Efficacy of Constancy and Frequency as Political Strategies for Assisted Suicide Legalization

Examining Political Strategies for Assisted Suicide Legalization

Abstract

The academic paper examines the efficacy of using constancy and frequency as political strategies for assisted suicide legalization.
It questions whether introducing many bills over time or introducing multiple bills at once increases the likelihood of bills passing in U.S. state legislatures.
Attempts to legalize assisted suicide have historically faced political and procedural challenges, with approximately 98% of such attempts failing in the last 25 years.
Trends are now beginning to change with Vermont adopting legislation in 2013, followed by California and Washington D.C. in 2015, Hawaii in 2018, and New Jersey and Maine in 2019.
The number of bills introduced has increased from a median of nine bills (1995-2013) to 31 bills (2015-2019).
The median number of states with multiple bills in play has doubled to five states + Washington D.C. since 2015.
The paper examines constancy (perseverance in introducing bills over multiple sessions) and frequency (introducing multiple bills in the same session).
Constancy cannot be ruled out as a beneficial variable, while there is no evidence suggesting multiple bills ensure success.
Ideological liberalism is a necessary but not sufficient condition to pass assisted suicide bills.
Increases in the number of bills and states with bills appear to be a response to environmental stimuli.

Introduction

Since 1994, 270 bills have been proposed in state legislatures, with only six becoming law in recent history.
Victories in one state often inspire attempts in other states.
States succeeding in passing assisted suicide legislation often have extensive histories of failed attempts.
The number of bills introduced in each state in a single session is also increasing.
The paper examines constancy and frequency as potential political strategies and other factors influencing assisted suicide diffusion across the United States.

Literature Review

Academic literature on American assisted suicide law has rarely focused on legislative battles.
Support for assisted suicide is growing due to medical technology prolonging life and cultural changes.
Euthanasia advocates have launched public advertising campaigns, court battles, and voter initiatives.
Political scientists have rarely studied assisted suicide in work on American legislative processes.
Legislators introduce bills to gain favor with constituents, even if the bills have no chance of passage, to move the issue further onto their political party's agenda long term.
Only a few frequent sponsors who value the support of right-to-die advocates can result in repeated bill introductions.
It is important to study the committee process, the amendments process, the lobbying process, and the unwritten norms that govern legislative houses.
Repeated introductions of bills can be an effective tactic when the party most likely to support the legislation returns to power.
Interest groups can successfully take advantage of repeated introductions to gain support through lobbying campaigns and move public opinion.
Very different procedures in each state have made developing models of state legislative processes difficult.
Strict deadlines, caps on the number of bills introduced, and thresholds to be met before a bill can be considered introduced make the variables of constancy and frequency difficult to define.
Extra time on controversial measures results in stricter scrutiny of the bill and its amendments.
Changes in public opinion, lobbying power of interest groups, and dynamics within a political party can result in different results when a bill is introduced in the next session.
Supporters of a bill may change tactics and agree to add amendments to increase the chances of passage, especially after repeated introductions.
Minority parties can successfully block bills in the legislature, especially when polarization is low.
Passing legislation after repeated attempts requires persuading the ideologically median members of the majority party, which would be likely to apply to moderate Democrats on assisted suicide.

Legislative History

Attempts to legalize assisted suicide in state capitols began in 1994 but were not successful until 2013.
Vermont was the first state to pass an assisted suicide bill.
Other states legalized the practice by ballot initiatives or judicial intervention.
The number of states that introduced assisted suicide legislation increased sixfold in 2015: from five bills in four states to 30 bills in 24 states.
In California, a bill passed the Senate but failed to gain sufficient support to exit the House appropriations committee.
The governor called a special session to address healthcare finance issues, and advocates reintroduced the bill to a more sympathetic committee.
By 2015, two new bills were tallied in the "win" column for assisted suicide, yet neither of these bills truly endured the full legislative process to do so.
These victories may explain, in part, the staggering increase in the number of bills introduced in other states in the 2017 sessions.
The hopes of advocates for assisted suicide have been bolstered by the increase in favorable public opinion nationally, which also motivates them to get more bills introduced in more states.
The number of attempts in each session appears to be increasing as well, and may be strategic move, informed by the three successful bills in 2013 and 2015.
The fact that the increase in the number of attempts does not represent new states introducing assisted suicide bills for the first time suggests that successful cases suggested to lawmakers who had previously attempted to legalize assisted suicide that more attempts would eventually yield a passing bill.
The paper questions what, if anything, both the victories and changes in bill proposal numbers could imply about the potential that any of these attempts will prove successful in the future.
Since California and Vermont have a similar history of being among the first states to introduce legislation and consistently reintroducing assisted suicide bills over nearly 20 years, perhaps these victories suggest that perseverance over time (constancy) leads to eventual victory.
Theoretically, persistence over time can build support and compromises from previous sessions can be built upon to introduce a more viable bill in subsequent sessions. It also allows lawmakers to test the waters and gage the level of support or opposition from their constituencies, taking some degree of ambiguity out of a highly volatile issue.
The new trend of introducing multiple bills (frequency) could be strategic as well, since introducing multiple bills offers an increased chance of at least one advancing out of a committee and onto the chamber floor in states that may have a sympathetic majority but strong opposition at various levels.
Determining what made the successful bills different from the 264 failures could explain why they succeeded and predict where other states may follow.

Research Questions

Q1: What variables can be identified in the successful cases as potentially necessary or sufficient conditions for assisted suicide bills to pass?
Q2: Does frequency help pass assisted suicide bills?
Q3: Does constancy help pass assisted suicide bills?

Methods

A dataset was constructed that listed each U.S. state (and Washington, DC) and every bill introduced in that state for every year since the first bill was introduced in 1994. This includes the number of bills introduced in each state.
Three totals were calculated across all states for each year: the total number of bills introduced, the total number of states that introduced bills, and the total number of states with more than one bill in a given year.
These totals were plotted on a graph to visually inspect for trends and deviations.
The chart confirmed the notable increase in all three variables: total number of bills, total number of states with bills in a given year, and the total number of states with more than one bill in a single year (session).
In the biennial session immediately following each successful bill, there was a significant increase in all three areas which is sustained.
Vermont, California, Hawaii, Maine, and New Jersey were examined closely as individual cases and examined first for the absence or presence of constancy and frequency. Washington, DC was excluded as it has neither variable and is often excluded from lacking the full legislative process and relying upon a council.
Constancy is defined as proposing at least one bill.
Constancy as a variable is measured as at least seven sessions of prior attempts, which would be a minimum longevity of 14 years for biennial states and seven in states like California that meet annually.
Frequency was defined as introducing more than one bill in a single session.

Analysis

The first step in the analysis is to note apparent commonalities among cases.
Necessary and sufficient conditions that must exist to pass any bill are not included as variables; only those the case studies revealed to be directly relevant to this particular issue.

Q1: Common Variables That Maybe Be Necessary or Sufficient Conditions for Passage.

When examining all cases, the results show that commonalities are quite limited.
However, the following variables were identified to address Q1: ideological liberalism (present across all cases), partisanship (present across most cases) and procedural shortcuts or extensions (present in many cases).
The only variable common across all cases is a high degree of ideological liberalism. Vermont is ranked the least conservative of all 50 states while California is ranked seventh and Hawaii at tenth (Newport, 2017).
The data on which states are proposing assisted suicide bills also support that liberalism is a necessary condition.
States that are considered conservative very rarely have an assisted suicide bill even introduced.
Even a liberal state with a conservative governor bodes poorly for assisted suicide when you look at New Jersey in 2014.
When even the absence of ideological liberalism in one role is enough to sabotage an assisted suicide bill, clearly a high degree of ideological liberalism is a necessary condition to turn an assisted suicide bill into law.
However, even if liberalism is a necessary condition, it is clearly not a sufficient one.
States of comparable levels of ideological liberalism still fail to pass assisted suicide bills through the entire legislative process after many sessions and many years of attempts.
Partisanship appears relevant as well.
Roll-call votes are also overwhelmingly partisan, indicating an unprecedented shift in how this issue is framed and perceived (Easterly, 2019).

Q2: The Potential Role of Frequency and Q3: The Role of Constancy.

For Q2, frequency was present in most cases. Vermont had introduced one bill in the session; that bill ultimately passed as did Maine, but California, Hawaii, and New Jersey all had multiple bills.
Another variable that bears mention: procedural shortcuts (like a special session) and/or extensions (like carry-over bills).
Introducing multiple bills was not a factor in all cases, it is clearly not a necessary let alone sufficient condition for passing an assisted suicide bill.
There is some evidence to support constancy as potentially effectual in passing assisted suicide bills as it was present in all cases but New Jersey.

6.1 Other potential variables to consider: Procedural shortcuts and extensions

Another potential influencing variable worth noting is quite similar to frequency and constancy but nonetheless distinct.

Conclusion

In our examination of potential variables common to successful adoption of assisted suicide bills, ideological liberalism and partisanship clearly stand out as necessary conditions.
The other two variables of interest, frequency, and constancy, we find both were present in most cases, 3 out of 5 cases and 4 out of 5 cases respectively.
It appears both the trends in increased numbers of proposed bills and passage are due to environmental contingencies, primarily public opinion.
With these victories, despite environmental factors being likely more salient than constancy and frequency, it is likely that right-to-die advocates will continue introducing bills in state legislature repeatedly, especially in those states such as Maryland, New York, and Connecticut where the legislative battle has existed for years.