Philly woman with terminal cancer is suing N.J. to change its medical aid-in-dying law’s residency requirement

Since Andy Sealy was diagnosed with breast cancer, she has hosted a series of parties, including fundraisers and a mastectomy farewell party with a “tatas” cake and the slogan “thanks for the mammories.”

The celebrations helped the 43-year-old from South Philly to enjoy life at a time when much of her health felt out of her control. She learned in 2017 that the cancer had spread to her bones and was terminal.

Now, before sending out the invites to her last party, she needs to know when she’ll die.

Sealy wants to host a funeral for herself, where friends and family share what they love most about her. She envisions it as a send off before retiring somewhere quiet to take medications that enable her to die at the time and place of her choosing, with loved ones and a faith leader by her side.

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The option is legal in New Jersey, a 10-minute drive from her home, but not in Pennsylvania. Sealy is among a group of patients and doctors who are suing New Jersey in an effort to expand access to its medical aid-in-dying law.

New Jersey is one of 10 states that allow terminally ill patients to obtain lethal doses of medications to use to end their lives. But the law prohibits doctors from prescribing these medications to anyone who is not a resident, a significant hurdle for people from neighboring states — including Pennsylvania and New York — where it’s not permitted.

The complaint, filed in federal court in late August, alleges that the residency requirement violates patients’ right to equal protection under the U.S. Constitution, because it forces doctors to treat them differently if they live out of state.

Opponents of these laws, including some disability advocates, argue that the provision is a critical safeguard to an irreversible procedure.

For Sealy, the medications represent a chance to have control over her body. Just having that option to die when she chooses would give her comfort in her final days — rather than uncertainty.

“I do very much want to live, but the cancer is what’s killing me,” Sealy said. “It’s just the option that I want to have.”

In 1994, Oregon became the first state to enact a medical aid-in-dying law. Since, nine other states and Washington D.C. followed. Gov. Phil Murphy signed New Jersey’s aid-in-dying bill into law in 2019.

The law allows adults who are residents of New Jersey and are expected to die within six months from a terminal illness to obtain a prescription for a lethal drug cocktail that involves between four and six medications. They must be able to make their own decisions and administer the medication by themselves.

Two physicians must confirm the prognosis. Then patients must make two verbal requests, 15 days apart, and sign a written request with witnesses present.

Last year, 103 New Jersey residents used the law to obtained such prescriptions, and 91 of them took the medication to end their lives, according to the New Jersey Office of the Chief State Medical Examiner. Cancer and neurological diseases, such as ALS, were the most common types of illness among people who sought a medical aid-in-dying prescription.

Deborah Pasik, a New Jersey physician who assists terminally ill people in dying, joined the lawsuit challenging the residency requirement because she frequently receives calls from patients in Pennsylvania or New York asking for help.

“A lot of these patients hit a brick wall, because they either don’t have resources to establish residency or they don’t have the time,” said Pasik, who is also the president of New Jersey Death With Dignity, a medical aid-in-dying advocacy organization.

Critics say that removing the residency requirement — and making aid-in-dying prescriptions more accessible — could make states with aid-in-dying laws destinations for medical tourism. And some disability advocates worry that as these laws become more common, the eligibility criteria would expand beyond the terminally ill.

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“These laws are supposed to be for people who are terminally ill, but doctors often make mistakes,” said Anita Cameron, a disability activist and director of minority outreach for Not Dead Yet, a national nonprofit that opposes aid-in-dying laws.

When Cameron’s mother was diagnosed with end-stage chronic obstructive pulmonary disease in 2009, physicians told her she had six months to live and placed her in hospice care. She lived for another for another 12 years. Cameron worries that other people in her mother’s position would choose to end their lives, wrongly thinking they are in their final days, she said.

Cameron said she also worries that racial bias among doctors may make them more likely to prescribe the lethal medications to people of color than to white patients. She fears patients with disabilities may be particularly at risk since people — including medical professionals — can be quick to assume they have a poor quality of life because of their physical condition.

The New Jersey lawsuit was organized by Compassion & Choices, a national nonprofit that advocates for aid-in-dying legislation and is a named plaintiff. The group succeeded in bringing similar cases in Oregon and Vermont.

Both of those cases ended in settlements in which the states agreed not to enforce the residency requirement. And lawmakers in both states went on to remove the provision from the law.

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New Jersey has not indicated whether it would agree to such a settlement. The Office of New Jersey Gov. Phil Murphy said it does not comment on ongoing litigation.

Sealy, the breast cancer patient from South Philadelphia, isn’t sure if she would end her life with medication, even if New Jersey law allowed it. But she would obtain the prescription, knowing that the final act of control over her body is in her hands.

“Having that with me would be a comfort,” she said.