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Falmouth man brings medical aid in dying case to the state's supreme court

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https://compassionandchoices.org/stories/roger-kligler-md/
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Dr. Roger Kligler

The state Supreme Judicial Court heard arguments last week in a lawsuit aiming to make medically assisted death legal in Massachusetts. The idea is to allow terminally ill patients the right to choose to have their physician prescribe a lethal dose to end their suffering.

The issue is complex and emotionally charged, but for the Falmouth physician who helped bring the case to the court, it’s also deeply personal.

CAI's Kathryn Eident talked with Dr. Roger Kligler.

Eident I think when someone hears the phrase "medical aid in dying," it strikes a chord because it and asks us to consider some profound questions about the value of life, and the value of quality of life when someone is suffering from a terminal illness and its treatments. And, you have a unique perspective on this issue, both as a retired physician and someone with a terminal illness. Can you talk about that?

Kligler So, I first came to believe in medical aid in dying after watching my mother and my father-in-law die of cancer. They both had really difficult deaths, and that made me believe in this for myself. I also have cancer and have been living with cancer for 20 years. Of course, as a physician, I took care of many people at the end of life, and I've had patients who have come to me to ask me to help them die quicker, which is basically what medical aid in dying is. It's the individual being able to ask their physician to help them to die with less suffering.

Eident The state Supreme Judicial Court heard your case last week. State Attorney General Maura Healey's office argued that doctors who prescribe a lethal dose to a terminally ill patient could be prosecuted. She said it's up to lawmakers to decide if medical aid in dying is legal, not the courts. A judge also said this as well in a lower court. What do you think about this?

Kligler Well, I think they're wrong, obviously, that's why we appealed the decision. I believe that there is no law in the Commonwealth preventing doctors from giving medical aid in dying. And so, that's what we're asking the Supreme Judicial Court to decide. There's precedent for this; this also took place in Montana. 10 states and the District of Columbia permit medical aid in dying, so it's 22 percent of the country, approximately.

Eident A judge at one point asked how a patient who dies from a prescription is any different than someone who overdoses on drugs bought on the street. That echoes some of the language and arguments of opponents. You argue, though, that the difference is intent. Can you elaborate?

Kligler The individual is the one who wants to end their suffering. Over a third of people don't even take it, but they have it there, so they make the decision that they want to end their suffering. It's no accident about it the way there is a drug overdose. This is the intent of the person and the doctors helping to facilitate what's in the best interest of the patient by the patient, defining what is in their best interest.

Eident To be clear, the patient would be the one to take the prescription. The doctor would not administer it, correct?

Kligler Only the patient can take it themselves. They can't get anything intravenously. They can take it by mouth. They can take it through a tube into their body, but they have to be the one doing it. So, it's autonomous decision by the individual that they have to be able to self-actuate.

Eident What do you say to someone who worries that medical aid in dying could be used to abuse someone who doesn't have as much of a say in their care due to an illness or disability?

Kligler They're unable to get medical aid in dying, so it has to be someone who's mentally capable to make their own decisions.

Eident You've seen bills stall on Beacon Hill, and you've seen voters reject a ballot question, but by a small margin, a few years ago. Do you think public sentiment is changing or has changed?

Kligler Well, public sentiment is in favor of this all across the board, 70 percent of voters in Massachusetts. And if you look at the demographics, Black, white, Hispanic voters, all age groups, all religions, including Catholics, people with disabilities are in favor of medical aid in dying. So, these are all absolute. In addition, in states where medical aid in dying has passed, legislators who supported [the bill] get reelected 95 percent of the time.

Eident Do you have a bill pending at the State House along with this case? Is this a multipronged effort?

Kligler We do have a multipronged effort, the End of Life Options Act. We're hopeful that things will line up so that we are able to get either through the court or through the Legislature one way or the other.

Eident I talked to you a number of years ago about this issue, and you and I went on a long walk during that interview with your dog. I wanted to ask you before we go how you're feeling these days and if you're still walking.

Kligler So cancer, if you're lucky, is an up and down issue. Sometimes it's just down, and I've been at what is usually the end stage twice. One of these I received immunotherapy from and ended up getting another condition that I think is from it, but I'm not sure. So, I was severely debilitated from that. It almost killed me from complications of that. And, I gradually have gotten better with medical treatment, and I'm back out walking again. So, I have a new dog, Lexie, and we go for four-mile walks around Long Pond every day.

Eident Well, I'm glad to hear that you're out walking again and that you have a buddy to go along with you. Dr. Roger Klingler of Falmouth, thanks so much for talking with us. Take care.

Kligler Well, thank you so much, Kathryn. I'm so glad to be able to talk to you again. It's really a pleasure.

After this interview was recorded, the state legislature's Joint Committee on Public Health reported as favorable Kligler's bill, the End of Life Options Act (S.1384 and H.2381).

Hear more about Kligler's diagnosis in this CAI story.

Learn more about the case by visiting compassionandchoices.org.

This transcript was lightly edited for grammar and clarity.

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