Thursday, May 12, 2016

Current version of assistance in dying.

Yesterday, I went with Compassion & Choices to lobby for a bill, identical to the laws in states like Oregon & Vermont, to allow aid in dying.

I first got interested in this topic, because my father was in it.  He spoke repeatedly about how frustrated he was both that there was no aid in dying and also that heroin, which is apparently the best pain killer for terminal cancer patients, and which was developed originally by a commercial prescription drug manufacturer, was illegal even for terminal cancer patients.  He belonged to some groups that were advocating for changes in the law in that area.

Sadly, changes in the law did not arrive in time fo him.

He got terminal cancer and died in hospice.  I want to make some observations about this process. 

First morphine had been touted to him as this wonder drug that would make the dying experience bearable.   This turned out to be wrong.  He hated morphine.  It caused severe constipation (the kind that requires a nurse to physically go in there and get the poop out). It also caused unpleasant hallucinations. 

Moreover, he did not like the sensation produced by this drug.  We hear reports all the time that morphine is addictive and that it makes people high.  My father hated the way it made his thinking cloudy.  He valued clear thinking.

Morphine may be wonderful for some people, but not for everyone.

Second, people have told me that you can die within two days if you don’t have anything to drink.  It took my father 3 weeks, with nothing to eat or drink and no feeding tube, to die.  I guess you only die so quickly if you’re out in the hot desert sun, not if you’re lying in a comfortable bed in a climate controlled house.

And all of that time, my father wished that he had the option to get aid in dying.


But I learned, as part of my lobbying trip, that the current bill has some significant limitations intended to prevent abuse

- you have to be terminally ill, with less than 6 months to live and no available treatments
- you have to be mentally competent.
- the drug prescribed must be self-administered, not administered by anyone else
- you have to make at least two requests for aid in dying within 15 days of each other

My dad could have met these criteria.

On the other hand, other friends family members, who I watched die, could not have.

Let me take first the example of my maternal grandmother. 

She had an initial major heart attack when I was in 4th grade, which left her somewhat brain damaged.  In the following two years, she had a series of small strokes, each of which left her more disabled than the previous, so that she was essentially a “vegetable.” After 2 years, during much of which she was helpless, confined to a wheelchair and unable to speak, she died; however, within 6 months of her death she was not mentally competent and therefore could not have exercised an option for assisted dying, under this law, even if she had left clear directives indicating that she would like aid in dying.  She would also likely not even have been able to self-administer the drug.

Another example was a friend whose wife died of early onset Alzheimers. For several years prior to her death, she was paralyzed and mute.  Again, six months prior to her death, she was not mentally competent, so she could not have used the procedure from this bill.

The representatives of Compassionate Choices spoke  — as if this were a good thing — of only 1/500 Oregonians opting for assisted dying.  I would submit that this low number is due to at least part of the people who would have liked to exercise this option were not mentally competent within 6 months of their death.

Therefore, though my father would have benefited from this bill; a lot of people wouldn’t really have the kind of dying experience that would be compatible with this bill.

Ideally, I would like to be able to sign a paper upon getting an Alzheimer’s diagnosis that I would like assisted dying at some particular time, or when my symptoms were at some threshold of acuteness — like maybe I could no longer recognize my children — or maybe I could no longer get to the toilet. This law would not help in such a circumstance.

Another example would be if my cancer were to recur and they could treat me, but the treatment might result in paralysis or being maimed by invasive surgery/radiation/chemo.  What if I would prefer not to have such treatment, but also do not want to go through a painful death?  I would not be eligible under this law, because treatment would be considered available to me.

I’m glad that this law is being considered, but I don't think it goes far enough.


Here is an interesting story about a woman in The Netherlands who was granted assisted suicide/aid in dying, because she had incurable PTSD from childhood sexual abuse

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