L.D. 652, sponsored by Sen. Eric Brakey, R-Auburn, abolished the requirement for a permit to carry concealed handguns and has been signed into law.

Brakey noted that a law requiring a permit does not stop criminals from carrying concealed. Until L.D. 652 was enacted, a law-abiding resident in Maine could carry a weapon openly, but became a criminal if the gun was hidden by a jacket.

Brakey, as chairman of the Health and Human Services Committee, did not extend the same kind of effort to L.D. 1270, An Act Regarding Patient-Directed Care at the End of Life.

It is already legal for a physician to increase morphine dosing for dying people with the intent to relieve pain, even though such an increase induces coma and hastens death. This is known as the “doctrine of double effect.” Some medical and legal ethicists argue that the “double effect” makes palliative sedation no different from a prescription a patient could take on their own as death approaches. And some medical professionals agree.

This excerpt from a draft American Academy of Hospice and Palliative Medicine position statement clearly shows the awareness of physicians [bracketed comments are mine]:

“Physician Assisted Dying is defined as a physician providing, at the patient’s request, a prescription for a lethal dose of medication that the patient can self-administer by ingestion, with the explicit intention of ending life. Although this activity has not been within the historic domain of modern medicine, it currently exists as both an explicit [open] and covert [concealed] practice across various legal jurisdictions in the United States.”

Acknowledging that morally conscientious individuals stand on both sides of the issue, the academy says it does not support a shift to include physician-assisted death as part of normal medical care, including palliative care. The academy, however, recognizes that some physicians sometimes assist patients in ending their lives. And making the means of death readily available actually may reduce the patient’s desire for a physician-assisted death.

The academy has been both honest and forthcoming in its perspective. Recently, the California Medical Association has done the same, recognizing as an organized body of physicians that sometimes even exceptional palliative hospice care is not enough.

In some dying circumstances, a rational decision to end one’s life a little early is fully justified and should be supported in a safeguarded, open, legal way. L.D. 1270 offered exactly that and was clear in its language that anyone who conscientiously objected to participating (physicians, pharmacists, hospitals, etc.) was free to do so. In fact, that bill was so safeguarded, that if no physician in Maine agreed to write a prescription, then no terminally ill patient could legally get one.

A physician wanting to help a dying patient in Maine currently risks criminal prosecution if he or she writes a prescription for that patient to take when death becomes imminent, yet the law protects a physician who gives an overdose of morphine to induce deep sedation, followed by death. In that instance, a patient is considered to have died a “natural death.”

The terminally ill who might have qualified for an end-of-life prescription under L.D. 1270 don’t have that option, despite public testimony from physicians, nurses, clergy, patients and families supporting the bill. Rep. Patricia Hymanson, D-York, a neurologist who sits on Brakey’s committee, supported the bill, citing one’s dying circumstances as deserving of “ultimate civil liberty.”

Maine’s dying can now legally conceal a handgun under their jammies without a permit. That’s little comfort for those who were hoping for L.D. 1270’s end-of-life option.

Valerie Lovelace, of Wiscasset, is executive director of It’s My Death, a public charity organization providing services and education to people who wish to actively explore the meaning of life through embracing the certainty of death.

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