Dying former official a focus of Maryland assisted suicide bill

Erin Cox
Contact ReporterThe Baltimore Sun
A friend asks state lawmakers to allow Death with Dignity

It's been more than 15 years since Dick Israel's body started to revolt.

Back then, in the early days of his Parkinson's disease, Israel still wrote legal opinions in flowery script from an old-fashioned fountain pen, churning out advice for the General Assembly. He charmed political giants with a wry wit, delivered in a baritone that seemed several octaves too deep for his short stature.

Now he never leaves his hospice room.

His booming voice has become a rumble, his clever words tumbling out slowly in a nearly undecipherable growl. A hospital gown has replaced his trademark straw hat and bow tie.

Richard E. Israel, 72, spent more than two decades behind the scenes in Annapolis guiding lawmakers. Now he plans to spend his final months alive lobbying them from afar, advocating for the right to die when he chooses, a final act of control over a disease that robbed him of it.

"It's about having a choice for others, not just for me," Israel said, each word taking a full second to articulate. "Death is inevitable. The question is when and how."

Israel volunteered for the legislative fight, but only reluctantly agreed to lend his name to a bill that would legalize "death with dignity" in Maryland. His friends convinced him that the measure would be more likely to pass in his memory than on the strengths of its arguments alone. It was a tough sell for the legal scholar who also served two terms as an Annapolis alderman and values the true meaning of the law above politics.

In all likelihood, even if the bill passes, Israel's medical struggle will end before anyone benefits from a law that bears his name.

A wave of such bills has garnered support across the country, sparked by the high-profile advocacy of 29-year-old Brittany Maynard, who had a terminal brain tumor and moved to Oregon to legally end her own life.

Legislatures from New York to Oklahoma, Wyoming to California are also considering bills this year — more than 15 in total. Lawmakers in another five states plan to introduce bills, too, a rapid reversal from the nationwide tide of physician-assisted suicide bans that followed the infamy of Dr. Jack Kevorkian in 1999.

That same year, Israel was dispensing legal advice on the budget when the Maryland legislature voted to make physician-assisted suicide a felony. It was also the year he first noticed symptoms of Parkinson's.

National advocates say Israel's choice to lead the movement here made Maryland one of four East Coast states where they'll target resources. Activists used to focus on one state at a time, and so far have passed laws in three states in the past two decades. But the tremendous shift in the political landscape has them rethinking strategy this year.

"Maryland came in because of Dick Israel," said Peg Sandeen, executive director of the Death with Dignity National Center. The state was under consideration as a target anyway, but "when you add someone who is willing to give a face to the campaign, who people know and understand, that makes a big difference."

The proposed law would allow a doctor to prescribe a life-ending drug for certain terminally ill patients, under a wide-ranging list of conditions and after a waiting period.

The bill also is named after former Annapolis Mayor Roger "Pip" Moyer, a political mentor to both House Speaker Michael E. Busch and Senate President Thomas V. Mike Miller. Moyer, renown for his ability to quell racial tensions in the late 1960s, died Jan. 10, two decades after he was diagnosed with Parkinson's.

But it's Israel and his painful decline that's expected to resonate most with lawmakers.

"He was as straight up and down as the hands of a clock. He's the most ethical guy I met in Annapolis," Busch said. "When they see Dick going through this trial at the end of his life, it becomes more of a personal, pragmatic support."

Both Miller and Busch, both Democrats, said they struggle with the issue because of their Catholic faith and haven't decided how to vote.

"My religion takes me one way, and my gut takes me another. I'm conflicted," said Miller, adding that he wished the bill had not been named after a good friend and would be debated on merits alone.

"If it was a member of my family or myself, I would like the ability to have that decision, to go with dignity, rather than have people see me as just a shell with a cancer eating my body away," Miller said.

'Human dignity' issue

On a recent day in Israel's room at an Annapolis retirement community, longtime friend Regina Brady offered him a cup of water and a straw. He focused all his attention on convincing his lips to close around it, took a sip, and then his body rebelled again. He lost the ability to form words for a while.

The medication that diminishes his tremors also weakens muscle control. He has a small window each afternoon when the drugs wear off enough to let him regain his speech before he takes the next dose. A lifelong bachelor, he packs that hour with visits from the many friends accumulated in Annapolis — lobbyists, top legislators and judges smitten with the Kansas-raised lawyer who chose to speak with the elongated cadence of a British aristocrat.

"You have to call ahead to make a reservation, no doubt about it," said Robert A. Zarnoch, a Court of Special Appeals judge who was Israel's boss for 25 years.

He said Israel's dry, cerebral humor resonated with the Annapolis political elite, including his frequent quip: "You should never say it writing when a wink will do."

"It's not like he's dying alone," Zarnoch said. "His friends are around him, and they want to take care of him."

He needs help, in part, to dictate his final wishes. His dry eyes, a condition related to Parkinson's, make it impossible for him to read a computer screen, which meant that late last year, he lost the ability to communicate by email. Friends read books and articles to him, and they write down, word for word, how he thinks Maryland should legalize death with dignity.

At the end of his long list of legal conditions that must be met to qualify for the program, Israel dictated his philosophy on the subject, directed more by his pragmatism than his life as a devout Episcopalian.

"Modern science has prolonged life without giving us insight into the meaning or purpose of life," he said. "The purpose of this legislation is to restore the role of science as a servant of humanity, not the master."

Modeled after the law in Washington state, the bill would apply only to a patient who is mentally competent and likely to die from terminal illness within six months. The patient must undergo a 15-day waiting period and be able to take the drug without help, among many other conditions. Old age and disabilities alone would not qualify someone for an aid-in-dying drug.

Del. Shane Pendergrass had been debating whether to introduce legislation this year or next, when Israel's friends approached her. The Howard County Democrat said the conversation brought back searing memories of her grandfather's battle with Parkinson's in the 1960s.

She volunteered to sponsor the Richard E. Israel and Roger "Pip" Moyer Death with Dignity Act, which was introduced Friday with 37 co-sponsors. In the Senate, Sen. Ron Young, a Frederick County Democrat, also sponsored a version.

Pendergrass anticipates a debate with religious groups and disability advocates who tend to oppose such measures across the country.

"This is about people who need to exit pain at the end of life," Pendergrass said. "This is law and not religion. I would hope this is kept as an issue of human dignity."

Mary Ellen Russell, executive director of the Maryland Catholic Conference, said her group also believes it's a matter of dignity to help people nearing death feel as though their life still has value.

She said the Catholic lobby doesn't plan to make fighting the bill a top priority, although they don't support it. Beyond religious objections, Russell predicted it could spark a "suicide contagion" effect, in which condoning the hastened death of the terminally ill undermines the value of life. "It sends a message that it's OK to do this."

Suicide rates in Oregon, which has had a death with dignity law since 1997, are as much as 40 percent above the national average and have been climbing since 2000, according to a 2012 report by that state's health department.

Gov. Larry Hogan, who is Catholic, told the Catholic Standard in September that he would oppose any efforts to legalize assisted suicide in Maryland. "I believe in the sanctity of human life, and I believe a physician's role is to save lives, not terminate them," he said.

On Thursday, the new Republican governor was less clear about his administration's view of the issue, saying, "We'll let you know if we've taken a position on it."

In decline

At Ginger Cove Health Center, on a day when Israel again could not speak, a friend handed him a worn piece of paper with the alphabet on it. Letter by letter, holding a pencil he used as a pointer, Israel spelled out the story of how he first noticed his muscles would not obey him. He was walking to work along West Street, watching other people swinging their arms. His right arm was motionless.

As he spelled, another friend took down each letter and tried to take a short cut. Israel spelled the entire sentence twice more, until she replaced "wasn't moving" with "was not moving."

Miller, who has known Israel for three decades, burst into laughter at the retelling of the anecdote. "That's Dick. He's so precise."

Israel's room is festooned with paraphernalia from Maryland law and his years in Annapolis, interspersed with medical devices.

As his health declined, he continued to serve as an alderman, poring over stacks of documents each weekend and hanging out for hours every Saturday at an Annapolis coffee shop in case an constituent wanted to visit.

Once he toppled out of his seat during city council meeting. Another time, he missed a meeting because he'd fallen and spent seven hours on floor of his bathroom. Afterward, he wryly joked he was reconsidering budget cuts for the Fire Department that rescued him.

Today, the poster-sized "Dick Israel, Ward 1 Alderman" magnets he made for marching in parades decorate the air conditioning unit in his room. He used them for the last time on July 4, 2013, a few months after he resigned his seat on the Annapolis city council because he had to move into a nursing home outside his district.

For the parade, he insisted the phrase "ex-" be affixed to his title, to be precise and to not detract from the alderman who replaced him.

Now that he's lost the ability to speak most days, he's designated friend McShane Glover as his spokesperson and insisted that she carry a piece of paper proving she's his authorized representative.

"He's the quintessential public servant," Glover said. "He's devoted his life to making people's lives better. He deserves a better death than the one he's experienced."

ecox@baltsun.com

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Richard E. "Dick" Israel

Born: Hutchinson, Kan.

Education: B.A., University of the South; LL.B., Washington and Lee University; M.A., Oxford University

Professional: Lawyer, counsel to Maryland General Assembly for 25 years

Public service: Annapolis alderman, 2005-2013

Personal: Single. 40-year member of St. Anne's Parish, Annapolis

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Richard E. "Dick" Israel

Born: Hutchinson, Kan.

Education: B.A., University of the South; LL.B., Washington and Lee University; M.A., Oxford University

Professional: lawyer, counsel to Maryland General Assembly for 25 years

Public service: Annapolis alderman, 2005-2013

Personal: Single. 40-year member of St. Anne's Parish, Annapolis

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