Controlling the quality of dying by Marjorie Arons-Barron

The entry below is being cross posted from Marjorie Arons-Barron’s own blog.

When it comes down to the last weeks and days of an excruciating dying process, it’s all about options.  If I am terminally ill, determined by my physician to be within six months of dying from an incurable and irreversible disease, then I want my physician to be able to prescribe medication that will allow me to end the anguish for me and my family, medication that I – and only I – will decide whether or not to swallow.  I want the right and the means to take the pill that will allow me to die with dignity.  That’s why I will vote yes on Question 2.

Thoughtful opponents on the other side, including many in medicine, argue that I shouldn’t have that choice and, more, that I shouldn’t need it due to advances in palliative care and hospice. But sometimes those are not enough.  My beloved father-in-law, ironically a physician and cancer researcher, suffered the tortures of hell from lung cancer that had mestasticized to his bones and liver, and hospital caregivers refused to give him enough morphine to stop the suffering of his last days.  He had a right not to go through that. He devoted his life to medicine and caring for others, and medicine and his caregivers let him down at the end.

This referendum would require the patient to make an oral request and then, at least 15 days later, put his or her request in writing. Two witnesses would have to attest that the patient is, to the best of their knowledge, capable of making the decision and not under duress.  The attending physician’s assessments would have to be confirmed by a consulting physician, and any physician who did not want to assist in this dying process would not be required to do so.

Physicians say their role is to be healers.  But in the situations envisioned by this proposed law, healing is not an option, and a physician’s role is to relieve suffering as the patients wishes.

As Dr. Marcia Angell, Harvard physician and former editor of the New England Journal of Medicine, has said, this isn’t physician assisted suicide.  “It is assisted dying,” she said on Channel Five “On the Record” program yesterday. Suicide is the act of someone choosing death over life.  In the terminal phase of an end-stage disease, life is not a possible outcome.  By self-administering the medication under the circumstances envisioned by Question 2, the patient is choosing the manner of dying.

A study of the 15 years in which Oregon has had such a law on the books, also according to Angell, 80 percent who chose to self-administer had widely metastasized cancer, 10 percent had end-stage emphysema and 10 percent had end-stage ALS (Lou Gehrig’s disease).

For me, if I am at the end and suffering unendurably, with that suffering only going to get worse, I want that pill on my night table.  I may, in the end, choose not to use it, but I want the option to die a more humane and dignified death.

I welcome your comments in the section below.

3 Responses to Controlling the quality of dying by Marjorie Arons-Barron

  1. Renee Aste says:

    My grandmother is over 100, over a month ago she was hospitalized. She even said something to the home health aide, she was ready to go. I got a text from a family member it would be a good time definitely visit.

    I even told some extended family members, that ‘she isn’t doing well’ FYI.

    Later that week, she was out and about during Grandparents’ Day.

    Six weeks later, she is still very much alive.

    There is nothing dignifying or humane about killing oneself, even at the end stages of death. Doctors are indeed healers, and to insist they become accomplices is selfish on the part of the patient.

    “More than 75 percent of the physician members of the Massachusetts Medical Society have voted to oppose physician-assisted suicide. Since their meeting in 1999, the members of the American Medical Association have voted to oppose physician-assisted suicide and have been consistent in their opposition, stating, “The AMA opposes physician-assisted suicide as antithetical to the role of the physician as healer. We are committed to providing the best end-of-life care.” At a meeting in 2003, the AMA went on to state, “Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would impose serious societal risks.”

    The Massachusetts Board of Registration in Medicine has imposed a requirement on physicians seeking to be licensed in Massachusetts that they must complete a course in end-of-life care and another in opioid prescribing. These courses educate the physician in the compassionate, considerate, and supportive care that must be offered to patients at the end of life. Reasonable prescribing of opioids should be offered only when necessary and should not be substituted for other needs such as treatment of depression.”

    Women ,when pregnant have a ‘due day’, but really it is a ‘due month’. Every time I give birth I ask ‘how much longer’, 20 minutes or 20 hours?

    You don’t know.

    Remember Haleigh Poute?

    Eight days after Poutre was admitted to the hospital, the Massachusetts Supreme Judicial Court ruled that life-support equipment, including a feeding tube and ventilator, could be withdrawn. However, the day after the decision, health care attendants found that Poutre could breathe on her own and follow simple commands.[1]
    In 2007, age 13, Poutre reportedly remained in rehabilitative care. The child abuse case against Jason Strickland has not been settled.
    In February 2008, 14-year-old Poutre was reportedly making statements about her abuse.[1]

    You never know….

  2. Renee Aste says:

    Ted Kennedy’s widow opposes assisted-suicide initiative in Massachusetts

    “Victoria Reggie Kennedy, the widow of longtime Senator Ted Kennedy, has taken a strong stand in opposition to “Proposition 2,” a statewide ballot initiative that would legalize physician-assisted suicide in Massachusetts.

    The proposal “seems harsh and extreme to me,” wrote Victoria Kennedy in a column that appeared in the Cape Cod Times. “It’s not, in my judgment, about death with dignity at all,” she wrote, adding the measure stood in stark opposition to her late husband’s commitment to providing adequate health care for all citizens.

    Proposition 2 is unjust, Kennedy wrote, because it is “intended to exclude family members from the actual decision-making process to guard against patients’ being pressured to end their lives prematurely.” She added that the bill also places undue weight on a doctor’s diagnosis that a patient has less than 6 months to live. Speaking from experience, the Senator’s widow notes that Ted Kennedy’s terminal cancer was discovered, he was told he had 4-5 months to live. “Because that first dire prediction of life expectancy was wrong, I have 15 months of cherished memories,” Victoria Kennedy said. “