On election night, Jim Carberry and others who had worked to put a “Death With Dignity” law on the Massachusetts ballot gathered in the back room of a Waltham restaurant and watched their effort go down to narrow defeat.
“We were disheartened,” Mr. Carberry recalled. “For a lot of us, it was personal.”
His wife Margie, diagnosed with a rare brain tumor in 1995, had sought aggressive treatment for years – many surgeries and procedures, lots of radiation – hoping to see her younger daughter graduate from high school in 2011. She survived long enough to attend the ceremony. Then, with no medical options remaining, she asked to have her feeding tube removed. It took her five weeks to die. She was 51.
“I made her a promise that I would do whatever I could to keep other people from going through what we did,” said Mr. Carberry, who is 56. He gave endless media interviews and appeared in a TV ad with his mother-in-law, urging a yes vote on Question 2.
Question 2, which would have allowed doctors to prescribe drugs with which terminally ill patients could end their lives, drew less national attention than Elizabeth Warren’s Senate victory. But for those concerned with end-of-life decisions, Massachusetts was a major battle in an ongoing campaign.
Heading into election season, the volunteers and staffers who had collected signatures to put the law on the ballot could point to solid public approval. In August and September, polls by the Boston Globe, Suffolk University and others found 60 percent support or more.
By late October, however, Question 2 could no longer claim a majority. It lost by about 68,000 votes, a 51 to 49 percent defeat.
This was a fight its opponents felt they couldn’t afford to lose. “If the proponents could pass this in 40-percent-Catholic Massachusetts, they’d be running through the other states within five years,” said Joe Baerlein, whose public relations and lobbying firm Rasky Baerlein marshaled the opposition.
Its early research showed that Massachusetts residents believed in individual choice, and respect for others’ choices, about death and dying, Mr. Baerlein said. So the anti-Question 2 forces didn’t attack on direct moral or ethical grounds; instead, its ads took aim at certain provisions and how they were worded.
For instance, the proposed law — which included multiple safeguards and waiting periods to prevent impulsive requests, coercion or abuse — required a physician to “recommend” that a terminally ill patient notify his next of kin of his intent.
But it didn’t “require” family notification. “How would you feel if you came home and your mother had decided to take her life?” Mr. Baerlein said. “Voters couldn’t get their arms around that.”
The law also required a prescribing physician to refer a patient to a psychiatrist or psychologist “if the physician believes the patient may have a disorder causing impaired judgment,” like depression. But opposition ads criticized it for not mandating that a psychiatrist be one of the two physicians a patient had to consult.
Opponents also pointed out that medical prognoses — the law required that a patient be within six months of death — can be wrong. One ad, almost a counter to Dignity 2012’s spot featuring Mr. Carberry, showed a young widow whose husband lived a year and a half longer than expected. She was grateful he hadn’t “made a terrible decision based upon a doctor’s guess.”
“In the end, even if you believed you should control your end of life decision-making, there are too many flaws in the language,” Mr. Baerlein said.
To supporters, however, none of this parsing mattered nearly as much as money. They were vastly outspent.
The two groups pushing for Question 2 spent a little over $1 million this year, state finance records show, the bulk of which came from national groups like the Compassion and Choices Action Network and the Death With Dignity National Center.
The two major opposition groups spent close to $5 million, mostly on TV and radio ads in the campaign’s final weeks. “It’s a tactic they’ve used in other states, to blitz the airwaves with commercials,” said Peg Sandeen, who heads the Death With Dignity National Center.
Though some opposition money came from anti-abortion groups and the conservative American Principles Project (it gave $175,000, and its board chairman personally contributed $523,000), most came from Catholic organizations and archdioceses around the country, including $450,000 from the Knights of Columbus and $250,000 from the Archdiocese of Boston.
Supporters of Question 2 couldn’t counter that onslaught. “It’s so easy to scare people on this issue; that’s what happened in Massachusetts,” Ms. Sandeen said. “Fear-based arguments work.”
Data from the two states where physician-assisted suicide is legal shows that “slippery-slope” fears are probably overblown. Very few patients take advantage of death with dignity laws: Last year, just 114 people received lethal prescriptions in Oregon and 103 in Washington. In both states, about a third of those patients ultimately didn’t use the drugs.
It seems unlikely that any change in language could make an assisted-suicide law acceptable to the Catholic leadership.
But the campaign continues and so, undoubtedly, will the opposition. In neighboring Vermont, Gov. Peter Shumlin said last week he believes the legislature will pass a death with dignity law this session. In Massachusetts, Ms. Sandeen said, since supporters must wait until after 2016 to put the law on the ballot again, they will take their case to the legislature.
Mr. Carberry was ready to re-enlist. “I’d like to think that it’s not over,” he said.
Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”
The New Old Age Blog: How the 'Death With Dignity' Law Failed in Massachusetts
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