I’ll be posting a few threads over the weekend about the questions on Tuesday’s ballot. Let’s start with Question 2, which concerns Prescribing Medication to End Life.
A YES VOTE would enact the proposed law allowing a physician licensed in Massachusetts to prescribe medication, at the request of a terminally-ill patient meeting certain conditions, to end that person’s life.
A NO VOTE would make no change in existing laws.
I will be voting No on this question. I think there are better options for end of life care than the suicide that is envisioned by this ballot question. I don’t think this increases the dignity of life, but instead possibly lessens it by giving the state’s blessing to a suicide performed without family input and psychological counseling.
Making suicide legal also would increase, in my view, the stress on the terminally ill, as there would now be implicit pressure on them to consider this state-sanctioned way to end their suffering and the burden on their family.
As Victoria Kennedy points out, families are are not required to be part of the decisionmaking process:
http://www.capecodonline.com/apps/pbcs.dll/article?AID=/20121027/OPINION/210270347&cid=sitesearch
Here’s the Boston Globe editorial against Question 2:
http://www.bostonglobe.com/opinion/editorials/2012/11/01/election-endorsement-question/qAAp21DlC6mkoGYPjA9J6M/story.html
I’m not completely decided but will probably vote against it since as written it has serious flaws. If the legislature comes up with a bill that has more safeguards, including assessment for depression, I could be in favor of it.
Thanks for posting those links, Anil. I found the piece written by Victoria Kennedy to be especially poignant. Particularly in light of the fact that I lost my wife, Laurie, to the same disease that took her husband, Senator Kennedy, and as a result shared many of the experiences living with a terminally ill loved one, she referenced in her commentary. My opinion on this topic however, differers considerably from Ms. Kennedy’s. I think people reading her commentary need to keep in mind, despite the parodies of the Kennedy family that have become part of the pop-culture, the family members themselves have a long history of deeply held religious beliefs.
When my wife, Laurie, was diagnosed with an inoperable, stage 4 Glioblastoma brain tumor, her prognosis was 6-9 months. This nightmare was thrust upon us suddenly, as she’d been in perfectly fine health preceding that fateful day, when she had her first seizure on the sidelines of our daughter’s soccer game. Our lives were changed in an instant, and suddenly we had to confront decisions and make choices that neither of us had ever contemplated in earnest.
From the beginning of that awful experience and until the very end, I never did anything but encourage my wife to fight to stay alive. We never discussed the possibility of ending her life deliberately. But in the back of my mind I was always worried about the degenerative nature of brain cancer, and fearful that Laurie might ask me to help end her life before the illness ran its natural course.
As a result of that experience I can totally understand how the emotional trauma of being diagnosed with a terminal illness, might cause a person to make a rash decision and end their life prematurely. In those cases however, no person would be at all dissuaded by the fact that suicide is “illegal.” They might have second thoughts based on their own religious beliefs, but they would not give two seconds of thought to the criminal aspect involved with that type of decision. Quite frankly, if my wife had consciously and coherently made the decision to end her life early, I would have helped her, with absolute disregard for the law. No family member should ever have to be in that position, caught in conflict between honoring the wishes of a dying loved one, while knowing they may well face criminal prosecution for their actions.
Everyone has a right to die with dignity. Terminally ill people of sound mind, should have the right to die in a manner of their own choosing. The only legitimate role the government should play, is to assure to the best of its ability that no one is coerced into making an end of life decision. The reason physician assisted suicide is illegal, is because our society has allowed religion to permeate our laws and dictate even the most personal decisions imaginable. In that regard, this right to die issue is no different than religious based laws regarding abortion.
We trust our doctors to provide us with good health care. And if the need arises, we trust our doctors to help keep us alive. Yet, when a person wishes to die because they have a terminal illness that will inevitably result in horrific debilitation or excruciating pain, we prohibit medical involvement in both the decision making and the process of dying itself. This leaves people who have made a clear, rational and conscious decision, in the worst situation possible. They can’t ask their doctor for help in making their passing a peaceful one, and if they ask a family member for help, they may expose their loved one to serious criminal charges. This is not only wrongheaded, it is an unconscionable intrusion of government into the most private personal decision imaginable. I hope the ballot initiative passes, so we can get government and other people’s religious beliefs out of a decision that should be exclusively the domain of an individual, in consultation with medical professionals and family members.
Mike’s story is the perfect validation that this law needs to be changed. People should be able to die with dignity.
@Kim. You are right. Mike Striar’s letter would make a powerful rejoinder to those that are voting against Question 2.
(a) why not just give the person a gun? the bullet would be cheaper.
(b) most of the people who we think of as needing to end life are incapable of making that decision, like people with Alzheimer’s, dementia, or in vegetative states. this will lead to people who have medical proxy making the decision, if it’s not covered now by this. it will no longer really be “suicide”.
(c) the Nazis killed people who didn’t meed standards. we are starting in the womb, moving to the sick and elderly, and eventually will, through government-controlled health care and cost constraints, decide who at any stage of life and for any reason of not fitting a standard will be subject to ending his/her life, either actively or through neglect because they aren’t “worth it”.
(d) I’m quite sympathetic to a situation like Mike’s, but we don’t change a way of life, or a respect for life, because some people’s situations seem to benefit from it. that’s the argument I presented in the medical marijuana blog, that “bleeding-heart” liberals change big things in the interest of few people, with no regard for the moral issues or the unintended consequences.
I’m voting against both medical marijuana and assisted suicide.
@ Barry – once again, you render me nearly speechless.
Now recovered, allow me to make a few points about Question 2:
– no patient will be required to go through the process
– no doctor will be required to go through the process
– no hospital or pharmacy will be required to participate in the process
– there are 16 distinct safeguards written into the bill, including waiting periods, three separate requests, and the need for two doctors to confirm a patient is terminally ill, with six months or less left to live
– if EITHER consulting physician believes the patient is being coerced or suffering from a mental illness that will prevent them from making their own decisions, they must be referred to psychological counseling
– this has been a law in Oregon for 15 years, and in Washington for 4. In those combined 19 years, there have been ZERO cases of abuse (statistics are required by the law to be made available to the public on the Oregon/Washington DPH websites)
– in Oregon, over the past 15 years, less than 1000 people have gone through the process, and only 596 have used the medication
– last year, 97% of patients who went through the Death with Dignity process were also enrolled in hospice care
– many, many other facts are available at http://www.yestodignity.com
The most important fact is this: the Death with Dignity Act offers patients an additional choice with how they deal with suffering at the end of their life. The patient needs to control the ENTIRE process – no proxy can make this choice for them- and any patient who explores the Dignity Act can withdraw their request at any time.
Folks, this is a carefully written, thoroughly tested bill. The opponents to this bill are making the same arguments they made in Oregon in the mid-1990’s — arguments which are still as unfounded today as they were back then.
I urge everyone to remember to vote on Tuesday — and vote YES on Question 2. If you have any questions about the Death with Dignity Act, my door is always open: call me at 781-237-5800, or shoot me an e-mail, at [email protected].
Best,
Paul Jones
Field Director, Dignity 2012
Paul,
I read the Roe v. Wade decision and it was supposed to allow abortions only before viability. That’s what the Supreme Court said. Now, we know that people have rationalized that it’s okay to in essence kill a baby that would be viable, if it is in the best interests of the mother, and she of course decides since a woman must “control her own body”.
You can build in all the “safeguards” you want today, but that says nothing about tomorrow. Each step is a step in the direction of the wrong path.
By the way, Mike, along with others who support the question like advocate Lester Grinspoon, really believes in full legalization of marijuana in the issue of that question, and not really just the legalization of medical marijuana, but is willing to accept that for now. I don’t believe in suicide at all, and I don’t accept assisted suicide regardless of the so-called safeguards or the experiences in other states. So, I really think people should vote against it, even if it never goes beyond the limitations allowed, but I think it’s just one step in the further trivialization of the human entity which has been going on for a couple of decades.
Life is precious. No matter how bad it seems at a given time, in many cases things will change, but it can not be predicted. I’ve seen it. We aren’t omniscient, and we can’t be sure when we let someone take one’s life, that the prognosis for the future was really correct. Yes, sometimes it is. But I take the approach that, just as we don’t want to accidentally convict an innocent person under our criminal system, at least in principal, I don’t want to allow a person who may eventually live a better life take his/her life at a time of great emotional stress.
Barry,
I respect the view that life is precious, and can argue that this is a view that everyone shares. This is not a matter of life or death – only people who are terminally ill, with a diagnosis of six months or less left to live (confirmed by two doctors) can qualify. These people who explore the Death with Dignity Act want to live, but their disease is killing them. This is about giving terminally ill patients another option in how they confront suffering at the end of their lives. This isn’t an option everyone will use, but it is an option everyone should have.
I appreciate that we philosophically won’t agree on the issue, and that’s okay. If this passes, you never have to participate. But some people may want this option, and I hope that most of the people that read this blog vote Yes on Question 2, even if they could never imagine using the law themselves.
Barry- Thank you so much for helping me clarify my thinking on this issue. Because of your statements, I have made a firm decision to vote “yes” on Question 2.
I’ll vote “Yes” on Question 2.
I’d find some comfort knowing that there’s a legal alternative to hopeless pain and suffering.
Where similar laws have been enacted it’s been shown to be an option that helps a patient feel empowered, to the point that many who get the prescription don’t use it; knowing they are empowered is enough.
It’s a personal vote, informed by our experiences.
There’s a very good column in today’s (11-4-12) Globe by Yvonne Abraham.
I’m voting yes on Question 2.
My father was also a victim of the same type of brain cancer that ended the lives of Ted Kennedy and Laurie Striar.
When he was diagnosed he was told he had about 14 months to live, and that’s exactly how long he lived past diagnosis. I cherish the time we had with him — in the early months of his diagnosis. But there was nothing to cherish about the last four or five months when he was in so much pain that we would find him holding his head and sobbing. His mind was still clear when he begged us to just let him go away and die.
Despite his pain and frustration, I actually don’t think my father would have chosen physician-assisted suicide, for religious/cultural reasons. And I would have voted yes on this question while my father was alive and healthy. But watching my Dad die strengthened my conviction that terminal patients — who gradually lose control over everything in their lives — should at least be given the opportunity to die with dignity.
I dont support this and I find comfort that Vicki Kennedy also does not support this ballot question. Having dealt with the death of both of my parents in the past few years – I think that doctors are not 100% accurate in their estimation of a persons life and quality of life during a terminal illness. I respect others opinion/experience with this however I will be voting No.
Joanne,
It’s not about an estimation of the length of a person’s life. It’s about the person determining their quality of life first and then turning to the doctor.
Kim – they will only give them a prescription if they have less than 6 months to live. Sometimes those estimations such as in Senator Kennedy’s situation are wrong. That is why among other things Vicki Kennedy is opposed to this bill.
As I said – I am voting NO – I respect your views please respect mine.
I think it’s important to point out that getting the prescription isn’t the same as taking it.
A patient would take it when the pain and suffering became intolerable- not because of a doctor’s estimation-that’s a legal hurdle.
If, as in the case of Kennedy, their quality of life satisfied them for much longer than doctors estimated… they are blessed and can carry on. If the pain and suffering become intolerable they at least would have a choice.
I am voting yes. I watched my dad bravely fight stage 4 kidney cancer for 5 years. He went through countless surgeries, experimental treatments, more than one hospital stay where we almost lost him, and spent almost 2 years on dialysis as his body just continued to betray him. At the end, after hospice had been on call for many months and after a summer of my sisters’ graduations, my many trips home, and lots of time with my mom, my dad made the decision to stop the dialysis knowing full well that it meant he would be gone within a matter of days. We were able to be there for the end. I am grateful that he had this choice to die with dignity and with his family by his side. Maybe I am voting emotionally, but I do not believe that if someone is suffering greatly from a disease that they didn’t deserve that they should continue to have to do so.
This is such a difficult issue for me. I cared for both of my parents through terminal illnesses. When my Dad was diagnosed with cancer he was living in a very remote part of Maine alone and without access to good medical care. It took a lot of effort to persuade him that we wanted him to live with us and that he wasn’t a “burden”. He was only with us for a couple of months, and I learned so much from him during that time: every single day he told me how happy he was to wake up and see his grandkids, and just enjoy the sun on his face. The only day he didn’t was the day he died. I worry that this will be used as an option, not just by people whose suffering cannot be alleviated, but by individuals (like my Dad) who view their illness as a great burden to be borne by their children, and that they will choose death to avoid being that burden. My mother lived for nearly a year beyond the prognostications of her physicians, while my Dad lived far less than they expected. Both left too soon. I cannot decide this one so I shan’t.
I am troubled by this ballot question for some of the the same reasons Lisap gave, and I haven’t made up my mind yet whether and how I will vote on it. But I do have a story.
Eighteen years ago, I represented a hospital in a “right to die” case. A patient with a spinal cord injury suffering from “chronic pain syndrome” (he reported that it felt like being hit by a truck, over and over and over again), who was a quadriplegic and totally dependent upon home health care assistants, was admitted to the hospital due to various complications. Before his injury, he was an athlete and a college student with a very promising future, who was engaged to be married after graduation. After his injury, his fiance left him and over time he became estranged from all of his family and former friends. He had literally no one in the world who cared about or for him other than his HCAs and the hospital staff, who knew him well from a number of previous admissions.
When he was admitted, he was malnourished and dehydrated, among other things. He refused to eat or drink and begged the hospital to let him die and give him only palliative care. After several days, as his condition worsened, the hospital, after extensive consultations between the medical staff, legal counsel and ethicists, sought a hearing on an injunction to insert a feeding tube and IV fluids to keep him alive. The outcome of the case hinged on whether the patient had a legal right to die. Counsel was appointed to represent the patient, and he agreed to allow himself to be fed just enough to keep him alive until the hearing.
The morning of the hearing, I received word that he had died, peacefully, in his sleep. As a nurse explained it to me, he simply “upped and died” once he knew the court had given him an opportunity to be heard. The way she told it, he was actually looking forward to the hearing, so that he could quite literally have his day in court. Apparently, the thing he wanted most in the world, even more than to die, was to be given control over virtually the only thing in his life over which he could exercise control–whether to continue to live with the pain and suffering he had endured for over ten years since his accident. In other words, he saw this hearing as a way to regain his dignity and control over his life.
When my mother was dying of cancer, she made arrangements to go to hospice so that she could receive palliative care and would not be a burden on her family in the last days of her life. The night she left home for the last time and went to hospice, she, too, died peacefully in her sleep. I have always believed that just knowing that everything was taken care of and that she was going to die on her own terms kept her alive for as long as it did, and also allowed her to let go once she was there.
I have concerns about how the proposed law would be applied and possibilities for abuse that are not answered by the explanation on the ballot. But I also think back to that young man, who lived in constant, excruciating pain and was wholly dependent on other people for virtually every aspect of daily living. Ironically, unlike my mother, he probably would not have been qualified under the proposed law, because he was not terminally ill. But, having been involved with, and having lost a lot of sleep over that case, I do see some value in giving someone who is terminally ill control over whether to go on living with the pain, even if they never exercise it.