By: Chris Haring

An op-ed  written by state Senator John Hoffman drew letters from several assisted-dying advocates with rebuttals to his misleading and inflammatory claims.

As right-to-die advocates across the United States gear up for a promising 2024 legislative session, the battle for public opinion relies more than ever on refuting inaccurate, unfair, and – in some cases – downright malicious attacks on medical aid in dying, both in principle and in practice.

Inflammatory accusations galvanize assisted dying supporters

In a December op-ed for the Star Tribune, Minnesota state Senator John Hoffman (DFL-Champlin) drew disturbing parallels regarding the End-of-Life Option Act (SF 1813/HF 1930), which would legalize physician-assisted death with safeguards and requirements in place similar to the country’s other jurisdictions that have provisions permitting Death with Dignity. 

While the senator’s criticisms were riddled with offensive historical analogies and sensationalized speculation about vulnerable communities, they also served to galvanize members of the Minnesota aid-in-dying movement, who submitted several compelling, passionate letters in refutation.

Minnesotans set the record straight on medical aid in dying

One Minnesotan, Tara Guy of Roseville, said she read Hoffman’s employment of terms like ‘suicide’ and ‘euthanasia’ with “incredulity,” emphasizing that his invocation of Nazi Germany was “outrageous.” “[E]lected and government officials routinely [present] ‘alternative facts’ as truth,” she added, calling Hoffman “either grievously uninformed as to the actual text of the draft legislation or… purposefully misrepresenting its content to frighten Minnesota citizens.”

Another writer, former Minnesota Hospital Association general counsel/University of Minnesota assistant professor David Feinwachs, criticized Hoffman’s professed concern over the potential for abuse driven by cost-reduction considerations within healthcare networks as “ironic.” 

While its medical assistance program exempts disabled people from being forced into managed care, the state legislature has failed to advance a bill that would have given other medical assistance enrollees more freedom in selecting their care outside its HMO network. “Unlike patients seeking [assisted death], patients in Medicaid managed care have no choice,” Feinwachs said, adding “If you want to worry about someone, worry about them.”

Ultimately, the discourse surrounding medical aid in dying is complex and deeply personal, often evoking reactions that can become heated even when both parties are engaging in a good-faith debate. The dynamic, informed messaging in the following letters exemplifies how to dismantle misconceptions and highlight the need for legislation that prioritizes bodily autonomy and dignity, especially when addressing spurious “concerns” such as those raised by Sen. Hoffman.

For more information on how to get involved in efforts to bring a Death with Dignity law to Minnesota, please visit the state page on our website.

Read the letters below:

Readers Write: Medical aid in dying

I read with incredulity state Sen. John Hoffman’s irresponsible comments in his opinion piece last week regarding Minnesota’s draft End-of-Life Options legislation (“Heed history’s warning on aid in dying,” Opinion Exchange, Dec. 15). His fearmongering assertions featured triggering imagery and outrageous comparisons to the Hadamar “killing center” operated by the Nazis in World War II; I could scarcely believe it was written by a lawmaker charged with crafting legislation for the citizens of Minnesota.

Medical aid in dying (already legal in 10 states and District of Columbia) is not “suicide,” though Hoffman referred to it as such a dozen times. Even less so is it “euthanasia,” which, by definition, requires purposeful action by one person to end the life of another. Minnesota’s option would only be available to adults of sound mind who are dying (with a double-verified medical prognosis of less than six months to live — most are in hospice) who can self-ingest the medication if suffering becomes unendurable as they near death. American laws are crafted so narrowly that only a tiny percentage of terminally ill people can even meet the necessary criteria to request the prescription. Protections against abuse are written into the law, any form of which would be prosecutable as a felony.

Our troubling times have devolved so far as to include elected and government officials routinely presenting “alternative facts” as truth. In this case, Hoffman is either grievously uninformed as to the actual text of the draft legislation or is purposefully misrepresenting its content to frighten Minnesota citizens. It’s hard to say which would be worse.

Tara Guy, Roseville
The writer is a volunteer with Compassion & Choices.

•••

I read with great interest Hoffman’s opinion piece on aid in dying.

Hoffman said that “HMOs’ health care decisionmaking introduces another layer of complexity. When profit-driven entities are entrusted with determining the allocation of resources and medical care, the risk of neglecting the needs of individuals with disabilities becomes pronounced. Ethical guidelines and oversight mechanisms must be in place to ensure that financial considerations do not override the commitment to the well-being of all individuals, regardless of ability.”

I could not help being struck by the irony of this statement. Last year a bill in the Minnesota Legislature would have given Medical Assistance enrollees the ability to choose fee-for-service health care as opposed to managed care in the Medical Assistance program. The proposal was killed just before it was scheduled to pass because certain interests wanted medical assistance patients trapped in managed care. Why? Because they make more money using the managed care model.

The irony here is twofold. First, the Medical Assistance program exempts disabled people from being forced into managed care. Very likely for exactly the reasons that concern Hoffman, who fears that economics will play no small part in shaping health care treatment decisions.

The second part of the irony involves the fact that while the Legislature rightfully protects the disabled, it throws the rest of the Medical Assistance population to the managed-care wolves. The measure that was killed would have saved the state and the taxpayers money while granting people the right to choose their health care. It was killed so certain hospitals could continue to make more money. Not long after the measure was killed, the U.S. Office of Inspector General released a study raising concerns about the dangers of managed care and health care access in the Medicaid program. Perhaps we should ask which hospitals and which legislators were responsible for euthanizing freedom to choose in Minnesota’s Medical Assistance program.

Unlike patients seeking medically assisted suicide, patients in Medicaid managed care have no choice. If you want to worry about someone, worry about them.

David Feinwachs, St. Paul
The writer is an attorney and former general counsel for the Minnesota Hospital Association and former assistant professor at the University of Minnesota.

•••

In his commentary, Hoffman begins by seemingly disparaging the legislative process. I am sure that he has spent time trying to massage his favorite legislation in order to recruit reluctant support toward passage. His complaint here seems disingenuous.

He then moves on to invoking Nazi atrocities as a bulwark against any discussion of the medical aid in dying movement. Unfortunately, this attitude by a member of the DFL caucus will go a long way to derail any hope of this bill passing or even receiving a genuine hearing. He mischaracterizes the concept of death with dignity by using the word “suicide” a dozen times. He also fails to mention that another Nazi favorite was starvation, which is currently the only legally acceptable method for hastening an inevitable death for a terminally ill patient. Very compassionate indeed.

In addition, he demonstrates his lack of bedside bona fide by mentioning that palliative care for the management of pain would render all other aspects of end of life care moot. Finally, he seems to imply that the folks in the cubicles at UnitedHealthcare will be making decisions to pull plugs in defiance of the ADA, instead of paying for colonoscopies.

Hoffman’s uninformed, misguided and scatterbrained opinion piece exemplifies why endlessly complicated medical decisions are best left to patients, families and their physicians who can best wrestle with the nuanced aspects of a patient’s care as it relates to comfort, dignity, autonomy and privacy.

And please, stop using the slippery slope metaphor as a negative. Buck Hill just opened.

David A. Plut, Minneapolis
The writer is a retired physician.