Tag Archives: Medical Aid in Dying

Medical Aid in Dying: Insights from Both Sides of the Stethoscope

What does it mean to make compassionate, informed end-of-life choices?

In this powerful episode of Delaware Health Care Reality, host Nicholas Biasotto, DO, leads a discussion on this complex and emotional topic. Guests Robert Varipapa, MD advocating in favor of MAID and patient autonomy, and Michael Vest, MD, a Critical Care specialist, presenting concerns against MAID legalization, debate Delaware’s proposed legislation, which could make it the 12th state to allow Medical Aid in Dying.

The three most frequently reported end-of-life concerns were loss of autonomy (92%), decreasing ability to participate in activities that made life enjoyable (88%), and loss of dignity (64%).

The conversation covers patient autonomy, palliative care, hospice support, and mental health resources. They also examine data from Oregon’s long-standing law and the ‘slippery slope’ argument (which has not turned out to be an issue.)

Medical Aid in Dying: Insights from Both Sides of the Stethoscope

A Transcript of Dr Varipapa’s introductory remarks with references and links is also available

Delaware Online

Dr Varipapa’s opinion piece on medical aid in dying (MAID) got published in Delaware Online.

https://www.delawareonline.com/story/opinion/2025/02/07/pass-end-of-life-legislation-in-delaware-opinion/78215409007/

Time for Delaware to Honor Patient AutonomyPass End-of-Life Legislation

A few days ago, the Delaware Health and Human Development Committee held a critical hearing on end-of-life legislation. The discussion was robust, focusing on essential issues such as patient autonomy, the unfounded fears of a ‘slippery slope,’ the role of hospice care, and the perspectives of physicians and advanced practice nurses. The time has come for Delaware to affirm its commitment to compassionate, patient-centered care by enacting medical aid in dying (MAID) legislation.

Patient Choice is Paramount

MAID is fundamentally about the right of individuals to make deeply personal decisions about their own bodies and lives. It does not impose any obligation on patients or physicians who choose not to participate, making it a model of respect for diverse values. The era of medical paternalism is over. We now recognize that patients—armed with medical guidance and personal convictions—are best suited to determine their own end-of-life care. Denying them this choice is not a safeguard; it is an infringement on their autonomy and dignity.

The Myth of the ‘Slippery Slope’

Opponents of MAID frequently cite the so-called ‘slippery slope,’ warning that legalizing medical aid in dying will lead to unchecked expansion and abuse. Yet, decades of data from the 11 states where MAID is legal provide no evidence to support these claims.

Medical ethicist Thaddeus Pope points out that the combined experience with MAID in these states spans over a century. The laws, largely modeled after Oregon’s Death with Dignity Act, have been in place since 1997, operating with strong safeguards and oversight. If there were any validity to the ‘slippery slope’ argument, we would have seen clear evidence by now. Instead, what we have is a proven framework that ensures patient choice while maintaining rigorous protections. Rather than succumbing to fear-based hypotheticals, Delaware should move forward with evidence-based legislation that reflects the real-world experience of other states.

Hospice Care and MAID Go Hand-in-Hand

Some argue that MAID is an alternative to quality end-of-life care, but the reality is quite the opposite. Data from Oregon, Washington, and California consistently show that more than 90% of patients who request MAID are already enrolled in hospice care. MAID is not about replacing palliative care; it is about giving terminally ill patients one more option in their final days. It provides peace of mind to those who, despite receiving the best hospice services, wish to exert control over their suffering.

Physician Support Reflects a Changing Medical Ethos

The medical community overwhelmingly supports MAID. Surveys consistently show that up to 70% of physicians favor giving patients this option. A recent Delaware physician survey mirrored national trends, demonstrating widespread professional support. Physicians—who bear witness to the suffering of their patients daily—understand the profound relief MAID can offer. It is time for policymakers to listen to those on the front lines of healthcare and align legislation with the evolving medical consensus.

Delaware’s Second Chance to Do the Right Thing

In 2024, the Delaware legislature approved end-of-life legislation, only to see it vetoed by the governor. This year, lawmakers have another opportunity to stand on the right side of history by reaffirming their support for patient autonomy and compassion. Passing House Bill 140 would grant the people of Delaware the fundamental right to make informed, personal decisions about their own healthcare.

This is not a partisan issue—it is a human one. It is about dignity, respect, and the recognition that every individual should have the right to determine how they meet life’s final chapter. The evidence is clear, the safeguards are strong, and the need is undeniable. The Delaware legislature must act now to pass MAID legislation and ensure that patients facing unbearable suffering have the freedom to make the choice that is right for them.

Medical Aid in Dying Nears Final Vote

Dr Varipapa Testifies in Legislative Hall

A legislative journey

The first attempt to pass medical aid in dying legislation in Delaware occurred back in 2015, and Rep. Paul Baumbach (D-Newark) has been persistently shepherding the measure through advancements and failures ever since.

This year, House Bill 140, also known as the Ron Silverio/Heather Block End of Life Options Law, named in honor of two advocates who died before its passage, has wound its way through the Delaware General Assembly. On Wednesday, the Senate Executive Committee advanced the bill to a Senate floor vote – it’s final step before heading to the desk of Gov. John Carney, where it’s future is uncertain.

The debate over physician-assisted suicide in the current legislative session has already seen some dramatic moments though, including its first approval by the House of Representatives in April. That vote was made possible in part by the vivid testimony from Middletown Republican Kevin Hensley, who changed his longstanding opposition after his own mother exercised the medically assisted suicide option last year in California, where it is already legal.

Just two weeks after her passing in April 2023, Hensley supported the measure through the House Health & Human Development Committee. Testifying through a choked-up voice, Hensley noted that he disagreed with her decision but came to understand that it was her choice to make.