Doctors who specialize in geriatric medicine say they're seeing Kentuckians with advanced cancer and other serious illnesses travel out of state to end their lives on their own terms.

It may mean going to Oregon, which as of last week will no longer require a person to establish residency to be eligible for medical aid in dying.

Oregon is one of 10 states, along with the District of Columbia, where the practice is legal.

Dr. Christian Furman, medical director of the Trager Institute and Smock Endowed Chair in Geriatric Medicine at the University of Louisville School of Medicine, explained most of her patients are terminally ill and in their 80s or 90s. She said doctors in Kentucky want to expand the options for these patients and their families.

"We can definitely help with a lot of the pain and symptoms, and taking care of the patient and family as they need care," Furman explained. "But there are those patients where, you know, you just can't."

A recent poll from the nonprofit Compassion & Choices found voters, nationwide and across party lines, are eight times more likely to vote for candidates who sponsor or support medical aid-in-dying legislation.

The American Medical Association is opposed to the practice, however its Code of Medical Ethics affirms that pro and con positions are in moral equilibrium and says physicians may participate in medical aid in dying without violating their ethical obligations.

Furman note it is common for terminally ill patients to refuse food or water, a sign they are ready to end their lives.

"I've never had anybody intentionally say, 'OK I'm going to stop eating and drinking, so I'll die quicker.' I have had people say, they're just ready," Furman recounted. "They've made the decision, they're ready to die, they don't want any life-prolonging treatments."

She added physicians in the state are becoming more aware of the importance of expanding end-of-life options for patients' agency, comfort and care.

"We have a palliative medicine fellowship at U of L, and we teach this in our fellowship, what medical aid in dying is," Furman stressed.

Rep. Josie Raymond, D-Louisville, introduced a bill earlier this year, which would legalize the option in Kentucky.

After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


get more stories like this via email

New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.