Jim Kelly remembers how his 91-year-old father died: alone in a nursing home bathroom after a long, agonizing battle with prostate cancer. Kelly, a 77-year-old Oak Park retiree, is now dealing with the same disease himself. While his cancer is under control at the moment, if it worsens, if he’s given a terminal diagnosis and his pain can’t be relieved, he hopes Illinois lawmakers will let him choose another path. “I can’t think of any better way to die than at home surrounded by our wonderful friends and neighbors.”

If a pending Illinois Senate bill is enacted, Kelly could drink a lethal drug cocktail prescribed by doctors to allow patients to die quickly, painlessly, at a time of their own choosing,  as terminally ill patients in 10 states and Washington, D.C., are already able to do. Senate assistant majority leader Linda Holmes, a Democrat from Aurora who is cosponsoring the End-of-Life Options for Terminally Ill Patients Act, plans to bring it up for a vote as early as this month. “Many of us of boomer age have watched our parents die, and that’s when you become an advocate of this,” says Holmes, whose own mother and father died painfully of cancer. “It’s horrible to lose a parent, but seeing them suffer and not being able to do anything to alleviate that suffering is worse.”

Proponents call such legislation medical aid in dying, or MAID. Opponents call it physician-assisted suicide. And like such laws in other states, the Illinois bill would limit the option to adults 18 or older who have a prognosis of six months or less to live and who are mentally capable of making an informed health care decision, as confirmed by two physicians. No health care provider is required to participate, and the patient must be able to self-administer the medication.

There has been a growing push for such right-to-die legislation since Oregon became the first state to implement the practice in 1997. This year, bills to legalize MAID were introduced in 19 states. If the one here is passed, Illinois, which previously considered such legislation in 1997, would be the first Midwestern state, and the second largest by population after California, to allow medical aid in dying.

Holmes, as well as House majority leader Robyn Gabel, a Democrat from Evanston, are guardedly optimistic that lawmakers will pass the bill in both houses this time — if not in the November veto session, then in 2025. The response to the bill among Democratic lawmakers and the public has been “overwhelmingly positive,” Holmes says. But would Governor JB Pritzker sign the bill? Gabel thinks he would. The governor did not respond to requests for comment for this story, but back in 2018, when he was running for office, he wrote this in a candidate questionnaire: “I am in favor of putting this very personal decision in the hands of patients to make in consultation with their doctors.”

The practice has support from both residents and doctors here, according to some surveys. A 2023 poll commissioned by Compassion & Choices, a national group advocating such legislation, found that 71 percent of Illinois residents favor giving terminally ill patients this option. And in a 2021 survey conducted by Medscape, 65 percent of Illinois physicians backed the same provisions that are in this bill. Although the Illinois State Medical Society has declined to take a side, it has noted that studies show MAID laws have led to increased referrals to hospice and to reduced patient worry about the pain or loss of control their condition might bring.

Still, the Illinois bill faces opposition from Catholic organizations, including the Catholic bishops of Illinois. That opposition comes primarily on religious or moral grounds. Some also argue that the legislation is not necessary. Mary Keen-Kirchoff, a rehabilitation physician in Wheaton who serves on the board of the Catholic Medical Association, points out that doctors are already allowed to prescribe heavy doses of opioids to the terminally ill. “Physicians working in palliative care and hospice can give out morphine without any restrictions. There is no reason that a person has to suffer physical pain in terminal situations.” But the bill’s advocates point out that pain can’t always be adequately controlled without drugging patients into prolonged unconsciousness, which many of them don’t want.

Another organization that has taken a strong stance against the legislation is Chicago-based Access Living, which worries that such a law would endanger the group it represents: people with disabilities. “They don’t want to be put at risk of being pushed into taking a pill,” explains Amber Smock, the organization’s vice president of advocacy. There has been no evidence, though, of that happening. “People always raise concerns about coercion or abuse, but we just aren’t seeing that in the data,” said Elissa Kozlov, an assistant professor at the Rutgers School of Public Health, who studies how MAID laws have worked across the country. “No horror stories have emerged.” The longtime executive director of Disability Rights Oregon said in 2019 that his agency had never received a complaint about coercion in the more than two decades since that state enacted its pioneering legislation.

Across the country, 8,451 terminally ill people received a lethal prescription under state MAID laws from 1998 to 2020, and 5,329 of those wound up taking the dose and dying, according to a study in the Journal of the American Geriatrics Society. The median age of those who died was 74, with cancer as the diagnosis in 69 percent of cases. Neurological diseases such as ALS were the next most common.

As a hospice medical director in Washington, D.C., where MAID has been allowed since 2017, Sonja Richmond has worked with 10 or so patients who asked for assistance in dying. The experiences have been only positive, she says. Most of the patients fall unconscious quickly after ingesting the prescription and die in less than an hour, sometimes even minutes. She remembers her first MAID patient, who had ovarian cancer. Richmond had many conversations with her, asking whether she truly wanted to go through with the process. The patient insisted that she did and, with her husband’s support, planned all the details of her death at home, including whom she wanted by her side and the music to be played. “She felt her suffering would now cease, and that was what I witnessed,” Richmond says. “For her to allow us to be part of her journey is something I’ll never forget.”