"Death With Dignity" laws...my sister is irate!

[DDD]

We've had three people close to us pass away this month. Two have had lengthly illnesses
and alot of discomfort. In a phone conversation with my sister I lightly said "if I have to travel that road, I'm going to Oregon". She started immediately trying to convince me that it was wrong to even think about "taking a life" etc. I was a bit shocked. When I told her "gee you
can't just run to Oregon or Washington State and get lethal medicine", she still continued on
about how wrong it is. I don't think it's wrong. The voters in those states don't think it is wrong. Now I'm wondering if most people agree with my sister or with me. Interesting.
(No, I don't think of this as a political debate but if the Mod does it can be excluded.) I'm just curious. DDD

 

[flutterby]

Your life, your decision.

 

[DaisyFace]

DDD--

There was an interesting television show on a few weeks ago about a man with MLS (aka Lou Gehrig's Disease) who traveled abroad for the pruposes of assisted suicide. The show was really sad--but it definitely made you think about this issue from many angles. In the end, I thought this man had an excellent argument for assisted suicide. He said that nobody ever complains about "Playin G-d", or "Messing with Mother Nature" when it comes to prolonging life. And let's face it--doctors are going to extraordinary lengths to save people from life-threatening conditons. It is only when a person says 'Enough!' that people begin to criticize and condemn a person's wishes. We should let folks choose for themselves and let it be.

And I can't help but agree with him...
It's hard to look at a person who is suffering so and tell them they must stay connected to a breathing machine and a feeding tube and an IV and just wait until death finally comes "naturally".

Just my two cents.

 

[AnnieO]

My family knows not to put me on life support if I'm not going to have a COMPLETE recovery.

I'll come back and haunt them if they don't like my wishes.

But otherwise - nah, my higher power makes that choice for me. Not me. I really really hope that didn't turn this into religion 'cause it's not. MY BODY, MY CHOICE.

 

[DammitJanet]

This is something near and dear to my heart.

Having a chronic condition that can be extremely painful I have always said that is what will drive me to end my life faster than my bipolar will. It troubles my doctors, therapists and family at times. I have an active plan. It makes it easier for me to live with my life as it is now and to deal with whatever pain I have. I know that someday, if I simply have enough, I can opt out. I probably will opt out if that decision isnt taken from me by other means.

It was almost taken from me with the meningitis. Of course, unknown to me, my family did go against all my wishes and told the doctors to do everything including extraordinary measures to keep me alive. While the doctors were telling my family that they might be wise to contact a funeral home, they refused to accept that and told them to keep me on life support. I guess I am glad now...lol. It probably was a little soon to accept I was done for. I still think it will be the pain and not something else that gets to me.

 

[witzend]

We voted for it three times. The first two times Alberto Gonzales forced our AG to overturn it, first trying to tell us that we misunderstood. We didn't, so we passed it again. The second time he tried to pull "It's DEA so it's Federal". We respectfully disagreed. Doctors' licenses are issued by the state, not the fed. And a pharmacist doesn't have to fill the RX if they don't want to. We voted it in again. The party of "State's Rights" had it's mitts all over us for years on this and several other issues.

If she doesn't want to do it, no one is forcing her. And honestly, I think you can move here to participate in the law. But you need the physician and the psychiatrist to agree with your decision.

The fact is, about 90% of the people who get the prescription end up not using it. But they have a choice, and they have the opportunity to discuss it with their families, their doctors, and their ministers, which is how it should be.

 

[Marguerite]

This is not always a b/w issue. Sometimes for various reasons, a person can end up on a ventilator, as my sister has, when nobody KNOWS if it's terminal, or if it's just a short-term measure. I remember being at a medical conference once and the keynote speaker said, "Most patients, the majority, are admitted to intensive care, their lives saved, and then eventually discharged and we never to have a definitive diagnosis for them."

My sister is currently improving very slowly and breathing on her own (with a little bit of oxygen handy). But she's just been told her condition is terminal. However, they didn't know that when they were fighting to save her life. Plus there is a SLIGHT chance, and her current improvement indicates she could be in that minor percentage that survives to recover lung function. She could recover completely, not simply recover to be discharged form hospital as an oxygen-dependent invalid. But we still don't know.

When the initial diagnosis was made, the family could have chosen then to let her die. In her current 'down' moments, she's saying she wishes she had died. But she has a chance of total recovery, plus those who do recover follow the same pattern and treatments that we see in her.

SIL1's mother is a partial quadriplegic. She's been fed up with it for years. Then she was diagnosed with cancer. We don't know what kind of cancer, we only know she refused all cancer treatment. She won't talk to her son about it. Now in her case, she sees the cancer as her ticket out of here and has been happy to let it happen. However, I see her as someone who now has to endure a great deal more pain in order to hasten her death this way. Again, it's been her choice, but surely there could have been an easier way? easy child tells me (SIL1 doesn't know) that her mother-in-law has stockpiled some morphine to use as a lethal dose when it all gets too much for her.

We also have mortality tourism happening here - I know people who've gone to Switzerland to support someone who has chosen to die. The laws here are still very strict, but patients can refuse medical treatment (as easy child's mother-in-law has) to hasten death. My mother did this. I believe her aunt did as well. And with my father, he was in increasing pain and they pushed his morphine dose up to deal with the pain, even though they knew it was going to lethal levels. But that isn't strictly euthanasia here, it's considered palliative care - to knock out the pain as a priority, in someone who is clearly dying anyway.

It's an interesting debate. I understand the concerns of those who feel that death shouldn't be made too available, or people in despair will act even though their lives are not truly in extremis. We had a very publicised case of a woman who did TV interviews and everything, on how she was determined to end her own life. And she did. But on autopsy, they couldn't find anything wrong, not the cancer she thought was the cause of her extreme pain.

I've also been in severe pain that felt like water torture, unending, apparently untreatable, greatly limiting my ability to do anything. Then finally a doctor started me on morphine. I realise now the dose was stronger than I needed, but the bliss of the relief from pain was so uplifting! That would have been about 14 years ago now. I still take morphine (yes, the dose has increased - but recently decreased a little as physiotherapy has helped ease some of the elements of the pain) and the pain is never completely gone. But I can function again.

I worry that some people will make a terminal decision while believing they have tried all options, when maybe they haven't. Some doctors here tend to crusade on euthanasia, and so perhaps don't put much effort into trying to help the patient stay alive in comfort. My pain specialist is a palliative care doctor, he must see a lot of patients for whom death is the only option left. There will be a lot of morphine drips he's authorised to be turned up that little bit more... but with me (and husband - also a patient) he works to find ways to help us function in life.

That is balance, and I think it is balance that the subject needs. Those with a vested interest either way can be a concern, in this debate.

Marg

 

[Marcie Mac]

I know when SO finally gets to the point that he no longer has any quality of life, the party's over. He has stated that many times, and who am I to insist he suffer needlessly. I wouldn't, and won't if or when that time comes for me.

Its a very personal decision for each person -one should be able to secure the means of release after consulting with their physician and they agree that they are only able to make you "comfortable" and there is no cure.

Honestly, we treat our animals more humanely when we know they are suffering and nothing more can be done.

Marcie

 

[witzend]

Marg, I get your point. In Oregon a person without a definitive diagnosis would and could NEVER get an end of life RX. Bearing that in mind, some people who are dying or think they are dying will always choose to not continue - usually in very crude and painful ways that don't always work.

 

[Marguerite]

Perhaps the points to hold onto here, are "informed choice".

We need choice and the right to choose. But it needs to be fully informed choice. And we need to be sure, for others, tat they had full information of all available choices. Building in choice is vital, but it is easy to forget that some of those involved can have a vested interest in guiding a patient's decision in ways tat could risk removing free choice. An elderly relative whose care is going to be a financial burden, perhaps. Or who is leaving a great deal in her will which will be a lot less after expensive treatments to prolong her life have used up funds. Or pressure on a patient by medical staff who need the bed vacated...

On the other side - we don't want our last days spent in futile screaming agony, just to keep someone else's moral code happy. I know I don't.

I have considered suicide in the past, mostly because of the pain I was in. I can look back now and I'm glad I'm still here. I am grateful now for good palliative care which focusses primarily on keeping me comfortable and functioning. But I'm also aware that there are idiots in the medical profession who see my pain regime now, as dangerous (ie the rheumatologist who seemed to think I would be healthier on long-term prednisone, than long-term morphine - the "morphine" scares some people who really should know better).

Whatever system is voted in to allow legal "informed choice", it needs to be well supervised to ensure that nobody is pressured unduly, either way.

Marg

 

[witzend]

Which is why no one person gets to advise on this choice, and the choice must be the patient's. No one decides mom's a burden and she should take a cocktail. No one decides they're dying when they're not. People are informed. No one has to participate in this at any level if they don't want to. FWIW, giving a patient in pain a lethal dose of pain medication would be murder under the statutes in my state, but we all know that it is done as a regular practice. Since we are discussing the Death with Dignity Act law in my state, I'll post the law's requirements here so you can see for yourself that measures are taken to ensure that everyone makes an informed choice.

The Death with Dignity Act (DWDA) allows terminally ill Oregon residents to obtain and use prescriptions from their physicians for self-administered, lethal medications. Under the Act, ending one's life in accordance with the law does not constitute suicide. The DWDA specifically prohibits euthanasia, where a physician or other person directly administers a medication to end another's life.

To request a prescription for lethal medications, the DWDA requires that a patient must be:

• An adult (18 years of age or older),
• A resident of Oregon,
• Capable (defined as able to make and communicate health care decisions), and
• Diagnosed with a terminal illness that will lead to death within six months.

Patients meeting these requirements are eligible to request a prescription for lethal medication from a licensed Oregon physician. To receive a prescription for lethal medication, the following steps must be fulfilled:

• The patient must make two oral requests to his or her physician, separated by at least 15 days.
• The patient must provide a written request to his or her physician, signed in the presence of two witnesses.
• The prescribing physician and a consulting physician must confirm the diagnosis and prognosis.
• The prescribing physician and a consulting physician must determine whether the patient is capable.
• If either physician believes the patient's judgment is impaired by a psychiatric or psychological disorder, the patient must be referred for a psychological examination.
• The prescribing physician must inform the patient of feasible alternatives to DWDA, including comfort care, hospice care, and pain control.
• The prescribing physician must request, but may not require, the patient to notify his or her next-of-kin of the prescription request.

To comply with the law, physicians must report to the Department of Human Services (DHS) all prescriptions for lethal medications. Reporting is not required if patients begin the request process but never receive a prescription. In 1999, the Oregon legislature added a requirement that pharmacists must be informed of the prescribed medication's intended use. Physicians and patients who adhere to the requirements of the Act are protected from criminal prosecution, and the choice of DWDA cannot affect the status of a patient's health or life insurance policies. Physicians, pharmacists, and health care systems are under no obligation to participate in the DWDA.

The Oregon Revised Statutes specify that action taken in accordance with the DWDA does not constitute suicide, mercy killing or homicide under the law. Links to statutes can be found at http://oregon.gov/DHS/ph/pas/ors.shtml.
​

 

[Shari]

If it wasn't for modern medicine, I wouldn't be alive right now, anyway...and I think I am a far cry from an exception...

If modern medicine can keep me here, why shouldn't it also be allowed to let me leave when my time is through?

Just my .02 cents on the topic...tho I agree that it should be a closely guarded process.

I am not about to say that I have the right to deem who should live and who should die, or what procedures should continue and what shouldn't, but I do beleive "modern medicine" has wreaked havoc on the laws of nature, natural selection, and survival of the fittest. I am thankful for it. But quandries such as this are a piece of the consequence we pay for it.

 

[busywend]

This was on Grey's Anatomy this week. A young girl was asking for assisted suicide due to the pain from her disease and she was terminal.

I think if the appropriate review is done of the patient's emotional status it should be up to them.

My DF is total opposite. He wants to go right to the freezer when he is pronounced dead - he says it won't be long before they find a way to fix whatever was wrong with me.

 

[DDD]

Glad to know that I'm not alone in supporting the concept. It just rather shocked me when my sister was so
shocked by my statement. I understand that NH has tried to pass this law also on a couple of occasions. I rather doubt that many out os staters travel far away to benefit from this option. A few years ago I replaced my husband as the medical surrogate with my will because I know that he could never bring himself to "let me go" even though he knows my feelings on the subject. Since we are not "monied" people...that decision is more important to me than who gets the good china or jewelry. DDD

 

[Lothlorien]

I'm with you on this one, ddd. If I was at that point, I'd want to do the same.

 

[TerryJ2]

Sign me up.

In fact, my husband and I have had living wills for a long time.

Unlike the case Marg used, it is relatively easy to see when someone is truly on his way out. My f-i-l was kept alive 2 days longer than he should have been, until his body was completely bloated and yellow. Every day, another organ went. But nobody had the guts to make the decision.
Very sad. And no dignity.

I had no idea that Oregon had passed a new law. I will look it up.

 

[TerryJ2]

DDD, speaking of sisters, one of my sisters and I completely disagreed on the Terry Schiavo case. I looked up the brain scans online and could see how little working brain area there was (it's probably still online if anyone wants to look it up). But my sister was dead set (excuse the expression ) against pulling the plug.
Sisters. Hmpf.

 

[muttmeister]

I'm with you guys on this one.

I love life and don't want it to end any sooner than necessary but I do have a living will and if I reach the point where somebody needs to pull the plug, it is all in the plan. As far as ending my own life while I am able, it is my life; why should somebody else be able to make that decision for me. You don't want to do it? That's your choice but DON'T TELL ME WHAT I CAN AND CAN'T DO.

 

[trinityroyal]

As far as ending my own life while I am able, it is my life; why should somebody else be able to make that decision for me. You don't want to do it? That's your choice but DON'T TELL ME WHAT I CAN AND CAN'T DO.

For me, this is the key. My feelings about this subject are very strong, but they are my feelings. I don't believe that I have a right to impose my views on anyone else. husband and I have opposite stances on this, but I have agreed to respect his wishes as he has agreed to respect mine, should we ever find ourselves in this situation.

 

[Mattsmom277]

I was just recently doing some reading on this topic, how ironic to see this post. I happen to feel it is a very individual decision and for me, I want to die with dignity. I know my family knows I want no extreme measures taken if my quality of life would require me to have constant care (they know all the details to the nitty gritty stuff on what is ok by me, what isnt). I do believe that a person who makes a certain choice, when of sound mind and with due consideration and not affected by a mental illness, should be permitted to own their choice and move forward how they feel fit. I firmly believe that. I have complete respect for those who dont agree. For me though, I know some things that would put me in a position where I might make a choice to go with dignity on my terms rather than suffer without a hope of recovery.