The Virginia Association of Centers for Independent Living (VACIL) is a nonprofit, consumer-directed, statewide association representing Virginia’s 17 Centers for Independent Living (CILs). CILs are nonresidential, cross-disability organizations that are governed and operated by people with disabilities and focused on integration and inclusion in all aspects of community life. Proponents of assisted suicide often refer to it as “death with dignity” or “medical aid-in-dying.” From the disability community’s perspective, there is nothing dignified about assisting someone to die rather than supporting them to live with appropriate medical care, physical supports, and emotional support. Coercion and fraud are real risks when society views death as more acceptable than living with illness or disability. Many people with disabilities are made to feel like a burden or that their lives are less valuable. If coercion occurs, it would be nearly impossible to prove, as the individual most affected would no longer be alive to explain the circumstances. States that allow assisted suicide have not demonstrated effective safeguards to prevent coercion or bias, and it is unlikely such safeguards could ever be fully enforced. While the medical community has made progress in understanding disability, harmful and outdated assumptions about “quality of life” persist. These attitudes often lead to diminished expectations, inadequate care, or discouragement from pursuing treatment. In this context, counseling people with disabilities about assisted suicide is deeply concerning and potentially dangerous. There is a meaningful and ethical alternative: palliative care. Proposed HB 435 would ensure that individuals with serious illness are informed about and connected to palliative care through hospital protocols, public education, and statewide oversight. Palliative care is patient- and family-centered, focuses on relieving pain and distress, and supports physical, emotional, social, and spiritual needs. Unlike hospice, it can be provided at any stage of illness and alongside curative or life-prolonging treatment. Palliative care affirms life and supports informed choice without hastening death. At a time when Virginia faces workforce shortages in home- and community-based services, long waitlists, and unequal access to care, legalizing assisted suicide risks offering death instead of fixing broken systems. Public policy should never present death as a solution to inadequate services or supports. Statements like “I could never live like that” often reflect fear, bias, or lack of support—not the lived reality of disability. When people receive appropriate supports, their outlook and experience often change. People with disabilities live worthwhile, dignified lives. Legalizing assisted suicide would reverse decades of progress reflected in the Virginians with Disabilities Act, Medicaid home- and community-based services, fair housing laws, and other policies that promote inclusion and independence. Our focus must remain on improving lives, not ending them. Rather than expanding assisted suicide, Virginia should strengthen Medicaid home- and community-based services, invest in the direct support workforce, and ensure equitable access to palliative care. These investments affirm life, dignity, and true choice. VACIL strongly opposes the legalization of assisted suicide and urges opposition to any effort to legalize it.

The attached document is a formal public comment submitted by the Virginia Association of Centers for Independent Living (VACIL) opposing legislation that would legalize assisted suicide (medical aid in dying). It explains the disability community’s concerns regarding coercion, discrimination, and systemic inequities, and emphasizes the Independent Living philosophy, the value of disabled lives, and the need for stronger investments in home- and community-based services and palliative care as ethical alternatives.

My mother has idiopathic pulmonary fibrosis. This incurable disease progresses until a person dies of respiratory failure often triggered by an acute exacerbation of the disease; infection/pneumonia, pulmonary hypertension, or heart failure. Recently, my mother was hospitalized with acute pulmonary failure from a secondary lung infection. Sitting at home one night, she was unable to breathe and not having enough time to wait for an ambulance, my terrified 83-year-old father got her to the ER just in time. Through excellent care she recovered, but as her lung capacity continues to decline, the physical and emotional pain increases especially knowing that a common respiratory virus might kill her next time. My beautiful mother is 82, has always been very active physically and socially, loves to travel, puts her whole big heart into feeding people, volunteering, and advocating for human rights, and has always been a strong independent woman who raised her children to be the same. This disease has already taken much of that away. Medical aid laws allow people the dignity of having control over their own bodies and lives to prevent the extreme suffering and family trauma fatal conditions cause. Currently this is legal in 12 states plus DC and there is pending legislation in 11 more. Legalizing medical aid is the most compassionate thing VA can offer to terminally ill people to help them and their families better prepare and cope with ongoing suffering and impending loss. These laws also protect families by ensuring that the official cause of death is the disease itself. We had a close family friend who was diagnosed with an inoperable brain tumor causing constant seizures impacting speech, memory, and mobility that prevented her from living independently. She lived in a place where medical aid was legal, and as her symptoms increased in duration and severity, she decided to use this legal option while she was still mentally competent. While it is heartbreaking having a final call or visit to say goodbye for good, it was a gift just having the opportunity to express our love and know the peace this decision brought our friend and her family. Being able to control the circumstances of her own death was what helped her, her family, and her beloved friends manage the stress and trauma surrounding the disease progression and terrifying unknowns. My mother is frustrated that she doesn't have that same option available to her in this state. Our family is facing an undetermined timeline for her disease, and we know that any virus/bacteria we bring in could kill her. The high anxiety we feel likely pales in comparison to what she is going through knowing that there will be progressively more physical and emotional pain as time goes on. While she is not ready now, the day will come when her life is reduced to a few short months and the pain and limitations become needless suffering. Allowing people with terminal diseases the option to protect themselves and their families through medical aid affords dying people autonomy and compassion, improves end-of-life care, and costs states almost nothing to implement. Allowing this gift to our and other families exemplifies a system that respects people by allowing them to assert their values and priorities as death approaches. There will never be enough I can do to thank my mother appropriately for giving me the amazing life I have, my support of this bill at least feels like a step in right direction.

I support this for competent people or power of attorney.