Category: Death with Dignity

Injunction Issued Against Operation of New Jersey Medical Aid in Dying For the Terminally Ill Act

This statute in May and August was the subject of two previous postings on this blog.  As of August 1, 2019, health care providers in New Jersey were to be authorized to provide qualified terminally ill patients with prescriptions for medication which would enable the patients to end their own lives.  The phrase “terminally ill” was defined as being “in the terminal stage of an irreversibly fatal illness, disease, or condition with a prognosis, based upon reasonable medical certainty, of a life expectancy of six months or less.”  Codified at N.J.S.A. 26:16-1 et seq., the statute would not actually be operational until August 16 because of a statutory provision requiring the patient to make a second oral request no sooner than 15 days after the first request as a precondition for the physician providing the prescription.

On August 14, 2019, an Order with temporary restraints was entered by Judge Paul Innes sitting in the Chancery Division-General Equity for Mercer County enjoining the Attorney General from enforcing the statute.  The Order was issued in response to an application by Verified Complaint in the matter of Yosef Glassman v. Gurbir Singh Grewal, Attorney General of the State of New Jersey, Docket No. MER-C-53-19.  With a ten-count Verified Complaint, plaintiff sought to invalidate the statute on a number of constitutional grounds. The plaintiff is a licensed New Jersey physician with moral and religious objections to the conduct that the statute would authorize.  Judge Innes scheduled an October 23, 2019 return date for the Order to Show Cause.

The Office of the Attorney General filed an emergent motion with the Appellate Division.  The Appellate Division ordered expedited briefing to be completed by August 23, but declined to dissolve the injunctive order.  An application was then made to the New Jersey Supreme Court.  It entered an Order on August 20 denying the request for immediate dissolution of the injunction against implementation of the statute and declined to take any further action concerning “an issue of this magnitude” until the Appellate Division addressed the identical motion with the “thoughtful consideration” reflected by its order for expedited briefing.  It requested that the Appellate Division resolve the matter expeditiously.

As pointed out in prior blogs, New Jersey is the eighth state along with the District of Columbia enacting such physician-assistance in dying legislation.  There has been litigation challenging the validity of such statutes elsewhere, some of which is ongoing.

New Jersey becomes Eighth State to Pass Death with Dignity Legislation

On March 25, 2019, both the New Jersey Assembly and the New Jersey Senate passed the Medical Aid in Dying for the Terminally Ill Act (the “Act”).  The final version of the bill was sponsored by Assemblyman John J. Burzichelli and Assemblyman Tim Eustace.  Governor Phil Murphy signed the bill into law on April 12, 2019 stating, “Today’s bill signing will make New Jersey the eighth state to allow terminally ill patients the dignity to make their own end-of-life decisions – including medical aid in dying.  We must give these patients the humanity, respect, and compassion they deserve.”

The Act “permits qualified terminally ill patient[s] to self-administer medication to end [their] live[s] in [a] humane and dignified manner.”  New Jersey is now only the eighth state in the country to allow competent, terminally-ill adults to exercise their “right to die.”  Under the Act, “terminally ill” is defined as a patient who “is in the terminal stage of an irreversibly fatal illness, disease, or condition with a prognosis, based upon reasonable medical certainty.” 

Furthermore, qualified patients choosing to exercise their rights under this Act will be required to submit their request in writing, stating, among other things, that they have been fully informed of any available alternatives.  Two individuals, one who must not be a relative, entitled to any portion of the patient’s estate, or the patient’s doctor, must witness and attest the voluntariness of the patient’s request. 

A “right-to-die” bill was first introduced in New Jersey in 2012.  Proponents of the Act believe it gives adults the right to control their lives, die with dignity if they so choose, and decrease their prolonged pain and suffering.  Proponents of the Act also believe that there are enough safeguards in place to protect vulnerable, elderly adults. For example, the Act requires a patient to make several requests prior to receiving a prescription.  Additionally, not all terminally-ill patients who request and receive the medication will actually end up self-administering the medication – some patients simply like having the option of requesting such medication. 

Opponents of the bill argue that once a “right-to-die” bill is passed, New Jersey will be unable to outlaw the practice.  Further, they argue that vulnerable adults may misuse the Act, while certain adults may feel pressured to end their lives, viewing themselves as burdens to their families.  A 2015 Rutgers-Eagleton poll found that sixty-three percent of New Jersey residents support the passing of a “right-to-die” bill. 

It will be interesting to monitor the effects of these statutes on physicians, psychologically and professionally.  It is debatable whether providing such medications to terminally ill patients in pain can be reconciled with a physician’s Hippocratic oath to do no harm.  It will also be interesting to see what, if any, pressure will be placed upon doctors to provide such services to patients given that many may have moral objections to administering such medications.