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Pennsylvanians support new option for terminally ill patients, but lawmakers are not taking action.The question: Should a terminally ill person with less than six months to live be allowed to self-administer lethal medication prescribed by a doctor?In poll after poll, a healthy majority of Americans answer that question in the affirmative.About two-thirds of people nationwide support allowing mentally competent, incurably sick people facing imminent death to work with a doctor to end their lives peacefully at a time of their choosing.That support includes most Republicans, Democrats, Catholics and Protestants.As is often the case, public support does not immediately or easily generate political will.In Pennsylvania, legislation that would allow doctors to prescribe life-ending medication to terminally ill patients has surfaced session after session for nearly two decades in both houses of the General Assembly, and none of the bills has gotten so much as a committee hearing.Politicians, and the special interest groups who influence them, can’t even agree on what to call the process.“Killing is not medicine,” says Tom Shaheen, the head of public policy for the Pennsylvania Family Institute, a religious liberty advocacy nonprofit that actively lobbies lawmakers in Harrisburg and opposes what it refers to as “physician-assisted suicide.” The group believes the right to life is the foundation of all human rights and extends “from conception until natural death.” On the other side of the philosophical aisle, advocates insist that caring is not killing and refer to the process with terms like “death with dignity,” emphasizing compassion and personal autonomy.They steer away from references to suicide, arguing it carries a criminal or mental health stigma that does not apply to the terminally ill.Meanwhile, few patients visiting their oncologists are fighting over nomenclature.Some whose bodies are failing after grueling rounds of treatment are lobbying to die in peace, at home, with people they love.The human element Francine Milano, 63, lives in a townhome in East Petersburg with her husband, stepchild and two cats, and she is dying of cancer.First diagnosed with a rare form of ovarian cancer when she was 39, Milano went through several weeks of chemotherapy and her doctor branded her “NED,” no evidence of disease.Regular scans every six months showed no tumors, and cancer left her alone for nearly two decades.Feelings of nausea and fatigue signaled a return of her cancer — low-grade serous ovarian cancer — in 2023.Chemotherapy did not slow the growth of the tumors, which had infected her bowels to an extent that they were inoperable.“So the word terminal came up, and I was like, ‘That’s just the way it is, and I’ll accept it,’ “ Milano said.“The journey started at 39, and at that point you expect to be a fighter.… At this point, I’ve lived a good life.It’s younger than I would have hoped to go home.” Because her cancer is slow-moving, she has had time to prepare for her death.To save her husband from having to purge her stuff when she’s gone, she held a garage sale “way too prematurely.” She made $800 that weekend but finds herself needing to replace some things she sold.She has also given a lot of thought to how she wants to exit the world.Milano is ready to die, she says, but she doesn’t want to suffer.Her doctors have told her that, given the nature of her disease, she will most likely die of bowel obstruction, an acutely unpleasant way to go.To prevent suffering, when the time is near, Milano wants to take advantage of medical aid in dying: to ingest a potent doctor-prescribed medication that will first put her in a state of deep unconsciousness, then cease her respiratory and cardiac functions.She would like to do so at home, but Pennsylvania law does not allow it.Milano grew up in the Cherry Hill, N.J., area and has family in that state, which does allow medical aid in dying, but only for state residents.Thirteen states and Washington, D.C., allow medical aid in dying, but only Oregon and Vermont will perform the service for out-of-state residents, so Milano has her eyes set on the Green Mountain State.She has visited with a doctor at the University of Vermont Medical Center in Burlington who has examined her medical records, confirmed her terminal diagnosis, her prognosis and her mental competency.A second physician must do the same, and when she asks for the medication, she must do so twice, each time at least 15 days apart.Those redundancies and multiple other safeguards are common to state medical aid in dying laws, including the ones drafted by Pennsylvania legislators.How the proposed Pa.law would work Federal law does not prohibit medical aid in dying, and the regulation of medical practice is primarily left to individual states, which are free to authorize or forbid doctors from prescribing medications.Oregon implemented the first law allowing medical aid in dying in 1997.Since then, the predominantly Democratic states that enacted similar laws (Montana is the only red state to allow it) have followed a well-prescribed formula that ensures patients own their choices.The proposed pieces of legislation currently on the table in Pennsylvania, House Bill 1109 and Senate Bill 570, are no different.The bills would legalize physician-prescribed end-of-life medication for qualified terminally ill patients.To qualify, the patient must be at least 18 years old and a Pennsylvania resident and have a terminal illness expected to cause death within six months.An attending physician and a consulting physician must confirm the patient’s medical diagnosis and mental capacity to make informed decisions, as well as the voluntary nature of their decision.Patients could rescind the decision to pursue medical aid in dying at any time, and the bills criminalize any form of coercion on the part of family members, heirs, beneficiaries, friends, caregivers and health care providers.Each of the bills is sponsored by several Democrats and no Republicans.David Rowe, who chairs the House GOP Policy Committee, declined to comment for this story, and none of Lancaster County’s Republican representatives responded to requests for comment.Republican silence on the issue does not surprise Rep.Carol Hill-Evans, the central York Democrat who is the primary sponsor of the House bill.“They won’t even have the discussion,” Hill-Evans said.“As with abortion, they believe in life regardless of what it looks like, how it feels, what it does.It’s all in the hands of the Lord.” Resistance has also come from inside her own party.She recalled pressing former House Democratic leaders about their reluctance to advance legislation that squares with party values and has broad public support.The answer she got: “We don’t want to be regarded as murderers.” Hill-Evans attributes her advocacy for medical aid in dying to conversations she’s had with constituents: a woman in her late 80s who was suffering and ready to die, a husband who in recounting his wife’s final distressing months broke down in her office.“Why would I not want to help somebody out of misery, to help them end their misery?” she said.Getting a bill onto the House floor for a vote will first require legislators to put their personal feelings aside, Hill-Evans said, to conduct a hearing where people on both sides of the issue can testify, including people struggling with illness who could directly benefit from the legislation.Boscola, the Bethlehem-area Democrat who penned the companion bill in the Senate, agrees.“I am realistic that this bill will not move quickly without sustained public pressure, but Pennsylvanians deserve more than silence,” Boscola said in a statement.“They deserve a hearing, a vote, and a serious discussion about whether terminally ill adults should have this compassionate option under strict safeguards.” Killing versus caring Opposition to medical aid in dying is well organized and includes groups like Pennsylvania Pro-Life Federa