• Decades in the making, House Bill 140 was set to give end-of-life options to terminally ill Delawareans with a prognosis of six months or less to live.
• While the General Assembly approved the bill earlier this year by tight margins, Gov. John Carney on Sept. 20 vetoed the legislation.
• Carney said he is “fundamentally and morally opposed” to the law, which he said has little concensus and support among medical professionals.

Ron Silverio. Heather Block. Chuck Knothe.

These terminally ill Delawareans, all of whom suffered from cancer, wanted the option to die on their own terms. They wanted the choice to self-administer life-ending medication so they and their loved ones wouldn’t be put through the often ugly and frequently painful last few days and weeks of death.

Silverio died on Jan. 7, 2018. Block died two months later, on March 3, 2018. Knothe died this week, on Sept. 16, 2024.

None of them lived long enough to have those options in Delaware. And Gov. John Carney’s veto of House Bill 140 on Friday ensures no other terminally ill First State residents will, either.

CHUCK KNOTHE’S DYING WISH: Facing imminent death, he wanted to go on his terms. Why governor’s inaction prevented that

Carney vetoed the bill commonly known as the Ron Silverio/Heather Block End of Life Options Law, blocking terminally ill Delaware residents with six months or less to live from being able to choose when and how they die. Delaware would have been the 12th state in the country to allow medical aid in dying.

In his veto letter to state lawmakers, Carney said he does not believe there is “firm consensus” on the issue within the medical community.

“Although I understand not everyone shares my views, I am fundamentally and morally opposed to state law enabling someone, even under tragic and painful circumstances, to take their own life,” he wrote. “As I have shared consistently, I am simply not comfortable letting this piece of legislation become law.”

How this legislation made its way to Gov. Carney’s desk

The legislation, which was nearly a decade in the making, was passed in the final days of this year’s session. This iteration of the bill was introduced last year by Rep. Paul Baumbach, with Reps. Eric Morrison, Melissa Minor-Brown and Sen. Bryan Townsend co-sponsoring the bill.

While the Delaware House of Representatives voted in favor in April, the Senate didn’t pass the legislation until June 25. It only narrowly survived an 11-10 vote along party lines.

Much of the debate over the bill echoed that of abortion rights, with some legislators invoking God in their arguments.

“Whether you believe in God or not, whether you’re an atheist or not, He still brought you in, He takes you home,” said Sen. Dave Lawson, a Republican representing Marydel, in late June.

(Democratic Sen. Laura Sturgeon briefly interjected as Lawson spoke, noting that government is supposed to “separate Church and State.”)

BACKGROUND: How a Delaware bill would give terminally ill patients end-of-life options

Others made the “slippery slope” argument that abortion opponents also frequently invoke.

“Once society begins to accept the premise that some lives are not worth living, where does it end?” asked Sen. Brian Pettyjohn, a Republican representing Georgetown.

“We risk normalizing the idea that suicide is an acceptable solution to suffering,” he continued, “which could lead to broader and more dangerous interpretations potentially encompassing those with non-terminal illnesses or mental health concerns.”

But proponents of the bill were quick to point out that the Delaware law is narrowly tailored. It’s also very specific about who is eligible and what safeguards must be in place.

What safeguards were in place?

Had Carney allowed for the passage of the legislation, only Delaware residents would have been permitted to request life-ending medication, unlike some states that do not have a residency requirement.

Residents would have had to make the request for themselves – it could not be done on a person’s behalf. To be eligible, a patient was required to have a terminal illness with a prognosis of less than six months to live. 

“An individual cannot qualify for medication to end life under this chapter solely because of the individual’s age or disability,” the bill says, adding that a mental illness is not a qualifying illness.

After eligibility is determined and a person has made an oral request for the medication – which typically induces death in about three hours – patients would have been required to perform numerous additional steps, including:

• Submitting a second, written request that is witnessed by at least two adults (with limitations on who can be a witness)
• Being provided the opportunity to rescind their request
• Undergoing two waiting periods before a physician can prescribe the medication.

According to lobbyist organization Compassion and Choices, even once prescribed the medication, less than two-thirds of patients actually use it.

Additionally, healthcare facilities were allowed to prohibit physicians or Advanced Practice Registered Nurses (APRNs) from prescribing medication as long as they notified all providers and the public of the policy.

Prescribers could have also refused a request for any reason.

Got a story tip or idea? Send to Isabel Hughes at ihughes@delawareonline.com. For all things breaking news, follow her on X at @izzihughes_