Monday, September 5, 2011

Death with Dignity

I have absolutely no patience with telephone solicitors, and even worse “robo-calls” Who in their right mind would listen to an unsolicited cold call RECORDING!? So much for jobs creation, even Boiler Rooms are now outsourcing jobs to technology.

If you are on a No Call List, people or institutions you have done business with in the past are still allowed to phone you. So I listened to the spiel when the guy identifying himself being from the Oregon Death with Dignity organization called.

In 1994 Oregon passed a landmark law allowing people with terminal illness to end their lives; this is sometimes referred to as physician-assisted suicide. The law was brought into effect through citizen initiative and handily passed the popular vote. However, in 1997 the law’s opponents (primarily the religious) mounted strenuous opposition, eventually placing a new ballot initiative attempting to repeal the law. The attempt failed, the repeal was voted down. Oregon voters had now made it abundantly clear, TWICE, that people should have the right to determine their own quality of life and chose the terms and time of their death.

The opposition was vehement; claims were made that the law would lead to euthanasia – a wholly preposterous claim as a patient must be terminally ill with a life expectancy of six months or less. The patient must be mentally competent and able to understand the consequences of their decision. Two physicians must review the medical request of the patient prior to approval of the application.

It was then claimed that Oregon would become a Mecca for terminally ill patients, flocking to the state in droves to take advantage of this law – It’s NEVER happened. Critics even charged that the law would be applied disproportionately to the poor, physically disabled, psychiatric patients, even racial minorities – Not even remotely true. Opposition rests solely with religious belief; who believe only god has the right to end a life. But such restrictions should not apply to the fifth of the population (and growing) who don’t believe in god.

Still George Bush’s Attorney General, John Ashcroft, an evangelical Christian who “speaks in tongues”, in 2002 petitioned the got the Ninth Circuit Court of Appeals to approve the suspension of medical licenses of doctors who prescribed life-ending drugs to dying patients. But in 2005 the US Supreme court ruled 6 to 3 that Oregon had the right to regulate the practice of medicine. Oregon’s Death with Dignity law “survived”.

Neighboring Washington State has since passed their own Death with Dignity law in 2008. A similar law is now being proposed by the people of the State of Massachusetts.

On its web site, the Oregon Death with Dignity maintains an information page on “Religion and Spirituality”, listing all the major religious institutions and their official position regarding suicide. Not surprisingly the vast majority are in opposition. Religion, you see, not only wants to dictate how you live your life but when and how you are allowed to end it. But then religion is seldom about choice.

I told the caller that I would contribute to help with the campaign to pass a similar law in Massachusetts.


KleinsteMotte said...

I have often wished for the common sense of this choice. Death is a natural process so why is there so much opposition?
What about quality of life? Those poor folks in late stages of Alzheimer's can't get a break because they don't qualify.
There are a lot of value shifts that humans need to work out. Religious organizations will hold on tightly because they need their funding. Just think of all the ties? God's workers have to be compensated. The whole infrastructure is being rocked.

billy pilgrim said...

we're going through a court case now where a terminally ill woman wants to be able to end her life at the time of her choosing. several years ago the same thing happened and a different woman won the right to end her life so i don't know why it's happening again.

a few years back one of our neighbors found out he had terminal cancer and went into his bedroom, took his gun out his night stand drawer and blew his brains out.

so it goes.

Kay Dennison said...

Can't one just decide that they won't take anything nut pain killers? If I'm terminal and there's no treatment or cure, I'm telling my doctor just to keep me as comfortable as possible. That, in my not so humble opinion, just makes sense. Then again, I'm poor so they'll just let me rot either way.

Robert the Skeptic said...

KleinsteMotte The opposition is indeed mostly religious. And once again, religion telling us how we must live our lives. This is the ultimate rejection of those who would tell us how THEY think we should live our lives.

Billy Of course people are taking their own lives due to terminal illness anyway. Statistics showing age spans for people committing suicide show a spike in the teen years, then a major drop off until you get into the elderly where the numbers radically climb again.

Yes, many through gunshot, which is traumatic (and messy) for relatives. Better it be planned and given the time for relatives to accept the decision and celebrate the life of the person.

Kay Many of the opponents of Death with Dignity point to palliative care as being an alternative. But pain is not the only reason to end one's life; quality of life is often a major factor. So you are not in pain but you are bedridden, on feeding or breathing tubes... any number of unpleasant life-sustaining technology which is now available to us. The point is now people have an option, that is the ultimate in freedom of expression.

Anonymous said...

Good for Oregon. We all should have control over our life and death decisions. I just have never understood how the "conservatives" who want no government can push for government to be involved in these deeply personal life decisions. Were they consistent in their logic, they should be fighting against any government involvement.

DJan said...

Years ago I read "Last Wish" by Betty Rollin, who helped her mother die with dignity. I think Rollin spent time in jail because of the book, but she wanted to tell her mother's story. It's very moving.

Paul said...

My mother died with dignity and she did it her way...The state has no business in dictating how people die-period...

Nance said...

Good. Good for you. And a gutsy post, at that.

Robert the Skeptic said...

Backrow Indeed, and for some odd reason Conservatives seem really interested in regulating what we do in the bedroom as well.

DJan I am not familiar with Rollin, but I am Kubler-Ross whose works were influential in helping my mother deal with her end of life decisions and face the ultimate life challenge.

Paul She sounds like she was an inspiration to you even in her final moments. The Oregon law has now ensured that government has no place in dictating end of life decisions.

Nance Donno how gutsy, all I can say is back in March when I was in the hospital with my heart infection I certainly was ready and willing myself to check out at that moment.

Stinkypaw said...

Dying in dignity shouldn't be something one has to fight for, it should be a birth right...

Dawn @Lighten Up! said...

Religion is not about choice. That much is true. :)

Bill Pieper said...

Yes, an Oregon type law doesn't cover all diffcult situations, like advanced alzheimer's patients or the desperate family member who has been left no advance directive to guide them as a loved one suffers, but it's a great place to start. If even a majority of states had such laws in place, we might be able to have a serious national discussion about who Oregon leaves out. As it is, the fearmongers and religious zealots usually drown the rest of us out.

Robert the Skeptic said...

Stinky Well people in Oregon and Washington had to fight for it, now it is a right!

Dawn I often remind people that religion is not a democracy; religion is a dictatorship which you must follow THEIR way or suffer the consequences.

Bill Welcome. The key to the success of the Oregon law is the fully informed consent of the patient. For that to happen the providers must be sure the patient is completely in control of their faculties and understands the ramifications and consequences of their choice. This is why it take TWO physicians to approve the procedure. MY brother-in-law had terminal cancer and reached a point where he wanted to make an end of life choice out of desperation. It's too late at that point. It was very sad.

Anonymous said...

I could not agree with you more, Robert. My husband and I have talked about this at length, how once the quality of life falls below a certain level there is no dignity.

We always had this discussion after visiting one of his relatives (recently deceased) who was confined to a nursing home. Like most of the patients there, she was kept medicated, was rarely lucid, and could not even use the toilet by herself let alone wipe her own bottom. She was "allowed" to shower 1-2 times per week when she had assistance.

Of course, the food sucked too, even when she had an appetite which wasn't very often. She said more than once that she wanted to die, thankyouverymuch. She occasionally had glimpses of her past -- when she accomplished great things with courage, intelligence, and wit; a far cry from being spoken to like a baby and hefted into the shower by well-meaning yet often very patronizing nursing home staff.

What amazes me is how the religious can visit hellholes like this and be appalled at the thought that most of the patients (when lucid) would rather die than suffer the daily indignities.

Robert the Skeptic said...

Dissenter The situation you describe with your relative is very sad indeed. Expiring due to stroke or heart attack sounds merciful in comparison. But even the situation you describe may not fall within the requirements of Oregon's law. Although you describe a horrendous quality of life issue, if she didn't appear to be terminal within 6 months the law would not help her.

That said, the mother of my brother-in-law who died in his mid 50's was moved from a nurshing home she liked to one where she was lonely and despondent. Formerly a nurse, she knew that if she did not drink in any water she would die within 3 days... which is precisely what she did.

I think about this as well, particularly since my heart surgery where I found that my coronary arteries are perfectly clear. The likelihood I will die of a stroke or heart attack is practically zero. Which makes me wonder under what terms I will need to face my own death.

secret agent woman said...

Whenever someone talks about putting a suffering animal to sleep, I think about how it is that we are so much more humane with animals than people when i comes to death. Why should our autonomy be taken away for such a basic right?

Robert the Skeptic said...

SecretAgent The religious would say it's because we have a soul and animals do not. I reject that and feel that no living creature should be allowed to suffer.

joared said...

FWIW palliative does not require tubes and vents, if for some reason this is what the patient would need to sustain life and they didn't want that life extension - in fact it would be contrary to such care. Simply set up an advanced medical directive addressing those issues and others.

I am aware of a patient who chose to stop eating and drinking and was one of the few who was able to do so effectively. She did not die within 3 days but survived over a week or so -- to the surprise of medical people, I might add. She was comfortable, reportedly, but it is not always a pleasant way to die. Also, typically, without hydration within a very short time the individual's mental functions change -- may hallucinate, other -- judgement can be affected so automatic reactions requesting food and water can occur. These requests must be honored legally in nursing homes.

Let me say I strongly support individuals having the right to make decisions relative to ending their life. I have been/am still intimately involved with individuals/families making choices that will precipitate that event (associated with swallowing/eating/drinking problems -- I'm not a doctor.)

That said, in defense of those who are concerned about people choosing to die, their hesitation/opposition often has nothing to do with religious beliefs. The argument has had to do with that "slippery slope" and potential for abuse not only by caregivers, but by medical/insurer dictates -- increasingly for those patients who may be expensive to care for, especially including elders.

I'm sure you realize the "rationing" of health care one political group sometimes cites as a fear tactic if the government took over all health care, is misleading. Health care decisions that curtail services could be viewed as already happening with some insurers/medical practitioners, probably beginning with the advent of HMOs in the effort to control rising health care costs those many years ago.