So when it came time to end her life under a new California law for the terminally ill, her caregivers propped her up and held the cup as she drank a fatal mix of prescription drugs.
But physical assistance in taking the toxic medications is illegal, multiple experts contend.
Davis, a 41-year-old artist, suffered from Lou Gehrig’s disease, or amyotrophic lateral sclerosis (ALS). The complications she experienced in taking her life while trying to comply with California’s assisted-suicide law are far from unique, a Des Moines Register investigation of assisted suicides around the nation found.
Such complications also offer reason to reconsider or adjust “right to die” efforts in Iowa, say both proponents and opponents of such a law here.
“This story and this data should give all Iowans reason to pause and to ask ourselves: Is this really the path we want to go down,” said Jenifer Bowen, executive director of Iowa Right to Life, a group that is most commonly known for its fight against abortion but that also opposes assisted suicide.
The Register this year launched a review of national data on assisted suicide in other states, prompted by renewed political debate over efforts to make Iowa the seventh state to allow doctor-assisted suicide for terminally ill patients.
But records on hundreds of deaths in the six states that allow physician-assisted suicide are nonexistent or incomplete. That makes it impossible to decipher whether applicable state law was followed or if vulnerable patients suffered unintended consequences, the Register found.
“Assisted suicide is nearly untraceable. There is minimal reporting and tracking,” said Marilyn Golden, a senior policy analyst for the Disability Rights Education & Defense Fund in California. “It almost appears as if the practice of assisted suicide has deliberately been made secretive, all with the claim of patient confidentiality.”
Among the 1,642 documented assisted suicides in Oregon and Washington since the states began reporting statistics in 1998 and 2009, respectively, the Register found:
COMPLICATIONS: At least 38 people (about 2.5 percent) experienced complications as they were dying, including regurgitation of the fatal medicine, seizures or waking up after taking the medication.
INCOMPLETE RECORDS: At least 478 deaths occurred without record of key details, such as whether complications occurred. At least 203 people have died without a record of whether the deaths were from ingesting medication or from natural causes.
PROLONGED DEATHS: In 2009, a person in Oregon took more than four days to die after taking the medication. Of the two states, Washington had the most complete data. For deaths where time was recorded, 17 percent took 91 or more minutes. In Oregon, the median time before death in 2015 was 25 minutes.
NO DATA: Two of the states where assisted suicide is an option — Vermont and Montana — do not track deaths at all. Data from California and Colorado, the most recent states to legalize assisted suicide, is not yet available.
Golden argues for ending legalized assisted suicide based, in part, on the data. But others warn the information should instead be used to rally for better laws. That camp includes Jennifer Holm, a 46-year-old Ankeny mother with multiple terminal illnesses.
Holm has been one of Iowa’s most outspoken advocates for assisted suicide. She says the data tell her that doctors should be allowed not only to prescribe the lethal drugs but to administer them as well, to help avoid complications.
“I know there are a lot of people who say, ‘That becomes a slippery slope,’ but that’s just not true,” Holm said, pushing back against critics who contend the physical act of a doctor’s assistance would lead to unsolicited euthanasia.
Struggling to die with her failing strength
Davis’ suicide became a team effort by sheer necessity.
“I didn’t know what to do,” said Heather Okray, Davis’ caregiver for two years who helped steady Davis’ hand as she drank the fatal mixture of medication and coconut gelatin. “They give us this completely absurd time limit you have to down your liquid in. And for an ALS patient — that I know every day can’t drink that much — we were looking for a Hail Mary there.”
Her withering body and what it meant to comply with the new law were very much on Betsy’s mind in her final weeks. “I’ve been meeting with doctors, and filing paperwork, and, well, this is my window,” she wrote to friends in an email. “I have just enough strength in my arm to self-administer the drug.”
But Betsy, one of the first patients approved under California’s End of Life Option Act, ended up needing more help than expected. According to her sister, a doctor at the scene told the group it was OK, but she declined to identify the doctor.
The California Board of Medicine and other experts consider that help illegal.
“At that point, our understanding of the law was that we couldn’t assist her,” Kelly said. “But we knew that no one was going to come and arrest — no one was going to get in trouble. But it was still just this kind of concern.”
Disputed meaning of ‘self-administer’
Kelly and Okray, Betsy’s caregiver, were left with a lingering question: Is there an easier way to do this?
Suffering from ALS, Betsy typifies patients in the end stages of a particularly scary, ruthless disease that leaves them powerless. Many advocates of assisted-suicide laws would consider somebody like her in desperate need of such an option. Yet the very law intended to help such patients is written so that it might exclude her.
And the family was unable to obtain secobarbital, a drug commonly used in assisted suicides. Secobarbital sodium is the most commonly prescribed drug in assisted suicides and widely considered to be the most effective. But Betsy, faced with a local shortage of the drug, was unable to attain it in time for her own suicide.
So instead, friends and family devised a plan to make a gelatin concoction to help make the morphine, chloral hydrate and phenobarbital more palatable.
“I think out of all of this, that’s what makes me upset,” Okray said, “is watching somebody die like that and knowing there was an easier solution to it.”
Kelly said she also was troubled by the legal gray area: Had they violated the “self-administer” clause of California’s law?
The law defines “self-administer” as the “physical act of administering and ingesting the aid-in-dying drug to bring about his or her own death.”
Kelly said she was reassured to learn, after consulting with the organization Compassion & Choices, that “taking the medication needs to be a conscious, affirmative act on the part of the patient.”
“That doesn’t mean they couldn’t hold a cup that a person is drinking out of,” said Matt Whitaker, state director in California of the organization, which supports assisted-suicide laws. “That would be fine.”
A spokeswoman for the Medical Board of California referred to her organization’s analysis of the law, which, in its view, “permits a person who is present to prepare the aid-in-dying drug (but not assist in the ingesting of the drug) without civil or criminal liability.”
Claire Marblestone, an attorney with the Foley & Lardner firm in Los Angeles, specializes in health care law and regulation. She and a colleague wrote about key requirements of the California law for the National Law Review.
The law’s requirements that patients “self-administer,” Marblestone said, is “a little bit untested.”
“It’s a very touchy subject with a lot of potential areas for gray,” she said.
What it could all mean in Iowa
California’s legal gray area now spreads to Colorado and may have consequences in Iowa as such laws reach further across the country.
Iowa Poll results in March showed 59 percent of Iowans favor allowing the terminally ill to end their own lives. That included a slim majority of Republicans (51 percent).
Iowa Republicans, including Gov. Terry Branstad, have not thus far supported physician-assisted suicide. But Sen. Joe Bolkcom, D-Iowa City, noted the effort has seen bipartisan backing in other states. He believes the lack of GOP support for the option in Iowa might change in the face of public support.
DES MOINES REGISTER
How far will Iowa doctors wade into ‘death with dignity’ debate?
The GOP has majority control of the Iowa House and Senate, beginning in January. Without Republican support, any bill on the issue cannot advance through the legislative process.
“I’ve not abandoned hope,” said Bolkcom, who plans to reintroduce a bill for the option in next year’s Legislature.
Bowen, of Iowa Right to Life, says her group is beefing up its opposition despite Republican control. She cited GOP lawmakers around the nation who have supported assisted-suicide laws. She believes her group must maintain an aggressive, ongoing educational effort about the issue.
“There may have been a Republican surge on election night, but we saw Colorado that night approve assisted suicide,” Bowen said. “We can’t take anything for granted.”
Tamales, a Tesla and a sunset: How Betsy Davis chose to die
Forty-one-year-old Betsy Davis went through the screening steps with her primary care physician soon after California’s End of Life Option Act took effect on June 9.
By this time, the neurodegenerative disease known as ALS had robbed her of the ability to walk, lift her arm to her face, or eat and drink without choking. Davis, the focus of a Des Moines Register investigation regarding the complications arising from physician-assisted suicides, dragged her right pinkie across the smooth surface of an iPad to control her TV with what little strength she had left.
“She was done living with ALS,” said her sister, Kelly Davis. “She wanted to put an end to her suffering.”
Betsy’s family was unable to obtain secobarbital, a drug commonly used in physician-assisted suicides but in short supply where Betsy was living. Instead, friends and family devised a plan to make a gelatin concoction to help make the morphine, chloral hydrate and phenobarbital more palatable.
On July 24, about 30 people gathered at Betsy’s rental home in Ojai, Calif., including her three caregivers and her doctor.
After a final dinner of homemade tamales, Betsy was dressed in a ceremonial kimono. (One of her unfulfilled bucket-list items had been to visit Japan.)
She was taken outside and driven in a new Tesla to a favorite spot near a grove of fruit trees and empty horse stables. She was seated on her massage table, which was sheltered by a canopy, and faced west, toward the evening sky.
That’s when one of her friends discovered the Jell-O mix wouldn’t congeal.
“It was kind of like Elmer’s glue,” said Heather Okray, Betsy’s caregiver. “It smelled like it, too. Like a really strong paint smell.”
Most of the assembled group said their final goodbyes before Betsy swallowed the medicine. The doctor stayed to watch.
The massage therapist helped Betsy sit upright and then leaned her back as she drank the glop. Okray helped Betsy with the cup. They stopped just once to wipe her chin and make sure she was taking all of the mixture.
“(Betsy) just totally focused on getting all the medication down as fast as she could,” Kelly said, noting the drink had to be completed in a window of two to eight minutes to quickly end her sister’s life.
“When it got to the point where Heather was just actually going to have to take the cup and hold it for Betsy, that’s when we turned and, like, looked at her doctor,” her sister said. ” ‘What are we supposed to do here? This is going to take too long.’ And the doctor said, ‘Go ahead and hold it for her.’
“What we thought the law said was that Betsy had to take the medication herself. So it was this effort to not — that we weren’t the ones holding the cup. That ended up just slowing down the process. And her doctor said, you know, ‘Go ahead and hold the cup for her; that’s OK.’ Because if she didn’t take all the medication — if she fell asleep before taking all the medication — she would be in a coma for a couple days and wake up. She had to take all of it.”
It took Betsy nearly nine minutes to drink the lethal dose — about a cup and a half of what her sister described as “sludge.”
“As soon she was done, she was out; we just kind of laid her down, and she was out,” Kelly said.
“This,” Kelly said of her sister, “is something that she felt strongly about — being able to have this choice.”
How California will track assisted suicides
Public records don’t yet show whether the complications Betsy Davis and her family experienced with California’s new End of Life Option act are common or a rarity.
Davis, a focus of a Des Moines Register investigation about complications with assisted suicides, was too weak to drink a deadly concoction of drugs without help.
Davis is one of the first to use the state’s assisted suicide law, which went into effect June 9.
The state’s first annual report compiling data on California’s physician-assisted suicides is due July 1. The California Department of Public Health is hiring two employees to manage data tracking for the End of Life Option Act.
That report, similar to those being kept in Oregon and Washington, will contain:
The total number of lethal prescriptions written;
The number of patients who died from those drugs and the rate of those deaths per 10,000 deaths in California over the same period;
The total number of patients with prescriptions who died, regardless of cause of death, with the cause of death listed;
The number of patients with prescriptions who died in hospice or a similar palliative care program;
The number of physicians who wrote lethal prescriptions;
The demographic percentages of those who died from the lethal drugs, according to the following categories: age at death, education level, race, sex, type of insurance (including whether they had insurance) and underlying illness.
California compiles the data through forms submitted by “secure fax or mail.”
The law requires physicians to submit the forms but does not outline penalties if they fail to comply. The Medical Board of California could issue citations and fines to physicians who don’t comply, as well as follow existing California law that would allow it to suspend or revoke licenses, among other professional penalties.
An important victory that bolsters opposition nationwide
Trenton, NJ – “The New Jersey Alliance Against Doctor-Prescribed Suicide applauds the New Jersey Senate for recognizing the dangers to older people and those with disabilities and allowing S 382, legislation to legalize assisted suicide, to die without a vote on the floor of the Senate,” stated Kate Blisard of Not Dead Yet. “People are surprised to learn that all major national disability groups that have taken a position on the issue oppose the legalization of assisted suicide because the dangers of misdiagnosis, coercion and abuse put us at great risk.”
“A bi-partisan group of New Jersey Senators took the time to listen to the disability-rights community and to understand why it is important that doctor-prescribed suicide not become law in New Jersey,” continued Democratic Senator Peter Barnes. “It became clear that this bill would have a detrimental impact on vulnerable populations and expose them to abuse, coercion and possible denial of health care because it costs more than suicide drugs. While the bill’s few, vocal supporters educated legislators as to their personal concerns, it became clear that there are other solutions than doctor-prescribed suicide to address end-of-life pain. For that reason, there was never a groundswell of support for this bill and, on balance, we heard from many more voices opposed to this bill.”
The New Jersey Alliance exposed the following flaws in S 382:
No requirement of mental health evaluation or pain relief consultation.
Permits an heir to witness a death request.
Requires no oversight on whether the patient was willing to take the lethal drugs.
No requirement that a medical person be present to supervise the ingestion of lethal drugs.
Allows a third party familiar with how the patient communicates to make the death request.
Permits lethal drugs to remain in a patient’s home without securing them.
Relies on the inaccurate premise that a doctor can predict death within six months.
No distinction as to whether the death prediction is with or without treatment of the patient.
No required notification of family members.
Immunizes from prosecution anyone participating in administering lethal drugs, even if their participation was coercive and out of self-interest
Falsely certifies the cause of death.
The New Jersey Alliance Against Doctor-Prescribed Suicide is a broadly-based, diverse coalition of organizations strongly opposed to the legalization of assisted suicide. Alliance organizations include:
Resources for Independent Living
Dial, Inc. Center for Independence
Center for Independent Living
Heightened Independence and Progress – Bergen
Heightened Independence and Progress — Hudson
Progressive Center for Independent Living
Total Living Center
National Council on Independent Living
Not Dead Yet
Disability Rights Education & Defense Fund
Autistic Self Advocacy Network
Association of Programs for Rural Independent Living
New Jersey Alliance Against Doctor-Prescribed Suicide is a coalition of disability rights, healthcare, civil rights, faith-based and patient advocacy organizations dedicated to preventing legalization of doctor-prescribed suicide in New Jersey.
Note: The California Governor signed the Physician Assisted Suicide bill on Monday, October 5. Consequently, certain forces are now pushing for the NJ Senate to pass the NJ Physician Assisted Suicide bill (A2270/S382) this session. Please go to our Legislative section of the website and send an email message to your State Senator urging him/her to vote No on A2270/S382. Please also call their office and ask to speak with them to deliver the same message, Please do both even if you have done so multiple times before. Thank you.
My Mom Just Died Of Brain Cancer. Here’s Why She Opposed Assisted Suicide
By Mary Karner
October 6, 2015
I’ll admit it, I’m an adrenaline junkie. And judging from the plethora of new TV shows like “Trauma: Life in the ER” or “Code Black,” most of America is too. Except that’s my life. I’m a Trauma Nurse. I eat, sleep, and breathe trauma.
Every time I walk into work with a French Vanilla Swirl Latte from Dunkin’ Donuts in my hand, life and death are waiting for me. And up until this week I thought I’d seen just about everything. I’ve performed CPR till I thought my arms would fall off to keep blood pumping through a child’s body. I’ve administered life-saving medication to a patient having a stroke and seen the joy on his face when he regained his speech. I’ve had a patient fall through a ceiling onto another patient (I can’t even make that up.) I’ve held the hand of patients as they’ve taken their last breath, and I’ve hugged family members so tight I couldn’t breathe. I really thought I’d seen it all.
And then last week, my mom died. She had a glioblastoma brain tumor. I knew all about it, even cared for patients with her same diagnosis. I knew what was going to happen. But no matter how much I thought I was ready, I wasn’t. Death stings. And my beautiful, 52-year-old mother’s grave is freshly dug.
But my mom’s name was Dr. Maggie Karner. And she was the textbook definition of awesome. Don’t take my word for it, Google her. She devoted her entire life to helping others and spreading Christ’s beautiful gift of mercy for all. I’m not sure I’ve ever heard my mom speak more passionately then when she was talking about the word “mercy.” And that’s why my mom used her last days on Earth to campaign against a very dangerous use of that word. A “merciful death” some would call it, or a “right to die.”
My mom is most famous for a YouTube video that went viral entitled “A Letter to Brittany Maynard.” In the video my mom pleaded with Brittany, who had the same diagnosis, not to commit assisted suicide. Unfortunately, Brittany eventually chose to end her life, but my mom never stopped advocating for life. In her words, “How long will it be before the right to die quickly devolves into the duty to die? What does this mean for all who are elderly, or disabled, or just wondering if they’ve become a burden to the family?” Even while she was receiving chemotherapy, my mom spoke at the Connecticut state house to lobby against a “right to die” bill. The bill did not pass.
Difficulty Doesn’t Justify Suicide
That’s why my heart breaks tonight to learn the news that California’s governor has just signed legislation allowing residents of the state to take their own lives in the face of terminal illness. This makes five states in our nation allowing assisted suicide.
‘My brain may be cancerous, but I still have lots to contribute to society.’
Believe me, terminal illness sucks. There is no way to sugar coat that. It stole my mom from me along with so many others. But it also gave me something that I could never begin to describe, the opportunity to serve her. My family and I cared for her when she could no longer care for herself. We were her left arm when hers was paralyzed. And when that became too much, we had the distinct privilege of being able to visit her at her hospice facility during the last month of her life. She was not herself, and many times confused, but she could laugh. Even up until the day before she died. We laughed about seagulls that she thought were drones. We laughed about how much she loved chocolate and McFlurry’s from McDonald’s. We laughed about all the stupid things I did as a kid. And then when she could no longer laugh, we sang to her and we prayed with her.
My mom said it best in an op-ed in the Hartford Courant: “My brain may be cancerous, but I still have lots to contribute to society as a strong woman, wife and mother while my family can daily learn the value of caring for me in my last days with compassion and dignity.”
I’m here to say that she was right. No matter how hard it was and still is. She was so right. And the greatest honor of my life was to care for my mom in her last days. I hope and pray that her legacy will continue to inspire caring American voters to support those choosing to squeeze life for every drop that it has to give. Support hospice and palliative care programs that give true meaning to “death with dignity.” Let those fighting illness and disabilities know that they are precious, no matter what. They should never have to feel for a second that they might have a “duty to die” just because the option is available.
Mary Karner is a Registered Nurse currently working in Connecticut.
On July 7, 2015, members of the California Assembly Health Committee pulled the bill after lack of support due to serious concerns about the bill.
Physician Assisted suicide legislation has been introduced in 24 states, To date, none of these bills have passed. A NJ bill (A2270/S382) passed the full Assembly in November of 2014 and was released from the Senate Health Committee on December 15, 2014 without recommendation. It is still pending a full vote in the NJ Senate.Since January, 2015, physician assisted suicide legislation was defeated in Connecticut, Maryland, Delaware, Colorado, Wyoming, Maine Utah, Rhode Island and Nevada.
Please continue to call, email and meet with your State Senator to urge him/her to Vote No on A2270/S382. Please also call the Governor 609 292 6000 and urge him to veto this bill if it reaches his desk. Thank you.
California assisted death bill finished for the year
Senate Bill 128 stalls in Assembly Health Committee
California’s controversial assisted death bill is done for the year, according to the Assembly Health Committee.
In an e-mail to legislative offices, committee secretary Patty Rodgers wrote, “The authors will not pursue this bill this year – waiting on a statement from the authors explaining details and future plans.”
Senate Bill 128 would have allowed doctors to prescribe lethal drugs to terminally ill patients. It passed the Senate last month, but stalled in the Assembly Health Committee two weeks ago over increasing objections from Latino Democrats.
But the Catholic Church remained firmly opposed to the bill, arguing that it was an ethical violation. Proponents were not able to sway a majority of members on the Assembly Health Committee, some of whom pointed to personal experiences that counseled them against backing the bill.
“You’ve got to look at what I’ve done before the Legislature … working to help save and protect peoples’ lives, giving that option – a second chance at life,” Assemblyman Freddie Rodriguez, D-Pomona, who worked as an emergency medical technician, said Monday. “Letting folks have that option to end their life, it’s just something I can’t come to grips with.”
Some members denied that religious objections were a decisive factor.
“There are times when I can be in clear policy opposition to the church – clearly with a pro-choice stand as a Democrat, I can say ‘no’ to the church,” Assemblyman Miguel Santiago, D-Los Angeles, a practicing Catholic who once weighed entering the seminary, said on Monday. “It’s more of an internal struggle of how to look at the end of life more than any impact of religious or political” pressure.
Alexei Koseff: 916-321-5236, @akoseff. Jeremy B. White of The Bee Capitol Bureau contributed to this report.
Despite passage by the House, Senate support falls one vote short.
THE ASSOCIATED PRESS
AUGUSTA – Maine lawmakers have defeated a bill that would have allowed doctors to provide lethal doses of medication to terminally ill patients.
Republican Sen. Roger Katz’s bill died Tuesday because the Senate and House failed to agree on the bill.
Katz and other supporters said that people who don’t have much time left to live should be free to end their life when they are ready. But opponents said lawmakers should focus on expanding access to palliative care. They said they feared it would send the message that the state of Maine condones suicide.
Lawmakers on Wednesday stalled legislation in committee that would allow terminally-ill patients to request medication to end their own life.
Rep. Paul Baumbach, D-Newark, said he requested that lawmakers on the House Health & Human Development Committee keep the ‘Death with Dignity’ legislation in committee.
“We knew when we filed the bill that we did not yet have a critical mass of support, but what we also knew was that the bill and the issue needs to be heard…,” he said. “I’m hopeful that we will continue to learn about this issue and see whether, and how we wish to proceed.”
Baumbach said he has plans to introduce a bill that would establish a task force exploring end of life treatment and choices in Delaware.
“Hopefully we’ll over the next six months we’ll have public meetings to learn more and hear more from each other and find best practices across the country,” he added.
By tabling the bill, lawmakers on the committee can always bring it back for a vote until June 30, 2016.
Patients would have to have an incurable and irreversible disease expected to end their life within six months. Two doctors would have to confirm the diagnoses, according to the legislation.
They would also have to be informed of all alternatives, including hospice care, and a mental health consultation is required if either doctor suspects any mental illnesses, like depression.
There is a three-step process for patients to receive the life-ending medicine, according to the legislation. A patient would have to make the initial request, then there would be a 15-day wait, another request, then a two-day wait, and then the patient would receive the prescription pills. After ninety days the initial request would expire.
According to the legislation patients can rescind their request at any time.
Doctors and healthcare providers are also able to choose whether or not they participate and can opt-out as well. Doctors and healthcare providers are protected from any retaliation under the legislation, according to the bill.
Oregon, Vermont and Washington have similar laws. Court decisions in Montana and New Mexico also have allowed the practice in those states.
Contact Jon Offredo at (302) 678-4271, on Twitter @JonOffredo or email@example.com
CHEYENNE — The Wyoming House Travel, Recreation, Wildlife and Cultural Resources Committee unanimously voted to table legislation which would allow physicians to prescribe life-ending medications to terminally ill patients.
The committee also recommended that an interim committee research the issue.
Proponents of the legislation argue that the legislation offers terminally ill patients a humane end-of-life option and a way to say goodbye to their families. Supporters also believe that they shouldn’t have to leave their home state to have the option available.
Rep. Dan Zwonitzer, R-Cheyenne, called the vote the best possible outcome for House Bill 119.
“Several committee members pledged to do their best to get management council to assign it to a committee during the interim and do a study,” he said. “That’s probably more successful than it going to the floor and dying.”
The committee heard emotional testimony from Wyoming residents who would be affected by death with dignity legislation. Testifying before the committee, Alisha Loveland of Casper, told the story of her father-in-law. He was diagnosed with emphysema and knew it was a matter of time until the disease took his life. Taking matters into his own hands, he ended his life with a firearm.
Loveland told the committee that she and her husband had to clean up the aftermath.
“He had gotten to the point where he couldn’t walk even to his workshop. He knew he would eventually suffocate to death. He didn’t want to wait until the agonizing end,” she said.
“I don’t understand why we have to be medical refugees and go to another state to die. I don’t understand why we can’t stay in our own state and die in our own bed with loved ones around us.”
Rep. Dan Kirkbride, R-Chugwater, serves on the committee. He said that he would oppose death with dignity legislation on the house floor for spiritual reasons. He also said that legislation would put doctors in a bad place, calling the legislation a “slippery slope.” He said that health care professionals take an oath to provide the best possible care and that assisting patients dying would violate that oath.
“It would probably open some doors to some other things in society that we haven’t considered,” the legislator said.
HB119 is among more than 10 bills proposed in state legislatures across the country. Five states have death with dignity laws on the books. New Mexico, Montana, Oregon, Washington and Vermont currently allow the practice.
Jessica Grennan, of Missoula, Montana, is the national field director for Compassion and Choices, the nation’s largest death with dignity proponent. She said that while she is pleased that the committee recommended that the state look into the issue, she would like to see the legislature hasten their work on the matter.
“I’m pleased that we’re going to further the conversation. I wish the people who want this end-of-life option now in Wyoming…I’m sad that they have to wait,” Grennan said.