On June 15, World Elder Abuse Awareness Day, we take time to acknowledge that an estimated 2.1 million older Americans fall victim to elder abuse, neglect and financial exploitation each year. At Compassion & Choices we work diligently to protect older adults by upholding their rights at the end of life, sometimes when they are no longer able to speak for themselves. And this year we became proud members of the Elder Justice Coalition in Washington, D.C.

Elder abuse occurs on a regular basis, affecting some of the most vulnerable members of our society. What’s even worse is that for every reported case of elder abuse, neglect and exploitation, experts believe there are five that go unreported. We must put an end to it.

Our work has exposed a form of elder abuse that is rarely discussed. It occurs when an older adult’s expressed wishes at the end of life are ignored, and as a result they are subjected to unwanted and invasive medical treatment. We believe this unwanted treatment absolutely constitutes elder abuse.

For example, when 92-year-old Marjorie Mangiaruca received full cardiopulmonary resuscitation including a tracheotomy in violation of the clear terms of her Do Not Resuscitate Order and consequently endured a long, slow death in the hospital, that was elder abuse. Right now, Compassion & Choices is helping her daughter bring this case to court in Florida.

When 85-year old William Bergman was dying of mesothelioma and moaned in pain with each breath while his daughter pleaded with doctors to prescribe more effective pain medication – and they did not – that was elder abuse. Compassion & Choices won a court judgment to that effect, the first of its kind, in 2001.

Our client Margaret Furlong went to the hospital at age 82 armed with her advance directive, which explained her personal wishes for treatment. She presented the document to the admitting doctors and relied on it to prevent invasive rescue procedures if she collapsed. Sadly, when she had a cardiac arrest, medical staff began a series of unwanted procedures to restart her heart and lungs, and she later awoke in the intensive care unit. When she pulled on the tubes, they tied her hands. When she squeezed her son’s hand and tried to tell him she wanted the machines turned off, they ignored her pleas. After ten days tethered to machines, Margaret’s condition continued to decline, and doctors finally agreed to disconnect life support. No one should have to endure this type of abuse in their final days.

For World Elder Abuse Day 2013, the United Nations’ Secretary General, Ban Ki-moon’s message states, “We owe it to older persons and societies at large to fight ageism in all its forms, and enhance the dignity and human rights of older persons everywhere.” Compassion & Choices couldn’t agree more.

The time is now to end elder abuse, neglect and exploitation. As a nation we must dedicate the same type of attention and resources toward this national tragedy as we do toward eradicating child abuse and domestic violence. Older Americans deserve to live their golden years free of abuse, and according to their rights and end-of-life wishes

CONTACT: Sean Crowley
202-550-6524, scrowley@compassionandchoices.org 

by Compassion & Choices staff

Historic Achievement is Breakthrough in Death-with-Dignity Movement

(Washington, D.C. – May 20, 2013) Vermont Gov. Peter Shumlin’s signing into law at 2pm today of the nation’s first death-with-dignity bill passed by a legislature is a “breakthrough” moment, according to the nation’s leading end-of-life choice advocacy group, Compassion & Choices. Vermont also will become the first eastern state and fourth state nationwide where aid in dying clearly is legal and accessible starting immediately.

“This historic achievement is a political breakthrough that will boost support for death-with-dignity bills nationwide,” said Compassion & Choices President Barbara Coombs Lee, an ER and ICU nurse and physician assistant for 25 years who co-authored the nation’s first Death-with-Dignity law in Oregon and was a senior advisor on the successful campaign to pass the Death-with-Dignity law in Washington state, both of which were approved by citizen-passed ballot initiatives and served as models for the Vermont legislation.

The Vermont law will let dying, mentally competent people determine when they have endured enough suffering and empowers them to end their lives with dignity. Specifically, it will provide criminal, civil and professional protections for physicians who prescribe medication to mentally competent, terminally ill patients that they can ingest to achieve a peaceful death.

“Gov. Shumlin and Vermont legislators have shattered a barrier by becoming the first politicians to show the courage to enact a death-with-dignity law,” added Coombs Lee.  “Given the high margin of public support for end-of-life choices nationwide, it is only amatter of time before legislatures in Massachusetts,New Jersey, and other states that are currently considering death-with-dignity bills enact them into law.”

Oregon and Washington enacted aid-in-dying laws thru citizen-passed ballot initiatives in 1994 and 2008, respectively. In 2009, the Montana Supreme Court ruled in a case brought by Compassion & Choices, Baxter v. Montana, that the state’s public policy supports mentally competent, terminally ill patients being able to choose aid in dying.

The Vermont law will have requirements similar to the Oregon and Washington laws, but the Vermont requirements will expire after a three-year period. Then the Vermont law will follow the model in Montana, where professional practice standards have successfully governed the practice of aid in dying.

Dr. Tom Preston, a Compassion & Choices leader in Seattle, chose these poignant words for the title of his new book. They are powerful words, gripping even on paper. Imagine them emerging from the lips of a patient, perhaps one whom the doctor has treated over decades, who is now dying of cancer. They strike right at the core of a physician’s identity, training and moral compass.

Preston knows well that each person, each healer and each caregiver responds to such a request from patient or loved one from the deepest parts of their own authentic being. He begins his book quoting Dumbledore, who in the last Harry Potter book pleaded with Snape to cut his dying short. “You alone know whether it will harm your soul to help an old man avoid pain and humiliation,” the wizard tells his reluctant friend. So it is with every doctor In America.

I recall hearing Dr. Peter Goodwin, Compassion & Choices’ leader and dear friend who died last March, describe how his “blood ran cold” the first time he heard these words. He responded to his patient he could not, but spent the remainder of his life regretting that answer.

Last month Dr. Eric Kress testified to the Montana legislature that when he refused the first patient who asked for his help in dying, the patient reacted in disgust and called him a coward. Thus began his own soulful rumination and his decision not to abandon subsequent patients who asked for his help. “What kind of man am I?” he asked himself. “What kind of doctor am I?”

Preston writes from his long and passionate interest in how doctors respond to this plea. By extension, he is also vitally interested in the historic and potential relationship between the field of Medicine and patients who yearn for choice and control in their dying. Today, it’s mostly a dysfunctional relationship. But it has not always been so, and this book may well help heal the dysfunction.

Preston is a fine writer, and a splendid historian. I greatly enjoy his reaches into ancient Greece and Medicine’s dawn as a profession. In one enlightening chapter he traces the transformation of medical oaths, “From Hippocrates to Lasagna,” to demonstrate how politics, religions and accidents of history influence the words and meanings that endure, even when at odds with ancient precepts or practices. Personally, I’ve always been fascinated to observe that sometime in the course of history the caduceus, symbol of Mercury, god of thieves and business, came to replace the staff of Asclepius, son of Apollo and the first mortal healer, as the symbol of Medicine. (That’s right, the patron god of financial gain stands as the profession’s symbol in modern times.)

Another of Preston’s great contributions is his concentration on “patient-centeredness” as the mark of excellent care. Preston acknowledges that his colleagues may pay lip service to the term, while actually delivering “physician-centered” service. Therefore he takes care to advocate a “meaningful” patient-centered approach. One of the speakers at this year’s TEDMED conference noted that even “patient-centered care” can mean that professionals circle the patient and impose a one-way dialogue.

Non-physician readers will find in Preston’s words the reassurance, courage and tools to approach their doctors with legitimate requests arising from their experience in health and in decline. Physician readers will find compassion and gentle guidance in adopting an open and responsive attitude toward the needs of their dying patients. Physicians across the nation are examining their position on intention and assistance in dying, and this book is bound to help.

CONTACT: Sean Crowley, 202-550-6524
scrowley@compassionandchoices.org

Politics Shift as Lawmakers Embrace Nationwide Support for End-of-Life Choices

(Washington, D.C. – May 13, 2013) The nation’s leading end-of-life choice advocacy group, Compassion & Choices, praised the Vermont legislature for becoming the first legislative body in the nation to approve death-with-dignity legislation. Gov. Peter Shumlin has vowed to sign the bill into law.

“This historic legislative victory proves that the aid-in-dying issue is no longer the third rail of politics. In fact, it’s a winning issue on which Gov. Shumlin campaigned,” said Compassion & Choices President Barbara Coombs Lee, an ER and ICU nurse and physician assistant who co-authored the nation’s first Death-with-Dignity law in Oregon and was a senior advisor for the nation’s second Death-with-Dignity law in Washington state, both approved by ballot initiatives. “We congratulate Patient Choices Vermont for its leadership of this multi-year campaign. Their success shows aid in dying has become a legislative winner.”

“Legislators now are embracing the high margin of public support for end-of-life choices nationwide,” added Coombs Lee.  “This bill’s passage should enable legislatures in Massachusetts, New Jersey and other states that are considering aid-in-dying bills to approve them.”

The Vermont bill provides criminal, civil and professional protections for physicians who prescribe medication to mentally competent, terminally ill patients that they can ingest to achieve a peaceful death.  It has requirements similar to the Oregon and Washington laws, but the Vermont requirements would expire after a 3-year period and then professional practice standards would govern the practice of aid in dying.

“Professional practice standards have successfully governed aid in dying in Montana for three years, and for the past two years in Hawaii,” said Compassion & Choices Legal Affairs Director Kathryn Tucker, who testified before both the Vermont House and Senate in favor of the bill and was co-counsel in a landmark case, Baxter v. Montana, in which the Montana Supreme Court ruled in 2009 that the public policy of the state supports mentally competent, terminally ill patients being able to choose aid in dying. “Professional practice standards guide all of medicine and it is appropriate for aid in dying to be governed in this manner.”

by Compassion & Choices staff
May 2, 2013

TV Host Calls End-of-Life Choice for Terminally Ill “Personal Decision”

(Washington, D.C.) Emmy Award-winning television host Montel Williams advocates for end-of-life choice, including aid in dying, in the spring issue of Compassion & Choices Magazine. Williams, who revealed in 1999 that he has multiple sclerosis (MS) and is an active healthcare advocate, expressed support for the right of terminally ill people with unbearable suffering to control the time and manner of their death.

Appearing on the cover and in the magazine’s “Voice of Choice” column, Williams states, “I do not believe people should be deciding what level of pain other people should endure, especially knowing they have no chance for recovery. It is a personal decision.”

As the nation’s oldest and largest nonprofit organization working to improve care and expand choice at the end of life, Compassion & Choices advocates access to aid in dying for qualified individuals. Mentally competent, terminally ill patients should be allowed to receive a prescription from their doctor for medication to self-administer if they choose, to achieve a peaceful death. Opponents inaccurately label this “assisted suicide.” Williams debunks that description.

“It is not assisting suicide. I have thought this out, including for myself, and I’ve had many discussions with members of my family. … I’m also aware that my disease is going to progress. And there may be a day when I am told I have a finite amount of time left on this planet and when I may be in incredible pain. So when that time comes, I don’t care what anybody thinks or calls it. It’s my decision. And if I choose to go, then that’s my call.”

Like Compassion & Choices, Williams encourages families to discuss end-of-life matters before a crisis occurs. He advises that doctors participate in those discussions – but “their opinion or advice shouldn’t be given any more weight than that of others who need to be included in the discussion, including the patient’s sage counsel, psychiatrists, psychologists, their clergy or family members.”

“We are grateful to Montel for using his eloquent voice to inform people about the importance of end-of-life planning and of their right to control life’s final chapter,” said Compassion & Choices President Barbara Coombs Lee, 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 in 1994. “Modern medicine has produced many life-saving achievements. Medicine can always do more. The question is whether they should, when a patient’s hope centers on dignity and comfort.”

Support for end-of-life choice is consistently strong in so-called red states and blue states and across demographic groups and religions. This strong support has held steady for two decades. A January 2011 Harris poll found that more than two-thirds (70%) of U.S. adults agree that “individuals who are terminally ill, in great pain and who have no chance for recovery, have the right to choose to end their own life.” A poll of likely New Jersey voters released last week found nearly two-thirds (63%) support allowing mentally competent, terminally ill adults with six months or less to live to receive a prescription for medication to end their suffering.

The full interview of Montel is available here:

http://viewer.zmags.com/publication/3d9a13e7#/3d9a13e7/24

The online edition of Compassion & Choices Magazine is available here:

http://viewer.zmags.com/publication/3d9a13e7#/3d9a13e7/1

Materials for advance healthcare planning are available here:

http://www.compassionandchoices.org/what-we-do/advance-planning/