Tim Appleton spent a lot of time walking. Thirty days and nearly 300 miles to be exact.

From Sept. 25 to Oct. 28, the senior campaign director for the Compassion and Choices Action Network of Connecticut crossed the state, dressed in a yellow safety vest inscribed with the words “ASK ME ABOUT AID IN DYING.”

“I would joke on any given day (that) this is either the best worst idea I’ve had or the worst best idea I’ve ever had,” Appleton said.

Appleton’s trek was the latest action in a more than decade-long campaign to win terminally ill patients in Connecticut the right to medical aid in dying — lethal medication prescribed by a doctor that allows patients to end their life, also known as medically assisted suicide.

Since 2013, proposed aid-in-dying bills have brought hundreds to the State Capitol to testify in favor of or in opposition to the proposal. The debate is expected to reignite with equal fervor in the 2024 session.

Last year, the Public Health Committee passed an aid-in-dying bill that contained some of the most restrictive language in the country, but, for the third year in a row, the bill stalled in the Judiciary Committee without a public hearing or a vote.

For Appleton, the legalization of aid in dying in Connecticut is not a matter of if but when.

“It’s time for change. And with the support we have in the legislature and with the support we have out in every community across the state, we are confident that this law will pass,” Appleton said. “The only question is how long will it take? And how many people will suffer unnecessarily without it until it does.”

As Appleton spoke to the Courant on Thursday morning, his mind was miles away in Vermont, where Lynda Bluestein ended her life at 9:15 a.m. with a lethal medication prescribed through the state’s Patient Choice at End of Life law.

Bluestein, a 76-year-old from Bridgeport who suffered from terminal fallopian tube cancer, sued Vermont in federal court in 2022, arguing that the residency requirement in the state’s end of life law violated the U.S. Constitution.

In March, after a settlement permitted Bluestein use of the Vermont law, the Associated Press quoted Bluestein as saying that she was struck by “just how hard it is to die the way you want to die.”

“It seems like everybody has an opinion on what should be allowed and what shouldn’t be allowed in my one personal, private and very sacred moment of death,” Bluestein said at the time. “There are people who say, no, you have to suffer. It’s very important for you to wait until God decides that it’s time for you to die. But that’s not my faith. That’s not what I want and that’s not what I believe.”

“I want to live the way I always have, and I want my death to be in keeping with the way I wanted my life to be always,” she told the AP. “I wanted to have agency over when cancer had taken so much for me that I could no longer bear it. That’s my choice.”

In May, Vermont became the first state in the nation to expand it’s end-of-life law to out-of-state patients. Bluestein was the first non-Vermont resident granted the right.

Ten days before her death, Appleton, who became friends with Bluestein through her advocacy for aid-in-dying legislation in Connecticut, said he thanked Bluestein for being a pioneer in the movement, gave her a kiss, and said goodbye, knowing that it would be like the last time he would see her.

As he spoke that morning of Bluestein’s death, Appleton emphasized that Bluestein should have been allowed to pass surrounded by her family in the Bridgeport home she built with her husband. Instead, Appleton said she spent her final days shuffling between Connecticut and Vermont for doctors visits.

“She was denied that,” Appleton said. “(That was) a right that she should have right here in this state.”

Opponents of aid-in-dying say that the very fact that Vermont expanded its life law to non-residents like Bluestein, lends credence to their biggest fear — that the guardrails in a potential aid-in-dying law would eventually be undone through legislation or litigation.

Among other provisions in Connecticut’s 2023 aid-in-dying proposal, patients seeking aid-in-dying medication would need to be over the age of 21, competent and a resident of Connecticut for at least one year. They also must have a life expectancy of less than six months, attend at least one session with a counselor, see a doctor every 30 days until their death, and submit two written requests for aid in dying signed by two witnesses.

Peter Wolfgang, the executive director of the Family Institute of Connecticut pointed that Compassion and Choices, the very group that advocated for the residency requirement in the 2023 law, simultaneously fought against Vermont’s requirement in Bluestein’s lawsuit.

“The problem for the pro assisted suicide people is they keep approaching this issue in Connecticut as if it’s still 2013,” Wolfgang said. “They keep going up to the State Capitol and saying, ‘Oh, we just want this for a very limited circumstances…’ But what’s happened in the 10 years since in other states is that the issue has progressed further. There’s been a suicide expansion over the border in Canada. There’s a law set to go into effect in March that will allow assisted suicide for people who are mentally ill. And so I think this is one of the things that has made it even more difficult for the pro assisted suicide folks to win in Connecticut.”

Wolfgang said that aid-in-dying opponents, especially those in the state’s disabled community, fear that a “right to die could become for them a duty to die,” as the burden of care and treatment costs pile up.

Cathy Ludlum, a disability rights advocate who has fought against aid-in-dying legislation with her organization Second Thoughts Connecticut said that aid-in-dying legislation puts the state’s most vulnerable at risk, including individuals living with disabilities, those living in poverty and members of marginalized ethnic groups who already struggle to get equal access to health care.

Ludlum said that she believes proposed aid-in-dying guardrails are destined to widen because “there’s no way to limit this service without discriminating against other people.”

“Once death is a treatment option, it’s a policy, it’s no longer an individual choice. It is something that will affect every person,” Ludlum said. “It starts as an individual choice, but it mushrooms from there once you write it into law.”

Ludlum said that the devil is in the details.

“It’s very different to walk up to someone on the street with a clipboard and say, ‘Do you believe people should have a choice about where and how their life ends?’ and probably everyone would say ‘Sure.’ It is very different when you say, ‘What about the impact on the insurance coverage? What about the impact on doctors? What about the impact on the medical system in general? What about discrimination? What about equality?’ Then people start to have second thoughts,” Ludlum said.

Appleton accused aid-in-dying opponents of spreading misinformation and fear to bully lawmakers into voting against any potential legislation.

He said that since aid in dying first became legal in Oregon in the 1990s, there has not been one instance of misuse or abuse of the law. He added that it took Vermont 10 years to repeal its residency requirement.

“It’s a bit unfair to suggest that we’re not going to pass a law because it might change, when on the other side, there are very real people with real challenges here in this state of Connecticut that are desperate for that change,” Appleton said, adding that all kinds of laws go up for legislative review each year and it’s up to lawmakers to decide whether or not to enact changes.

Appleton said that he believes a public hearing on aid-in-dying legislation in the Judiciary Committee would be a game changer for the movement.

“We had a few rough public hearings in the Public Health Committee over a few years, and that process of education and storytelling got members of the Public Health Committee to a place where they were supportive of aid in dying and voted out (the legislation in a) bipartisan vote. But that took time. We need to have that same process in the Judiciary Committee,” Appleton said.

After the Judiciary Committee announced that it would not take action on the 2023 aid-in-dying proposal, committee Chair Rep. Steven Stafstrom said that religion did not influence the outcome, rather he suggested that “outstanding questions” drove “struggle and concern on this bill.”

“I think I struggled less with it earlier in the session, before we saw legislative efforts and litigation efforts in other states to undo many of the protections we tried to put in this bill,” Stafstrom said at the time. “Maybe I’m in agreement with some that this legislation’s day may come but I think that there are still some outstanding issues we are right to be cautious on.”

When Jill Hammerberg learned that the 2023 bill would not move forward, she said she had “no words.”

“I just exploded in sadness and tears,” Hammerberg said.

Hammerberg and her family have advocated for medical aid-in-dying legislation since the death of her husband, Mark Fey, in 2012.

On Fey’s final day, Hammerberg said the hospice nurse warned her to get the dark towels ready and “prepare for the bleeding to begin ––” her husband’s vitals indicated that he would start “breaking down” at any moment.

That night, Hammerberg said she awoke to “unearthly sounds” as Fey thrashed and struggled in insufferable pain that no amount of medication seemed to abate. It took 14 hours before Fey finally drew his last breath.

Hammerberg said she holds her husband in her heart every day, as well as the “broken promise” that he would not feel any more pain once he entered hospice care.

“To carry that burden, it’s just sometimes too much because I know so many other people are going to have to face that, and it’s not necessary,” Hammerberg said. “It’s a desperate feeling to be running out of time.”

Hammerberg said she shares her husband’s story, over and over again, each time a new aid-in-dying bill is proposed, because she knows there are so many people in the state who desperately need the option.

She said that in a democracy, individuals at the end of life should have the choice to pursue a gentle death on their own terms through lethal medication.

As the years tick by without the passage of aid-in-dying legislation, those who have passed or are still suffering weigh on Hammerberg’s heart.

“I just worry about those of us who are running out of time for ourselves or for our loved ones,” Hammerberg said.