In 2022, Northern Virginia resident Barbara Green got news no one wants to hear: she had pancreatic cancer. Doctors told her she likely had nine months to live. A year and a half later, the 79 year-old has defied the odds, but said she's clear-eyed about the future.
"There is no cure for pancreatic cancer," Green said. "It will kill me at some point."
The prognosis led Green to consider ending her life on what she calls her own terms. In ten states and Washington D.C., some patients with terminal illnesses can request medication from their doctor to end their lives. A doctor — or in some states, nurse practitioner or physician assistant — must deem the patient mentally competent and with a prognosis of six months or less to live.
"They can give me horrible chemotherapy drugs that can make me very sick," Green said. "But they can't give me a drug to help me die peacefully if I'm at that point? I just — I don't understand it."
The debate has become increasingly common in statehouses across the country. Nineteen state legislatures, including Virginia, are considering bills related to physician-assisted death, according to the advocacy group Compassion & Choices.
The group's CEO, Kim Callinan, notes national and state-level polling show broad support for the practice. In Virginia, a 2022 poll from Christopher Newport University found two-thirds of voters support allowing a mentally capable adult with a terminal disease the right to request and obtain medication to end their life.
"Death is not partisan," Callinan said. "When you look at the data, Democrats, Republicans, independents, libertarians— all of them are supportive of this option."
In Virginia, Callinan has a powerful ally in U.S. Rep. Jennifer Wexton. Last year, the 55 -year-old was diagnosed with progressive supranuclear palsy — a rare, terminal illness she's described as "Parkinson's on steroids."
Wexton, who announced in September year she wouldn't seek reelection, declined an interview.
At a press conference last month, state Sen. Jennifer Boysko read a letter from Wexton describing her illness.
The disease "has robbed me, my family and the many people in my life who I love (and who love me) of so much," Wexton's letter read. "But if this bill becomes law in Virginia, it would return control over when, where, and how our stories end to us, not to our diseases."
Virginia Democratic lawmakers, who control the state legislature, are supportive of the measures. The state Senate bill is set for a vote as early as Thursday afternoon.
It's not clear how Republican Gov. Glenn Youngkin would treat the bills if they made it to his desk; a spokesperson said he'd review any measures passed by the legislature.
The debate continues
The debate over physician-assisted death remains as heated as ever. There's disagreement over what to call the practice; critics and some news organizations use "physician assisted suicide," while backers refer to it as "medical aid in dying."
"When you talk to people who are choosing this option, they get deeply, deeply offended if you refer to it as assisted suicide," said Callinan of Compassion & Choices. "Most of them desperately want to live. But unfortunately, a disease is taking their life and they can't."
Critics of physician-assisted death include some religious groups, disability rights advocates, and the American Medical Association. Last year, the AMA's legislative body voted against changing its stance on physician-assisted death, which its code of ethics describes as "fundamentally incompatible with the physician's role as healer."
Olivia Gans Turner, president of the Virginia Society for Human Life, said she thinks the focus should be on reducing pain and addressing anxiety and depression, not hastening the end of a patient's life.
"If you are going to die, you're going to die," Turner said. "Let's use that time in a way that assists you to be lifted up emotionally, physically, and those around you."
Turner said while backers of these types of bills focus on personal autonomy, physician-assisted death has ripple effects on loved ones and reflects a community's shared values.
"It's much bigger than the individual," Turner said. "And it's much more complicated than just 'I want to have control.' What does that mean for our entire society?"
If the bill fails in Virginia, patients who have the time and means to travel — and move through bureaucratic and medical regulations — may still have options. Last year, the governors of Oregon and Vermont signed laws allowing out-of-staters to access physician-assisted death.
Green plans on establishing residency in Washington D.C. to access the option if the Virginia measures don't pass. She's preparing for contingencies; she said she doesn't know exactly how her final weeks or days will go.
"Nobody does," Green said. "And that's really, I think, what people need to remember: You never know what's going to be in your future."
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