St. Paul Pioneer Press

Distributed by Tribune Content Agency

Although a “Compassionate Care” bill — one actually allowing patients who meet a strict set of criteria to end their lives with lethal prescriptions — was withdrawn from consideration after a hearing in the Minnesota Legislature last week, the issue will remain before Minnesotans.

It involves a tough conversation, and there’s no cause to shy from it.

Kirk Allison, who directs the program in human rights and health at the University of Minnesota’s School of Public Health and testified against the bill, told us he thinks Minnesota is pretty good at airing difficult issues. “At the hearing, people were impassioned, but they were civil.”

Civility isn’t the only thing that matters, but it does help make room for reason.

More education is needed, the bill’s chief author, Sen. Chris Eaton, a Democrat from Brooklyn Center, told us. The strategy to defeat the measure “is clearly to spread fear.” Information will help calm those fears, she says.

With one side emphasizing “compassion” and the other “assisted suicide,” it’s a conversation in which language matters.

“Sen. Eaton says this isn’t suicide. Well, it is. It’s the hastening of death, and we know that to be true,” Dr. Cory Ingram, who works at Mayo Clinic, and who also testified against the bill, told us.

“This is about physician-hastened death, and to use terms such as ‘compassion’ and ‘choices’ for death with dignity really confuses the public,” he said. “It makes it seem as though non-death-hastening practices are by definition not dignified and not compassionate.”

It’s also a discussion in which consideration of a “slippery slope” is necessary.

Ingram was a medical student in the Netherlands in the 1990s, when that nation was considering the matter. He was reassured that the Dutch could make workable law and set limits.

Now, after “what started out just like S.F. 1880,” Eaton’s measure, “they offer both physician-assisted suicide and euthanasia, the active administration of medicines to the patient,” with the intent of causing his or her death, Ingram said.

In the Netherlands, it is offered to some people with disabilities, some with depression, personality disorders or dementia and people “tired of living” over the age of 70, he said, noting a recent trend, “spousal self-euthanasia,” for elderly couples who wish to die at the same time.

Minnesota also will need to consider the issue in light of health-care cost pressures in the face of a fast-growing aging population. “Every day, I see people who are looking at the possibility of spending $5,000 to $10,000 a month to receive care near the end of life,” Ingram said. Such legislation could be attractive to hasten the end, “rather than spend their wealth.”

He said he recommends “legislating the right to comprehensive and affordable care through the end of life instead of a law to hasten death.”

Most objections are on religious grounds, said Eaton, a registered nurse, who told us she has witnessed deaths that were both peaceful and agonizing.

“I just find it kind of ironic that they want to impose the way they practice their religion on the rest of us,” she said. “This is totally voluntary, and no one can be forced or required to participate.”

Our editorial board met last week with Dan Diaz, who moved from California to Oregon with his wife, Brittany Maynard, who chose to die in 2014 at age 29, rather than suffer through the final stages of a fatal brain tumor.

Diaz makes his case passionately and poignantly. Like Eaton, he emphasizes that the Minnesota bill, which follows Oregon’s, has numerous safeguards.

“In the 18 years the Oregon law has been in effect, there has not been any instance of failure to comply with the guidelines of the law and no attempt to weaken the safeguards,” Eaton told us.

Looking at the data will be important, the U of M’s Allison suggests.

“In Oregon, it’s frequently said that there are no problems,” he told us, but the state agency that receives data has “no budget and no authority to investigate malfeasance.” Allison also questions records-retention practices that put accountability in question.

As Minnesotans talk about end-of-life options, there’s much to consider. The soul searching to come will call on us to weigh competing values and society’s role in individual decisions. Whatever its outcome, the conversation will be informative.