Thursday, October 16, 2008

Proposition 1000, Death with Dignity: A Personal Story

After a four year battle with ovarian cancer, my mother died in Oregon in 2004.

More than once during those four years, Mom reminded me that she was lucky to live in a state in which assisted suicide was legal because there was nothing she feared more than being incapacitated, locked inside her dying body, in pain, and unable do anything for herself, let alone to express herself. "At least I won't die with Alzheimers," she'd say, implying that losing one's mind and one's sense of control is more dire, somehow, than battling stage 4 ovarian cancer.

Over the years, Mom had gathered a collection of pills large enough to be considered a lethal dose of painkillers. Those pills -- the simple possession of them -- gave Mom a sense of security, knowing that no matter what, she wouldn't need to suffer. On the one hand, she seemed to deny that she really was terminal and that she really was dying (even after she was on Hospice), but at the same time, she'd mention that the fact that she lived in Oregon would allow her to die with dignity.

When the time finally came, Mom went downhill too quickly to self-administer her lethal dose of painkillers. Overnight, she seemed to not only became confused, she lost the ability to swallow reliably. And because the law requires that the patient be of sound mind and to self-administer the medication, Mom's window passed her by. And Dad, at that point, felt awful that he didn't see that fleeting window and draw her attention to it, and he worried that she might now suffer needlessly and be unable to express herself and her pain. It was excruciating for all of us to know that Mom's wish, her last act of control in her life, would not be granted.

So we waited for nature to take its course. And while we were treated to some undeniable gifts during those days (such as the Mom recalling her life's most precious memories in halted words and emotional grimaces and her whispered request to Dad: "Can you carry me across?"), I know that Mom didn't die as she wanted and on her own terms.

I'll never know if or how much she suffered. I choose to believe that, after her spirit left her body on Wednesday, she was just a shell until her heart stopped beating on Sunday. I want to believe that, but did she suffer during those days? Did she endure what she so feared: being locked inside herself with her pain, unable to express herself? I don't know... and it sometimes eats me up to this day.

Washington State will be voting on its own "death with dignity" act, Proposition 1000, in a few weeks. I am a firm supporter of this proposition because people like Mom, who are at the end of their lives, suffering and in pain, need to know that they have the option to go when they feel it's time. Some, like Mom, won't ultimately act on the law, but people like her will have one less thing to fear and to worry about, knowing that the option is there for them. Mom depended on that knowledge and it gave her peace at a time when peace was the ultimate gift.

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Anonymous said...

I totally agree. To die with dignity is surely the most basic human right that we all deserve.


Snooker said...

A simple human right... it is my body, keep your laws off of it.

Haralee said...

The situation that your family and your Mom found yourselves in is common with administering drugs for their lethal dose. If the death with dignity law and practice was more common and practiced, loved ones and the patient may be more alert to the signs of their demise sooner and their wishes acted upon. I hope WA state passes this law for all of us, not just in OR and WA.

Anonymous said...

Beautiful post. Two years ago (2006), my mom went through a similar experience. She'd been suffering horribly in agony for several years due to a back that was beyond repair — spinal stenosis, degenerative arthritis, and a spinal infection. She tried everything from invasive surgeries to acupuncture and absolutely nothing helped. The pain was beyond belief. For at least a year she had to sleep sitting up in a firm chair because she just could not lie down. She could hardly walk, hardly function, and this was a strong-willed woman who prided herself on her independence. Her eyes were always haunted and frantic with such constant pain. Morphine patches did nothing. And then, unrelated to this issue, her kidneys failed so my dad had to drive her to dialysis three times a week for 4 hours at a time — and she spent most of that time screaming in agony because of her back (and she couldn't take pain meds because of the kidney failure!) She finally decided that she was done. No more dialysis. Hospice came in and provided enough pain medication to make her comfortable, although it had to be so much that she was basically incoherent and then comatose. Before the meds took complete effect, she and I had the most lucid conversation we'd had in years and I know that this decision was very comforting to her. Lots of people tried to talk her out of it, but I didn't. I knew that for her it was the right decision. And she was so thankful that her kidneys had failed to give her this option. Otherwise, she would have had to spend who knows how long dealing with that agony. She died on her 70th birthday, which also happened to be Mother's Day.

Margaret said...

I so agree with you. And rereading Tonya's story made me remember what her family and she went through during that time. Her mother was ready to be free of the pain, and it's not our right to judge that. Thanks for sharing.

Goofball said...

Euthanesia is regulated in Belgium and I think that's a good thing. But I'd never be able to make that choice or assist for someone else I'm afraid.

Although never say never.

Anonymous said...

Well, as President of Hospice Patients Alliance, I have seen just about everything at the end-of-life. There is a great need for improvements in palliative care in hospice or elsewhere to relieve the symptoms at the end-of-life, however there are many hospices doing a great job in relieving symptoms.

What most proponents of assisted suicide will never admit, is that the pressure to die, the "duty to die" is a very real threat to the most vulnerable portion of our society: the elderly and very disabled. In the Netherlands, the residents of nursing homes are afraid to take their orange juice or other drinks, because they fear they are laced with overdosages of lethal medications (which sometimes is true). Government studies proved that at least 1,000 people are killed without their wish (involuntary "euthanasia") in the Netherlands alone ... see the Remmelink report by the government there.

Family members have been calling our organization for years and years, crying hysterically because a nurse overdosed their loved one, often against their stated wish, and the patient died within hours, or days. These were patients who were walking, talking, eating, drinking, even shopping who may have gotten a terminal diagnosis, but who did not wish to just roll over and die because of it. They wanted to live.

I also see family members reporting that another family member who stood to inherit much of the estate of the patient, had that patient overdosed in a hospice, pushing morphine or other medications till the patient died. The person with the Power of Attorney has the power to steer the end-of-life care in such a way so as to impose death.

The financial motive for family members who inherit is a strong motive which we should be fighting against, in order to protect the most vulnerable of us all.

The financial motive to kill a patient is huge for the state and federal governments that save BILLIONS of dollars each year through the hastened deaths of thousands each year in the USA. This is absolutely already occurring all over our nation. I know it. I get reports from doctors, nurses, therapists and others who were unable to protect their loved ones because they did not have the power of attorney for the patient.

See what happened in Oregon where insurance companies seek to limit their expenditures for expensive medical treatments, but the state is happy to pay for lethal drugs to cause death. The state and federal government save over $100,000 per year for each patient that is "assisted" to die. This is how the government is really balancing the budget and why no real fix for Social Security is pursued. The final solution is already here. Look at this article from ABC:

ABC News
Death Drugs Cause Uproar in Oregon
Terminally Ill Denied Drugs for Life, But Can Opt for Suicide
Aug. 6, 2008 —

"The news from Barbara Wagner's doctor was bad, but the rejection letter from her insurance company was crushing.

The 64-year-old Oregon woman, whose lung cancer had been in remission, learned the disease had returned and would likely kill her. Her last hope was a $4,000-a-month drug that her doctor prescribed for her, but the insurance company refused to pay.

What the Oregon Health Plan did agree to cover, however, were drugs for a physician-assisted death. Those drugs would cost about $50.

"It was horrible," Wagner told "I got a letter in the mail that basically said if you want to take the pills, we will help you get that from the doctor and we will stand there and watch you die. But we won't give you the medication to live."

Critics of Oregon's decade-old Death With Dignity Law -- the only one of its kind in the nation -- have been up in arms over the indignity of her unsigned rejection letter. Even those who support Oregon's liberal law were upset.

The incident has spilled over the state border into Washington, where advocacy groups are pushing for enactment of Initiative 1000 in November, legalizing a similar assisted-death law.

Opponents say the law presents all involved with an "unacceptable conflict" and the impression that insurance companies see dying as a cost-saving measure. They say it steers those with limited finances toward assisted death."
[end of article]


The ideal scenario that advocates of assisted suicide legalization present do not address the lethal result of legalization: increased involuntary deaths of vulnerable patients. How would you like it if your mother, father, grandmother or grandfather was killed medically, against their will and nothing could be done about it, because the patient had been diagnosed as "terminal" whether accurately or not.

Bad results can easily arise from good intentions.

Marie said...

I am sorry to say I am one who is against Death with Dignity measures. in 2006 my husband was in St Vincents Heart Hospital in Indianapolis, In and although he was going through a bad time he still did not want to die. He was a fighter and always looked for alternatives in health too. Well one morning he was having a rough time because the Dr. decided to take him off this medication because it was to EXPENSIVE and neither medicare or the VA or his other insurance wanted to pay for him to receive it anymore. Too expensive so then he started having problems and the Dr said to me and our daughter if goes into cardiac arrest I will not save him. Geez that was not his wishes nor was it what he had written and given me his power of attoenwy for. He fought to the point that finally the Dr. said we are going to transfer him to Hospice and then the nightmare really began and Did they cause him so much pain all because he wanted to live . After he arrived at hospice and they put him back on the medication he started getting better and they were thinking About moving him too a rehab center everyone was so surprised at his recovering just from being off that EXPENSIVE drug. Well then this other Dr stopped by and took him off it again sent me home saying I needed to leave his side for awhile since I had been continuely their for over 30 days. So I decided to take a break and run home and go through some mail and come back. Well I was gone for about 2 hours and when I got Back I knew I did the wrong thing and leave his side. For this I knew was going to be his end and they "KILLED" him. For he still had his mind and was a fighter for life they did it. Well when I was gone they said they was going too clean him and bath him and when they put him in the shower they left him alone and he fell and his hips were broken and he had cuts on his head and body. I do not beieve their story. So anyway they started giving him morphine and I knew this was all done because he wanted to live. NO I AM AGAINST DEATH WITH DIGNITY> THEY FIND A WAQY TOO KILL EVEN THOSE WHO WANT TO CHOSE LIFE OVER DYING. Marie Austin

Anonymous said...

I fought unsuccessfully to protect a stepparent from my bioparents neglect and concern about themself over there relatively new spouse who was a educated, assertive patient, and therefore got offered 'hospice' without any terminal diagnosis and the ultimate 'cause of death' having in fact been ruled out by a specialist.

I post in response to a request, even though I don't agree completely with the requester whose commens are found above though i've not had the time to review even them here.

life and death are not petty issues needing statutory law to resolve. When someone needs to be murdered, or kill themself, the least one can expect is to require lawyers be involved, litigation, subtantial expense.

Savings of less then hundreds of dollars a day should not justify an earlier cremation.

Guns after all exist, and are considered to kill humanely. Plenty of people are glad to accept reasonable pay to clean up the mess this leaves. Before conviction for murder, or even felony neglect, we have the right to a jury.

I do however agree that the very low number put down in Oregon is a good sign. For that reason I continue to repect teh argument that regulating euthanasia is better then allowing it to occur routinely, despite it's utter illegality.

The bottom line is that in order to be safe from being killed it is now necessary to say NO to comfort care, because it simply can't be trusted any longer. THere was a time when it was safe to goto a hospice- I thought it was when one proceeded to kill a member of my family, not deny it, and so far has gotten away with it.

Because the two primary physicians in this conspiracy remain unindicted, largely because of a lack of time on my part, I can not name myself here, now.

Rest assured they are punks, with enough years left in there practice to lose some of it to prison, when and if, my family and I, are able to recover, and seek justice effectively.

I will also help others, especially if my case isn't successful, to put more dr's, nurses, family members, in prison, etc. so as to allow for safe comfort care once again.

Before killing someone you have power to kill, remember, as long as you shall live, until aquited, you can to, have your conduct reviewed, and if beyond a reasonable doubt murderous despite being 'routine', spend many many years in prison. That everyone is doing it is not a defense to murder. It does not generate reasonable doubt even that you didfn't know 'technically' your scheme was illegal.

Please don't waste my time after reading you allow anonymous comments. You have not said those without a name will be deleted. IT is clear therefore you could of spared me the time, if you do that. I have been civil. I can confirm my story with ease. Someday I may play a major role in reforming what is occuring. At present I know that thousands of have killed for my having taken so long to fight back more effectively. That doesn't feel good at all.

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