have a terminal disease that is determined by two physicians to result in death within six months.
A diagnosis of major depressive disorder does not alone qualify patients for end-of-life medication.
Patients requesting treatment must make both oral and written requests for aid in dying. A physician would then need to evaluate the patient’s mental capacity and evaluate potential sources of coercion or undue influence and inform the patient of alternative hospice care and pain control options before writing a prescription for life-ending medication.
Those who qualify must be able to self-administer the medication, as no one else is permitted to administer it to them. Patients who qualify and receive medication have the right to withdraw their request at any time or choose not to ingest the medication.
Death certificates of those who take end-of-life medication under the bill will attribute their cause of death to the underlying terminal disease, not suicide.
Bill sponsor Linda Holmes, D-Aurora, said on the Senate floor that there are “over 20 guardrails in place” to prevent coercion and abuse, pointing to Oregon’s 28-year history of providing medical aid in dying care.
“In the years that this has been in effect in Oregon, starting in 1997, there have been no substantiated cases of coercion or abuse,” Holmes said.
Including Oregon, 10 states and the District of Columbia have legalized medical aid in dying. Illinois would be the first Midwestern state to do so.
Guardrails explained
Critics of the bill felt there were not enough safeguards in place to prevent harm. Jil Tracy, R-Quincy, raised concern about the six-month diagnosis window, saying that advancements in modern medicine can allow people to outlive their diagnoses.
Holmes said this is not common, as doctors tend to overestimate patients’ prognosis.
“There aren’t that many patients that outlive what that prognosis ends up being,” Holmes said. “Those that do are very likely not to take the medication until they get to a point where the pain has gotten so bad.”
Only 62% of patients prescribed the medication end up taking it, Holmes added.
Tracy and other senators additionally voiced concerns about potent drugs, which patients would bring into their homes to self-administer, falling into the hands of young people struggling with mental health.
“There’s no controls over who might access it besides the patient,” Tracy said. “In this day and age, we have young children that have suicidal thoughts.”
Brian McCurdy, who began advocating for medical aid in dying after the death of his life partner Harriet, said the bill doesn’t introduce any risk that is not already there.
“Right now, there’s very little control over the medication, the morphine, that’s being given to hospice patients in a home setting,” McCurdy said. “So, I don’t think this legislation creates more opportunities for bad things to happen.”
After someone dies in hospice, the medication is collected by a hospice nurse or other medical provider. McCurdy said he expected the same to be true for planned deaths under this bill.
Tracy also raised concerns about coercion of disabled or elderly populations, particularly that the bill did not prevent heirs from acting as one of the two witnesses required to sign the patient’s request for end-of-life medication.
Impact on physicians, culture
Sen. Steve McClure, R-Springfield, quoted studies finding very high rates of death by suicide among veterinarians, in part due to the toll of euthanizing animals. McClure likened veterinarians to physicians who care for humans, suggesting the provision of end-of-life care would create a mental health crisis among medical professionals.
The American Medical Association has long opposed the practice of physician-assisted aid in dying, calling it “fundamentally incompatible with the physician’s role as healer” and stating that it would pose “serious societal risks.”
The bill does not require physicians to prescribe end-of-life medication and protects physicians from civil or criminal liability and professional discipline for either prescribing or refusing to prescribe aid-in-dying care.
“One of the things I love about the legislation that we’ve passed in Illinois is that it’s not going to require anybody who’s in opposition to be involved,” McCurdy said. “Not patients, not family, not doctors, not pharmacists. Nobody who doesn't want to be involved is going to have to be involved.”
Sen. Chris Balkema, R-Channahon, called the bill “a slippery slope” and pointed to other states expanding options for medical aid in dying after what was initially introduced, including Oregon removing its residency requirement.
“It’s not right to introduce a culture of death into Illinois,” Balkema said.
Advocates of the bill said it is not introducing a culture of death but rather giving agency to those who are already actively dying.
“I don’t like the term assisted suicide, I feel that is very insulting because people with terminal illness want to live,” Suzy Flack said of her son Andrew. “He fought for many years; he wanted desperately to live.”
Balkema spoke from his experience witnessing both of his parents die in hospice in the past three years. Both were at peace with their deaths, Balkema said, and both said they were ready to go “when the Lord wants to take me.”
“Those are hard words to hear but also comforting to know that we are not in control,” Balkema said.
But advocates of the bill say having that control is crucial.
Compassion, not suicide
Sen. Laura Fine, D-Glenview, thanked legislators for a heartfelt discussion on medical aid in dying.
“This is a very personal issue and it’s an issue that is about choice,” Fine said. “This is not suicide, it is compassion.”
Having the option to control his passing, even if he did not ultimately need it, was something that Flack says brought her son peace of mind.
“He was so comforted by having that option,” Flack said.
Flack said she hoped Gov. JB Pritzker would sign the bill to provide agency to people like her son.
When asked about the bill at a news conference in Glen Ellyn on Monday, Pritzker said he was reviewing the specifics of the legislation.
“I know how terrible it is that someone who's in the last six months of their life could be experiencing terrible pain and anguish. And I know people who've gone through that,” Pritzker said. “It hits me deeply and makes me wonder about, you know, how we can alleviate the pain that they're going through?”
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