Barbara Coombs Lee: Toward death with dignity
Today, all across America, people with end-stage cancer, ALS (often referred to as “Lou Gehrig’s Disease”) and other diseases are nearing the end of life. They and their loved ones are struggling to grieve and cope. Enamored by medical wizardry to forestall death, we can barely grasp what’s going on when the time comes to say good-by to a parent or spouse. Yet a time does always come when modern medicine either cannot forestall death, or only at the price of great suffering.
When this happens, one true hope is for an end to suffering and a peaceful passing.
One true dignity is the dignity of acknowledging that hope.
After acknowledgment, the patient’s own values, beliefs and preferences come first. We need to say, “You’re the boss. I’ll support whatever you want.” For to die with dignity is to die in accordance with the hallmarks of a life. To die with dignity is to seal a life’s meaning.
For many, control is fundamental to dignity as well. For them, ending life in an ICU, amid wires, tubes and machines is not a death with dignity. Nor is ending life in pain, delirium, or coma. Some will want medication they may take in their own time, to die peacefully and escape needless and brutal suffering. We love them, so we want what they want.
National polls consistently show the vast majority of Americans want the right to choose their medical treatment at the end of their life. A 2012 national poll by Republican pollster Frank Luntz showed 84 percent agree that: “How a terminally ill person chooses to end his/her life should be an individual decision and not a government decision.”
In February, the New Jersey Assembly Health & Human Services Committee approved an aid in dying bill by a 7-2 vote. The Vermont House soon will consider a similar bill already approved by the Vermont Senate. If successful, Vermont will become the first legislature to pass an end-of-life choice law.
Oregon voters approved the first-in-the nation Death with Dignity Act in 1994 and Washington voters approved a similar law in 2008. In 2009, the Montana Supreme Court ruled in a case brought by Compassion & Choices, Baxter v. Montana, that it does not violate state public policy in Montana for a physician to provide aid in dying to a mentally competent, terminally ill adult. These laws empower patients with a six months prognosis, who are mentally competent and capable of self-administering medication, with an aid-in-dying option.
Some question the need for these laws, since few people (1 in 500) in Oregon die with prescribed medication. But many more (1 in 6) consider the option and many complete the eligibility process and never ingest the medication. Thousands achieve comfort and peace of mind, knowing they have choices. Fifteen years of experience reveals no evidence of abuse, coercion or negative impact on hospice care.
Our parents and their loved ones need support for their values and choices. Doctors need assurance the law allows them to honor their patients’ wishes.
Death with dignity should not be confused with assisted suicide. Those already dying are not “suicidal” for wanting their life to end in love and peace, not agony and despair.
Barbara Coombs Lee is president of the end-of-life choice advocacy and support group, Compassion & Choices. Previously, she was a nurse and physician assistant for 25 years before becoming a private attorney and a chief petitioner of the first-in-the nation Oregon Death with Dignity Act.